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'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.
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Figure 1

'Risk of bias' graph: review authors' judgements about each risk of bias item presented as percentages across all included studies.

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'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.
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Figure 2

'Risk of bias' summary: review authors' judgements about each risk of bias item for each included study.

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Forest plot of comparison: 1 Chest physiotherapy plus routine treatment versus routine treatment alone, outcome: 1.1 Mortality.
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Figure 3

Forest plot of comparison: 1 Chest physiotherapy plus routine treatment versus routine treatment alone, outcome: 1.1 Mortality.

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Forest plot of comparison: 1 Chest physiotherapy plus routine treatment versus routine treatment alone, outcome: 1.2 Cure rate.
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Figure 4

Forest plot of comparison: 1 Chest physiotherapy plus routine treatment versus routine treatment alone, outcome: 1.2 Cure rate.

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Forest plot of comparison: 3 OMT plus routine treatment versus placebo plus routine treatment, outcome: 3.1 Mortality.
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Figure 5

Forest plot of comparison: 3 OMT plus routine treatment versus placebo plus routine treatment, outcome: 3.1 Mortality.

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Forest plot of comparison: 3 OMT plus routine treatment versus placebo plus routine treatment, outcome: 3.2 Cure rate.
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Figure 6

Forest plot of comparison: 3 OMT plus routine treatment versus placebo plus routine treatment, outcome: 3.2 Cure rate.

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Comparison 1 Chest physiotherapy plus routine treatment versus routine treatment alone, Outcome 1 Mortality.
Figuras y tablas -
Analysis 1.1

Comparison 1 Chest physiotherapy plus routine treatment versus routine treatment alone, Outcome 1 Mortality.

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Comparison 1 Chest physiotherapy plus routine treatment versus routine treatment alone, Outcome 2 Cure rate.
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Analysis 1.2

Comparison 1 Chest physiotherapy plus routine treatment versus routine treatment alone, Outcome 2 Cure rate.

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Comparison 1 Chest physiotherapy plus routine treatment versus routine treatment alone, Outcome 3 Duration of hospital stay.
Figuras y tablas -
Analysis 1.3

Comparison 1 Chest physiotherapy plus routine treatment versus routine treatment alone, Outcome 3 Duration of hospital stay.

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Comparison 1 Chest physiotherapy plus routine treatment versus routine treatment alone, Outcome 4 Duration of fever.
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Analysis 1.4

Comparison 1 Chest physiotherapy plus routine treatment versus routine treatment alone, Outcome 4 Duration of fever.

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Comparison 1 Chest physiotherapy plus routine treatment versus routine treatment alone, Outcome 5 Rate of improvement of chest X‐ray.
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Analysis 1.5

Comparison 1 Chest physiotherapy plus routine treatment versus routine treatment alone, Outcome 5 Rate of improvement of chest X‐ray.

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Comparison 2 Active cycle of breathing techniques plus routine treatment versus routine treatment alone, Outcome 1 Cure rate.
Figuras y tablas -
Analysis 2.1

Comparison 2 Active cycle of breathing techniques plus routine treatment versus routine treatment alone, Outcome 1 Cure rate.

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Comparison 2 Active cycle of breathing techniques plus routine treatment versus routine treatment alone, Outcome 2 Duration of hospital stay.
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Analysis 2.2

Comparison 2 Active cycle of breathing techniques plus routine treatment versus routine treatment alone, Outcome 2 Duration of hospital stay.

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Comparison 2 Active cycle of breathing techniques plus routine treatment versus routine treatment alone, Outcome 3 Rate of improvement of chest X‐ray.
Figuras y tablas -
Analysis 2.3

Comparison 2 Active cycle of breathing techniques plus routine treatment versus routine treatment alone, Outcome 3 Rate of improvement of chest X‐ray.

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Comparison 2 Active cycle of breathing techniques plus routine treatment versus routine treatment alone, Outcome 4 Duration of antibiotic therapy.
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Analysis 2.4

Comparison 2 Active cycle of breathing techniques plus routine treatment versus routine treatment alone, Outcome 4 Duration of antibiotic therapy.

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Comparison 2 Active cycle of breathing techniques plus routine treatment versus routine treatment alone, Outcome 5 Duration of sputum production.
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Analysis 2.5

Comparison 2 Active cycle of breathing techniques plus routine treatment versus routine treatment alone, Outcome 5 Duration of sputum production.

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Comparison 2 Active cycle of breathing techniques plus routine treatment versus routine treatment alone, Outcome 6 In‐patient sputum weight.
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Analysis 2.6

Comparison 2 Active cycle of breathing techniques plus routine treatment versus routine treatment alone, Outcome 6 In‐patient sputum weight.

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Comparison 3 Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment, Outcome 1 Mortality.
Figuras y tablas -
Analysis 3.1

Comparison 3 Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment, Outcome 1 Mortality.

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Comparison 3 Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment, Outcome 2 Cure rate.
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Analysis 3.2

Comparison 3 Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment, Outcome 2 Cure rate.

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Comparison 3 Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment, Outcome 3 Duration of hospital stay.
Figuras y tablas -
Analysis 3.3

Comparison 3 Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment, Outcome 3 Duration of hospital stay.

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Comparison 3 Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment, Outcome 4 Duration of fever.
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Analysis 3.4

Comparison 3 Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment, Outcome 4 Duration of fever.

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Comparison 3 Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment, Outcome 5 Rate of improvement of chest X‐ray.
Figuras y tablas -
Analysis 3.5

Comparison 3 Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment, Outcome 5 Rate of improvement of chest X‐ray.

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Comparison 3 Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment, Outcome 6 Duration of oral antibiotic therapy.
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Analysis 3.6

Comparison 3 Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment, Outcome 6 Duration of oral antibiotic therapy.

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Comparison 3 Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment, Outcome 7 Duration of intervenous therapy.
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Analysis 3.7

Comparison 3 Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment, Outcome 7 Duration of intervenous therapy.

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Comparison 3 Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment, Outcome 8 Duration of total antibiotic therapy.
Figuras y tablas -
Analysis 3.8

Comparison 3 Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment, Outcome 8 Duration of total antibiotic therapy.

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Comparison 3 Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment, Outcome 9 Duration of leukocytosis.
Figuras y tablas -
Analysis 3.9

Comparison 3 Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment, Outcome 9 Duration of leukocytosis.

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Comparison 3 Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment, Outcome 10 Change in leukocyte count.
Figuras y tablas -
Analysis 3.10

Comparison 3 Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment, Outcome 10 Change in leukocyte count.

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Comparison 3 Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment, Outcome 11 Mean leukocyte count.
Figuras y tablas -
Analysis 3.11

Comparison 3 Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment, Outcome 11 Mean leukocyte count.

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Comparison 4 Positive expiratory pressure plus routine treatment versus routine treatment alone, Outcome 1 Duration of hospital stay.
Figuras y tablas -
Analysis 4.1

Comparison 4 Positive expiratory pressure plus routine treatment versus routine treatment alone, Outcome 1 Duration of hospital stay.

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Comparison 4 Positive expiratory pressure plus routine treatment versus routine treatment alone, Outcome 2 Duration of fever.
Figuras y tablas -
Analysis 4.2

Comparison 4 Positive expiratory pressure plus routine treatment versus routine treatment alone, Outcome 2 Duration of fever.

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Comparison 1. Chest physiotherapy plus routine treatment versus routine treatment alone

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mortality Show forest plot

2

225

Risk Ratio (M‐H, Fixed, 95% CI)

1.03 [0.15, 7.13]

2 Cure rate Show forest plot

2

225

Risk Ratio (M‐H, Fixed, 95% CI)

0.97 [0.91, 1.04]

3 Duration of hospital stay Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

4 Duration of fever Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

5 Rate of improvement of chest X‐ray Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected
Figuras y tablas -
Comparison 1. Chest physiotherapy plus routine treatment versus routine treatment alone
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Comparison 2. Active cycle of breathing techniques plus routine treatment versus routine treatment alone

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Cure rate Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

2 Duration of hospital stay Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

3 Rate of improvement of chest X‐ray Show forest plot

1

Risk Ratio (M‐H, Fixed, 95% CI)

Totals not selected

4 Duration of antibiotic therapy Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

5 Duration of sputum production Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

5.1 In‐patient

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5.2 Out‐patient

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

5.3 Total

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

6 In‐patient sputum weight Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Figuras y tablas -
Comparison 2. Active cycle of breathing techniques plus routine treatment versus routine treatment alone
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Comparison 3. Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Mortality Show forest plot

2

79

Risk Ratio (M‐H, Fixed, 95% CI)

0.27 [0.05, 1.57]

2 Cure rate Show forest plot

2

79

Risk Ratio (M‐H, Fixed, 95% CI)

1.54 [0.97, 2.46]

3 Duration of hospital stay Show forest plot

2

79

Mean Difference (IV, Fixed, 95% CI)

‐2.02 [‐3.46, ‐0.58]

4 Duration of fever Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

5 Rate of improvement of chest X‐ray Show forest plot

2

75

Risk Ratio (M‐H, Fixed, 95% CI)

1.16 [0.77, 1.73]

6 Duration of oral antibiotic therapy Show forest plot

2

79

Mean Difference (IV, Random, 95% CI)

0.97 [‐1.25, 3.20]

7 Duration of intervenous therapy Show forest plot

2

79

Mean Difference (IV, Fixed, 95% CI)

‐2.11 [‐3.36, ‐0.87]

8 Duration of total antibiotic therapy Show forest plot

2

79

Mean Difference (IV, Fixed, 95% CI)

‐1.93 [‐3.12, ‐0.74]

9 Duration of leukocytosis Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

10 Change in leukocyte count Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

10.1 Change between Day 3 and 1 from admission

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

10.2 Change between Day 5 and 1 from admission

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

11 Mean leukocyte count Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

11.1 Day 3 from admission

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]

11.2 Day 5 from admission

1

Mean Difference (IV, Fixed, 95% CI)

0.0 [0.0, 0.0]
Figuras y tablas -
Comparison 3. Osteopathic manipulative treatment plus routine treatment versus placebo plus routine treatment
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Comparison 4. Positive expiratory pressure plus routine treatment versus routine treatment alone

Outcome or subgroup title

No. of studies

No. of participants

Statistical method

Effect size

1 Duration of hospital stay Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected

2 Duration of fever Show forest plot

1

Mean Difference (IV, Fixed, 95% CI)

Totals not selected
Figuras y tablas -
Comparison 4. Positive expiratory pressure plus routine treatment versus routine treatment alone
Ir a la tabla de la revisión