Physical therapy for airway clearance improves cardiac autonomic modulation in children with acute bronchiolitis

Background

The effects of physical therapy on heart rate variability (HRV), especiallyin children, are still inconclusive.

Objective

We investigated the effects of conventional physical therapy (CPT) for airwayclearance and nasotracheal suction on the HRV of pediatric patients withacute bronchiolitis.

Method

24 children were divided into two groups: control group (CG, n=12) withoutrespiratory diseases and acute bronchiolitis group (BG, n=12). The heartrate was recorded in the BG at four different moments: basal recording (30minutes), 5 minutes after the CPT (10 minutes), 5 minutes after nasotrachealsuction (10 minutes), and 40 minutes after nasotracheal suction (30minutes). The CG was subjected to the same protocol, except for nasotrachealsuction. To assess the HRV, we used spectrum analysis, which decomposes theheart rate oscillations into frequency bands: low frequency(LF=0.04-0.15Hz), which corresponds mainly to sympathetic modulation; andhigh frequency (HF=0.15-1.2Hz), corresponding to vagal modulation.

Results

Under baseline conditions, the BG showed higher values in LF oscillations,lower values in HF oscillations, and increased LF/HF ratio when compared tothe CG. After CPT, the values for HRV in the BG were similar to thoseobserved in the CG during basal recording. Five minutes after nasotrachealsuction, the BG showed a decrease in LF and HF oscillations; however, after40 minutes, the values were similar to those observed after application ofCPT.

Conclusions

The CPT and nasotracheal suction, both used for airway clearance, promoteimprovement in autonomic modulation of HRV in children with acutebronchiolitis.