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Respiratory Physiotherapy and Hospitalization in Infants With Bronchiolitis

Sponsor: University of Sao Paulo • ClinicalTrials.gov ID: NCT07682844

Registry updated: 2026-09-16

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Description

Acute Viral Bronchiolitis (AVB) is one of the leading causes of respiratory illness and hospitalization among infants during the first year of life, generating a substantial burden on healthcare services and public health expenditures. Despite the widespread use of respiratory physiotherapy in clinical practice, there is limited evidence regarding its effectiveness in preventing hospital admissions when provided in an outpatient setting. This quasi-experimental study aims to evaluate the impact of an outpatient respiratory physiotherapy protocol on hospitalization rates among infants up to 12 months of age diagnosed with mild to moderate acute viral bronchiolitis in the public healthcare system of Sorocaba, Brazil. Infants referred for respiratory physiotherapy will be compared with a similar group of infants who receive standard medical care without physiotherapy referral. The physiotherapy protocol includes slow expiratory techniques, rhinopharyngeal retrograde clearance, cough stimulation, and continuous positive airway pressure (CPAP) when clinically indicated. Participants will be followed through medical records and telephone monitoring. The primary outcome is hospital admission due to bronchiolitis. Secondary outcomes include length of hospital stay, healthcare costs, and clinical evolution. The findings may provide evidence on whether outpatient respiratory physiotherapy can reduce hospitalizations and optimize healthcare resource utilization in infants with acute viral bronchiolitis.

Interventions

Outpatient Respiratory Physiotherapy (Procedure)
Participants will receive an outpatient respiratory physiotherapy protocol for the management of mild to moderate acute viral bronchiolitis. The intervention may include Prolonged Slow Expiration, Slow Expiratory Flow Increase, Rhinopharyngeal Retrograde Clearance, cough stimulation, and continuous positive airway pressure (CPAP) when clinically indicated. Treatment will be individualized according to the infant's clinical condition, respiratory assessment findings, and bronchiolitis severity as determined by the Wang Bronchiolitis Severity Score. Sessions will be performed by trained physiotherapists and repeated as necessary based on clinical progression until discharge from physiotherapy follow-up.

Eligibility criteria

Inclusion Criteria: * Infants aged 12 months or younger. * Clinical diagnosis of acute viral bronchiolitis. * Mild or moderate bronchiolitis according to clinical assessment and Wang Bronchiolitis Severity Score. * Initial evaluation performed at a participating emergency care unit (UPA). * Parent or legal guardian able and willing to provide informed consent for participants receiving direct physiotherapy care. Exclusion Criteria: * Severe bronchiolitis requiring immediate hospitalization or emergency medical intervention. * Infants who did not follow the predefined clinical care pathway (e.g., no initial evaluation at a participating emergency care unit). * Absence of a clinical diagnosis of acute viral bronchiolitis by the attending pediatrician. * Any medical condition that, in the opinion of the clinical team, would make participation inappropriate or interfere with study procedures.

Conditions

Acute Viral Bronchiolitis

Locations

School of Public Health, University of São Paulo (USP), São Paulo, Brazil — São Paulo, São Paulo, Brazil

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Official Source

Data sourced from ClinicalTrials.gov, a service of the U.S. National Institutes of Health.

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