Related Experiment Video
Updated: Apr 16, 2026
Simultaneous Laryngopharyngeal and Conventional Esophageal pH Monitoring
Published on: December 14, 2020
[Influence of chest physiotherapy on gastro-œsophageal reflux in children]
G Reychler1, L Jacques2, D Arnold3
1Service de pneumologie, cliniques universitaires Saint-Luc, avenue Hippocrate 10, 1200 Bruxelles, Belgique; Institut de recherche expérimentale et clinique (IREC), pôle de pneumologie, ORL et dermatologie, université catholique de Louvain, Bruxelles, Belgique.
Insights
Chest physiotherapy, including slow expiration (ELPr) and positive expiratory pressure (PEP), can trigger gastro-oesophageal reflux in children. This study found no link between reflux during therapy and pathological reflux or technique type.
Area of Science:
- Pediatric Pulmonology
- Gastroenterology
- Respiratory Therapy
Context:
- Chest physiotherapy is a cornerstone of respiratory management for pediatric conditions like cystic fibrosis.
- Gastro-oesophageal reflux (GOR) is prevalent in children with cystic fibrosis and may be exacerbated by certain physiotherapy techniques.
Purpose:
- To investigate the impact of two common chest physiotherapy techniques on the occurrence of gastro-oesophageal reflux in children.
- To determine if slow expiration (ELPr) or positive expiratory pressure (PEP) maneuvers influence GOR events during treatment.
Summary:
- Twenty-nine children underwent pH monitoring while performing ELPr and PEP techniques in a seated position.
- Twenty-one percent of participants experienced GOR during the physiotherapy session.
- No significant association was found between GOR during physiotherapy and overall pathological reflux or the specific technique employed.
Impact:
- Findings suggest that seated chest physiotherapy techniques, specifically ELPr and PEP, can induce GOR in children.
- This highlights the need for careful monitoring and potential modification of physiotherapy regimens in pediatric patients with or at risk for GOR.
Introduction:
Chest physiotherapy is regularly prescribed for children, particularly in cystic fibrosis. Gastro-oesophageal reflux is common in this disease and is associated with certain chest physiotherapy manoeuvres.
Aim Of The Study:
To evaluate the influence of two chest physiotherapy techniques on gastro-oesophageal reflux in children.
Material And Method:
Twenty-nine children were investigated by routine pHmetry. During the examination, they performed two chest physiotherapy manoeuvres in a seated position for 10 minutes each with a 5 minutes rest between them. The two manoeuvres used were a slow expiration technique (ELPr) and positive expiratory pressure (PEP). It was a prospective study and the order of manoeuvres was randomised. The pH traces were analysed blindly when all the studies had been completed.
Results:
In the sample, 21% of children had gastro-oesophageal reflux during the physiotherapy session. No relationship was found between reflux during physiotherapy and pathological reflux (P=0.411) nor the physiotherapy technique used (P=0.219).
Conclusion:
The use of these two chest physiotherapy techniques in children in a seated position can produce gastro-oesophageal reflux.
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