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Safety, tolerability and efficacy of LEGA-Kid® mechanical percussion device versus conventional chest physiotherapy
Yuen Ling Hue1, Lucy Chai See Lum2, Siti Hawa Ahmad3
1University Malaya Paediatric and Child Health Research Group, Kuala Lumpur, Malaysia.
Insights
Mechanical chest physiotherapy (CPT) using LEGA-Kid® is more effective than manual CPT for reducing respiratory rate in children with lower respiratory tract infection (LRTI). Both methods improved respiratory distress symptoms without adverse events.
Area of Science:
- Pediatrics
- Respiratory Medicine
- Medical Devices
Background:
- Lower respiratory tract infection (LRTI) is common in children under five.
- Chest physiotherapy (CPT) can aid LRTI management, but technique efficacy varies.
- Mechanical CPT devices offer potential advantages over manual techniques.
Purpose of the Study:
- To compare the efficacy of mechanical CPT (LEGA-Kid®) versus manual CPT in pediatric LRTI patients.
- To evaluate the impact of different CPT techniques on respiratory rate, oxygen saturation, and respiratory distress scores.
Main Methods:
- A randomized controlled trial involving 30 children (5 months to 5 years) with LRTI.
- Participants were assigned to either manual CPT or mechanical CPT using LEGA-Kid®.
- Outcomes measured included respiratory rate, oxygen saturation, and mRDAI scores pre- and post-intervention.
Main Results:
- Both manual and mechanical CPT significantly reduced respiratory rate and mRDAI scores.
- Mechanical CPT demonstrated a significantly greater reduction in respiratory rate (16.5%) compared to manual CPT (8%).
- No significant difference in mRDAI score reduction was observed between groups; oxygen saturation showed no significant improvement. No adverse events occurred.
Conclusions:
- Mechanical CPT with LEGA-Kid® is superior to manual CPT for improving respiratory rate in pediatric LRTI.
- Both CPT methods are safe and effective in improving respiratory distress symptoms.
- Combining nebulized hypertonic saline with CPT may enhance airway secretion clearance and respiratory distress improvement.
Introduction:
Chest physiotherapy (CPT) may benefit children aged below five years who suffer from lower respiratory tract infection (LRTI). However, its effects depend on the technique used. This study aimed to determine whether mechanical CPT using the LEGA-Kid® mechanical percussion device is superior to manual CPT in children with LRTI.
Methods:
Children aged five months to five years who were admitted and referred for CPT from January to April 2017 were randomised to either manual CPT or mechanical CPT with LEGA-Kid. Outcomes measured before intervention and two hours after intervention were respiratory rate (RR), oxygen saturation and modified Respiratory Distress Assessment Instrument (mRDAI) score.
Results:
All 30 enrolled patients showed significant reduction in post-intervention RR and mRDAI scores. There was an 8% reduction in RR for the manual CPT group (p = 0.002) and a 16.5% reduction in the mechanical CPT group (p = 0.0001), with a significantly greater reduction in the latter (p = 0.024). mRDAI scores decreased by 2.96 in the manual group (p = 0.0001) and 3.62 in the mechanical group (p = 0.002), with no significant difference between the groups. There was no significant improvement in oxygen saturation, and no adverse events were observed after CPT.
Conclusion:
Children receiving both manual and mechanical CPT showed improvements in respiratory distress symptoms, with no adverse effects. A combined strategy of nebulised hypertonic saline followed by CPT for LRTI removes airway secretions and results in improvements in moderately severe respiratory distress. The LEGA-Kid mechanical CPT method is superior to manual CPT in reducing the RR.
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