The Effect of Chest Physiotherapy on Airway Clearance in Toddlers with Pneumonia: A Quasi-Experimental Study

Authors

DOI:

https://doi.org/10.33992/jik.v14i1.5057

Keywords:

Pneumonia, chest physiotherapy, airway clearance, toddlers

Abstract

Pneumonia remains a leading cause of morbidity among children under five, particularly in developing countries. Excessive mucus accumulation often leads to ineffective airway clearance, worsening respiratory distress. Evidence on the effectiveness of chest physiotherapy using structured clinical assessment is still limited. This study aimed to examine the effect of chest physiotherapy on airway clearance in toddlers with pneumonia. This study used a quasi-experimental design with a one group pretest–posttest design was conducted in the Melati B Inpatient Ward of RSUD Kota Cilegon in 2024. A total of 36 toddlers were recruited using purposive sampling. Airway clearance was assessed using a structured respiratory checklist, including respiratory rate, breath sounds, sputum production, and use of accessory muscles, with acceptable reliability (Cronbach’s alpha > 0.70). The intervention consisted of postural drainage, percussion, and vibration administered twice daily for three days. Data were analyzed using paired t-test (p < 0.05). Results show that the mean airway clearance score increased significantly from 3.28 ± 0.659 to 5.81 ± 0.525 after the intervention (p = 0.001). Chest physiotherapy significantly improves airway clearance in toddlers with pneumonia and can be recommended as an evidence based pediatric nursing intervention.

References

1. World Health Organization. Pneumonia fact sheet. 2023.

2. McAllister DA, Liu L, Shi T, et al. Global, regional, and national estimates of pneumonia morbidity and mortality in children younger than 5 years between 2000 and 2015: a systematic analysis. Lancet Global Health. 2019;7(1):e47–e57. doi:10.1016/S2214-109X(18)30408-X

3. Kementerian Kesehatan Republik Indonesia. Profil Kesehatan Indonesia. Jakarta; 2023.

4. Bradley JS, Byington CL, Shah SS, et al. The management of community-acquired pneumonia in infants and children older than 3 months of age: clinical practice guidelines by the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America. Clinical Infectious Diseases. 2011;53(7):e25–e76. doi:10.1093/cid/cir531

5. Hockenberry MJ, Wilson D. Wong’s nursing care of infants and children. 12th ed. Elsevier; 2021.

6. Hammer GD, McPhee SJ. Pathophysiology of disease: an introduction to clinical medicine. 8th ed. McGraw-Hill Education; 2019.

7. Torres A, Cilloniz C, Niederman MS, et al. Pneumonia. Nature Reviews Disease Primers. 2021;7(1):25. doi:10.1038/s41572-021-00259-0

8. Lestari P, Sari M, Nugroho T. The effectiveness of chest physiotherapy on oxygen saturation in pediatric pneumonia patients. Jurnal Keperawatan Indonesia. 2022;25(2):85–92.

9. Chaves GS, Freitas DA, Santino TA, et al. Chest physiotherapy for pneumonia in children. Cochrane Database of Systematic Reviews. 2019;(9). doi:10.1002/14651858.CD010277.pub3

10. Widodo A, Pratiwi R, Handayani S. Effect of chest physiotherapy on respiratory rate and breath sounds in children with pneumonia. Jurnal Keperawatan Soedirman. 2021;16(3):150–156.

11. Walker CLF, Rudan I, Liu L, et al. Global burden of childhood pneumonia and diarrhoea. Lancet. 2013;381(9875):1405–1416. doi:10.1016/S0140-6736(13)60222-6

12. Falagas ME, Mourtzoukou EG, Vardakas KZ. Sex differences in the incidence and severity of respiratory tract infections. Respiratory Medicine. 2007;101(9):1845–1863.

13. Nair H, Simões EA, Rudan I, et al. Global and regional burden of hospital admissions for severe acute lower respiratory infections in young children in 2010: a systematic analysis. Lancet. 2013;381(9875):1380–1390. doi:10.1016/S0140-6736(12)61901-1

14. Rudan I, O’Brien KL, Nair H, et al. Epidemiology and etiology of childhood pneumonia in 2010. Journal of Global Health. 2013;3(1). doi:10.7189/jogh.03.010401

15. Troeger C, Blacker B, Khalil IA, et al. Estimates of the global, regional, and national morbidity, mortality, and aetiologies of lower respiratory infections in 195 countries, 1990–2016. Lancet Infectious Diseases. 2018;18(11):1191–1210. doi:10.1016/S1473-3099(18)30310-4

16. Jackson S, Mathews KH, Pulanic D, et al. Risk factors for severe acute lower respiratory infections in children: a systematic review and meta-analysis. Croatian Medical Journal. 2013;54(2):110–121. doi:10.3325/cmj.2013.54.110

17. Spruit MA, Singh SJ, Garvey C, et al. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. American Journal of Respiratory and Critical Care Medicine. 2013;188(8):e13–e64. doi:10.1164/rccm.201309-1634ST

18. McCool FD, Rosen MJ. Nonpharmacologic airway clearance therapies. Chest. 2006;129(1 Suppl):250S–259S. doi:10.1378/chest.129.1_suppl.250S

19. World Health Organization. Pneumonia in children. 2023. Available from: https://www.who.int/news-room/fact-sheets/detail/pneumonia

20. Lubis L, Siregar PS, Sucahyo D, Nurhayati E. Effect of chest physiotherapy on respiratory effectiveness in children with pneumonia. 2025.

21. Arifin NA, Yunanto RA, Ridla AZ, Siswanto H. The effectiveness of chest physiotherapy for pneumonia patients with ineffective airway clearance problems in intensive care unit. Jurnal Kegawatdaruratan Medis Indonesia. 2024;3(2):199–209. doi:10.58545/jkmi.v3i2.153

Downloads

Published

2026-04-13

Citation Check

Similar Articles

You may also start an advanced similarity search for this article.