Role of respiratory physiotherapy in the management of childhood asthma: An integrative review

Abstract

Introduction: Childhood asthma is a chronic respiratory disease characterized by airway inflammation and hyperresponsiveness, potentially leading to recurrent episodes of respiratory symptoms, functional limitation, and exacerbations. In this context, respiratory physiotherapy can be integrated into multidisciplinary care as a complementary strategy to conventional treatment. Objective: To analyze the role of respiratory physiotherapy in the management of childhood asthma and its main clinical and functional benefits. Methods: This is an integrative literature review conducted using the PubMed, SciELO, and Virtual Health Library (VHL) databases. Initially, 175 records were identified, 75 of which were removed due to duplication. After screening and eligibility assessment, seven studies met the established criteria and formed the final sample. Results: Among the seven included studies, significant heterogeneity was observed regarding the objectives and the interventions evaluated. Only some of the studies directly investigated physical therapy interventions, while the others addressed pharmacological treatment, biological therapy, epidemiological aspects, or associated conditions, serving primarily to provide clinical and therapeutic context for asthma. In the studies directly related to physical therapy, interventions such as breathing exercises, respiratory muscle training, and—in a specific context—non-invasive ventilatory support combined with physical therapy were described, yielding favorable results regarding certain respiratory and functional parameters, exercise-induced bronchospasm, and clinical control. However, these findings should not be generalized across the entire set of seven studies nor interpreted as uniform evidence of the efficacy of respiratory physical therapy in children and adolescents with asthma. Thus, heterogeneity was observed in the techniques employed and a lack of standardization in clinical approaches, while some of the included evidence addressed physiotherapy only indirectly by investigating pharmacological treatment, comorbidities, and epidemiological aspects of asthma. Conclusion: Respiratory physiotherapy shows potential as a complementary approach in the management of childhood asthma and should be individualized and integrated into multidisciplinary treatment. Nevertheless, more robust clinical studies are needed to establish specific protocols and determine long-term effects.