Summary
Introduction: Physiotherapy may play a role in the recovery of signs, symptoms and function of patients with lower respiratory tract infections (LRTI) but its effectiveness is still controversial.
Objectives: To assess the effects of respiratory physiotherapy compared with standard pharmacological care on symptoms and function in outpatients with LRTI. Design: Single-blind, randomised controlled trial.
Setting: Outpatients were recruited from the casualties of a central hospital.
Participants: Outpatients with LRTI were recruited and randomly allocated to the control (pharmacological) or experimental (pharmacological and respiratory physiotherapy) group.
Intervention: The intervention consisted of conventional pharmacological treatment and conventional pharma- cological treatment plus respiratory physiotherapy. Respiratory physiotherapy included breathing and airway clearance techniques, exercise training and education during 3-weeks, 3 times per week.
Main outcome measure: Primary outcome measures - occupation rate of wheezes Wh%; Secondary outcome measures - number of crackles, peripheral oxygen saturation (SpO2) modified Borg scale (mBorg), modified Medical Research Council scale (mMRC), 6-min walk test (6MWT), forced expiratory volume in 1 s and forced vital capacity, and volume and density of the lung and bronchial tree volume.
Results: Ninety-seven patients (53 controls and 44 experimental) completed the intervention. After the inter- vention, both groups improved significantly in all variables (0.0001 < p < 0.04; 0.001<ƞ2<0.092), with the exception of the mBorg. The magnitude of improvement of the experimental group exceeded the control group in the number of crackles, SpO2 levels, mMRC and 6MWT (0.002 < p < 0.032; 0.002<ƞ2<0.092).
Conclusion: Adding respiratory physiotherapy to the pharmacological treatment of outpatients with LRTI results in greater recovery of symptoms and function parameters.

Relevance
This paper points out that after the respiratory physiotherapy intervention, significant improvements of patients with LRTI, independently of their group allocation, were found, namely in the primary outcome measure (wheeze occupation rate). It also concludes that adding respiratory physiotherapy to the experimental group, lead to improvements in the number of crackles, SpO2 levels, functional exercise capacity and activities limitation due to dyspnoea, which exceeded the control group. These improvements are associated with symptom and function recovery, which are fundamental for patients’ daily life.