Nicholas 1999.
| Study characteristics | ||
| Methods | Randomised, open controlled trial Participants were randomly allocated to control and treatment groups using a random sequence number. | |
| Participants | Infants admitted to the hospital with a clinical diagnosis of acute bronchiolitis and with respiratory distress severe enough to require nasogastric tube feeding or intravenous fluids N = 50 participants randomised and analysed: 24 were allocated to control group and 26 to treatment group. Mean age of control group: 3.2 (range 0.4 to 8.3); intervention group 2.4 (range 0.4 to 6.9). RSV+: control 79%, intervention 85% |
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| Interventions |
Group 1: vibration and postural drainage techniques twice a day (N = 26)
Group 2: no intervention (N = 24) In the physiotherapy arm, the infant was treated on the physiotherapist's knee, percussion and vibration lying on right side, lying on the left side, and sitting; suction performed after on each side, if necessary, until clear; no oxygen required during treatment. Modifications were allowed if infant could not tolerate the procedure. Oxygen was allowed depending on infant tolerability. |
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| Outcomes | Primary outcome: validated clinical score (Dick 1991) with values 0 to 20, assigning scores 0 to 2 to heart rate, respiratory rate, blood gases, rhinitis, hyperinflation, use of accessory muscles, recession, cough, wheeze, crackles Secondary outcomes: length of stay (days); provision of inspired oxygen; requirement for nasogastric feeding; oxygen saturation |
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| Notes | The study ended at 5 days or if the infant was transferred to the ICU. Authors did not report SD. No information on funding |
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| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | "random sequence number generated by the Medical Statistics Unit of the University of Edinburgh" |
| Allocation concealment (selection bias) | Unclear risk | Not described |
| Blinding (performance bias and detection bias) All outcomes | Unclear risk | Not described |
| Incomplete outcome data (attrition bias) All outcomes | Unclear risk | 50 participants were randomised and assessed, although 1 child was excluded from the trial after being admitted to the ICU. It is not clear how these data were treated. Saturation of oxygen pulse assessments comprised 2 excluded children who were not assessed for clinical outcomes. |
| Selective reporting (reporting bias) | Unclear risk | Not described |
| Other bias | Low risk | No other biases detected. |