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      Manual hyperinflation in children Translated title: Hiperinsuflação manual em crianças

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          ABSTRACT

          Manual hyperinflation is used in neonatal and pediatric intensive care units to promote expiratory flow bias, but there is no consensus on the benefits of the technique. Thus, a review that presents supporting evidence is necessary. This study aims to review the literature on the manual hyperinflation maneuver in neonatal and pediatric intensive care units to analyze the evidence for this technique in terms of the forms of application (associated with other techniques or not), its safety, the performance of manual resuscitators and the influence of the physical therapist’s experience, in addition to evaluating the methodological quality of the identified articles. A search was performed in the following databases: Web of Science, ScienceDirect, PubMedⓇ, Scopus, CINAHL and SciELO. Two researchers independently selected the articles. Duplicate studies were assessed, evaluated by title and abstract and then read in full. The quality of the articles was analyzed using the PEDro scale. Six articles were included, two of which had high methodological quality. The main results provided information on the contribution of the positive end-expiratory pressure valve to increasing lung volumes and the use of chest compressions to optimize expiratory flow bias, the negative influence of operator experience on the increase in peak inspiratory flow, the performance of different manual resuscitators when used with the technique and the safety of application in terms of maintaining hemodynamic stability and increasing peripheral oxygen saturation. The available studies point to a positive effect of the manual hyperinflation maneuver in children who are admitted to intensive care units.

          Registration PROSPERO: CRD42018108056.

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          Reliability of the PEDro scale for rating quality of randomized controlled trials.

          Assessment of the quality of randomized controlled trials (RCTs) is common practice in systematic reviews. However, the reliability of data obtained with most quality assessment scales has not been established. This report describes 2 studies designed to investigate the reliability of data obtained with the Physiotherapy Evidence Database (PEDro) scale developed to rate the quality of RCTs evaluating physical therapist interventions. In the first study, 11 raters independently rated 25 RCTs randomly selected from the PEDro database. In the second study, 2 raters rated 120 RCTs randomly selected from the PEDro database, and disagreements were resolved by a third rater; this generated a set of individual rater and consensus ratings. The process was repeated by independent raters to create a second set of individual and consensus ratings. Reliability of ratings of PEDro scale items was calculated using multirater kappas, and reliability of the total (summed) score was calculated using intraclass correlation coefficients (ICC [1,1]). The kappa value for each of the 11 items ranged from.36 to.80 for individual assessors and from.50 to.79 for consensus ratings generated by groups of 2 or 3 raters. The ICC for the total score was.56 (95% confidence interval=.47-.65) for ratings by individuals, and the ICC for consensus ratings was.68 (95% confidence interval=.57-.76). The reliability of ratings of PEDro scale items varied from "fair" to "substantial," and the reliability of the total PEDro score was "fair" to "good."
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            Evidence for physiotherapy practice: A survey of the Physiotherapy Evidence Database (PEDro)

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              Evidence for physiotherapy practice: a survey of the Physiotherapy Evidence Database (PEDro).

              Evidence-based practice involves the use of evidence from systematic reviews and randomised controlled trials, but the extent of this evidence in physiotherapy has not previously been surveyed. The aim of this survey is to describe the quantity and quality of randomised controlled trials and the quantity of systematic reviews relevant to physiotherapy. The Physiotherapy Evidence Database (PEDro) was searched. The quality of trials was assessed with the PEDro scale. The search identified a total of 2,376 randomised controlled trials and 332 systematic reviews. The first trial was published in 1955 and the first review was published in 1982. Since that time, the number of trials and reviews has grown exponentially. The mean PEDro quality score has increased from 2.8 in trials published between 1955 and 1959 to 5.0 for trials published between 1995 and 1999. There is a substantial body of evidence about the effects of physiotherapy. However, there remains scope for improvements in the quality of the conduct and reporting of clinical trials.
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                Author and article information

                Journal
                Rev Bras Ter Intensiva
                Rev Bras Ter Intensiva
                RBTI
                Revista Brasileira de Terapia Intensiva
                Associação de Medicina Intensiva Brasileira - AMIB
                0103-507X
                1982-4335
                Oct-Dec 2021
                Oct-Dec 2021
                : 33
                : 4
                : 616-623
                Affiliations
                [1 ]Postgraduate Program, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo - Ribeirão Preto (SP), Brazil.
                [2 ]Postgraduate Program, Universidade Federal de São Carlos - São Carlos (SP), Brazil.
                Author notes
                Corresponding author: Daiane Menezes Lorena, Programa de Pós-Graduação, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Avenida Bandeirantes, 3.900, Zip code: 14049-900 - Ribeirão Preto (SP), Brazil, E-mail: daianemlorena@ 123456gmail.com
                Author information
                https://orcid.org/0000-0002-4193-7946
                https://orcid.org/0000-0002-0167-3114
                Article
                10.5935/0103-507X.20210071
                8889592
                35081246
                99fcee42-8c23-495b-b02f-c791cb56bd4f

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 17 December 2020
                : 10 March 2021
                Categories
                Review Article

                physical therapy modalities,respiration,artificial,respiratory therapy,respiratory mechanics,ventilators,mechanical,intensive care units,pediatric,child,infant,newborn

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