Belt during physiotherapy/inhalation

Question

Does it make sense for my one-year-old daughter with CF to put a belt (or bandagae,...what is the technical term here?) around the thorax during physiotherapy and inhalation? If yes, can this "belt" be prescribed as a therapeutic appliance?
Many thanks!

Answer

Hello,
the thoracic belt is at the moment in active discussion, however, it is not a therapeutic appliance with number, that means it cannot be prescribed. In single cases however, the insurances pay the costs after having received an estimate of costs [situation in Germany, as this was a German question].
I am not aware of any studies on the question if inhalation is better with belt than without.
During inhalation in generally, slow and deep inspiration maneuvers are desired, that can be supported in a toddler/baby via contact breathing, that means, one accompanies the thorax with the hand softly into the expiration. With this, a full expiration is achieved, and by this reflexively a deep inspiration and therefore a good deposition of the drug.
For sure, your physiotherapist has already shown and explained to you the contact breathing, if not, you find more detailed information in the German "guideline physiotherapy" of the German patient organisation Mukoviszidose e.V.
A belt would limit this deeper inspiration. I personally do never use thoracic belts during inhalation at my patients due to the mentioned thoughts.
Furthermore, according to my opinion, all advantages of a belt during breathing physiotherapy (correction of the thorax form, lowering of the breating central position) do not come into effect in a toddler respectively can be achieved manually better or to the same extent.
I hope to have helped you with this short answer.
Yours sincerely,
B. Dittmar
Head of sport- and physiotherapy of the specialist hospital Satteldüne/Amrum, Germany
Referent of the working group physiotherapy of the Mukoviszidose e.V. [German patient organisation]

13.01.2014