Abdominal belt in physiotherapy

Question

Hello,

I have a question concering physiotherapy.

Meanwhile, our daughter (2 years old) has received two belts that are placed around the abdomen and the chest (ribs). At the beginning, only one belt was used, and that at the level of the ribs.

Despite explanation I am still not sure what the belt is used for.

Why is the abdomen now bound as well? What is the effect of the belt? What is the optimal usage and how long should it be used? There seem to be different opinions. Would it be best to use the belt as often as possible or is it sufficient to use it twice a day during the inhalation and additionally at night?

Many thanks for answering.

Answer

Hello,

You ask a very good question which is much discussed in the working group “physiotherapy” of the Mukoviszidose e.V. [German patient organisation].

For answering your question in a detailed manner, a lot of information is missing:
Does your daughter have a hyperinflation of the lungs?
Does she have a lot of secretion or secretion at all?
Does she have germs in the lungs?
What does she inhale; NaCl only?
How does she tolerate the belt? How does she tolerate both belts?
Why has your physiotherapist decided to use the belt?
For giving an individual advice it would be necessary to look how the respiration of your child is changed when the belt is used. Does it help to reduce hyperinflation and is there any secretion maybe afterwards? What happens without the belt?

Generally, it can be said that the blue firm or the white soft belts were introduced to Germany by Jean Chevaillier, the founder of the Autogenic Drainage (AD). He teaches in his lessons that these belts help to correct the chest, that means to bring the ribs from the inhaling position back to a physiological, regular position (for adults; children have slightly lifted ribs by nature). On the other hand the belts are supposed to prevent too deep inhaling, moving the breathing baseline in direction of exhaling and to mobilise secretion in the small respiratory tract in this way. In our group mentioned above, the thorax fixation belt is not or hardly used for children.
For adults it is used once in a while.

Summarizing it can be said:
In case of hyperinflation or tight chests usage can be very reasonable, especially for supporting the mobilisation of secretion.
One should always be aware of the fact that such a belt restricts the movement of the ribs, i.e. reduces the chest mobility. However, it is as much an aim of the CF therapy to maintain the chest mobility as to support the mobilisation of secretion.
As far as I know there are no studies and statements about frequency and duration of usage. A long-term usage has always to be accompanied by intensive exercises for thorax mobilisation.
I hope to have been helpful.

B. Dittmar

02.08.2011