Effectiveness of combined chest physiotherapy, nebulization, and therapeutic positioning in improving respiratory status among children with pneumonia: A literature review
DOI: https://doi.org/10.56922/mchc.v5i4.3815
Chest Physiotherapy Children Nebulization Pneumonia Therapeutic Positioning
Abstract
Background: Pneumonia remains one of the leading causes of morbidity and mortality among children worldwide, particularly in developing countries. Airway obstruction caused by retained secretions frequently impairs respiratory function, indicating the need for effective evidence-based supportive interventions in addition to pharmacological treatment.
Purpose: To evaluate the effectiveness of combined chest physiotherapy, nebulization, and therapeutic positioning in improving the respiratory status of children with pneumonia.
Methods: A systematic literature review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) approach. Relevant articles were identified through Google Scholar, PubMed, and Portal Garuda using predefined keywords and Boolean operators. Studies published between 2021 and 2025 that investigated chest physiotherapy, nebulization, positioning, or their combination in pediatric patients with pneumonia were screened according to predetermined inclusion and exclusion criteria. Eleven eligible studies were included and synthesized using narrative analysis.
Results: The reviewed studies consistently demonstrated that combining chest physiotherapy, nebulization, and therapeutic positioning improved respiratory outcomes in children with pneumonia. The interventions increased oxygen saturation, reduced respiratory rate and respiratory distress, enhanced airway clearance through secretion mobilization, and improved patient comfort. Compared with single interventions, combination therapy produced more comprehensive improvements in respiratory function by simultaneously optimizing pulmonary ventilation, airway clearance, and oxygenation.
Conclusion: The combination of chest physiotherapy, nebulization, and therapeutic positioning is an effective evidence-based supportive intervention for improving respiratory status in children with pneumonia. Integrating these interventions into pediatric nursing care may optimize respiratory recovery and complement pharmacological management to achieve better clinical outcomes.
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Abd El-Monem El-Deeb, H. A., Abd El Hafeez, N. A. A., Rashwan, M. A., El-Sayed, M. M., Khedr, M. A., & Fathy Ahmed Dawood, R. (2025). Effect of Self-Proning on Respiratory Functions, Pneumonia Severity, and Mortality Risk Among Patients Diagnosed With Community-Acquired Pneumonia: A Nursing-Based Quasi-Experimental Study. Clinical Nursing Research, 34(1), 47-57.
Agustina, N., Nurhaeni, N., & Hayati, H. (2021). Right lateral position can improving oxygen saturation and respiratory rate on under-five children with pneumonia. La Pediatria Medica e Chirurgica, 43(s1).
Cunha, L. S., Passos, X. S., Fonseca, D. R. P., & Matsunaga, N. Y. (2024). Chest physiotherapy in children with pneumonia: a systematic literature review.
He, Y., & Huang, R. (2025). The efficacy and safety of acetylcysteine combined with budesonide nebulization in treating mycoplasma pneumonia in children: a meta-analysis. Frontiers in Pediatrics, 13, 1574257.
Irshad, A., Sajjad, A., Lata, P., Chaudhary, S. (2025). Effects Of Nebulization and Chest Physical Therapy to Improve Respiratory Status Among Pediatric Pneumonia Patients in a Tertiary Care Hospital. Retrieved From: Https://Www.Researchgate.Net/Publication/397557216_Effects_Of_Nebulization_And_Chest_Physical_Therapy_To_Improve_Respiratory_Status_Among_Pediatric_Pneumonia_Patients_In_A_Tertiary_Care_Hospital
Kusumaningrum, N. V., Arini, T., Ambarwati, A., & Harigustian, Y. (2023). Inhalation Medication Administration in Children with Pneumonia with Ineffective Airway Clearance: Case Study. Retrieved from: https://jurnal.globalhealthsciencegroup.com/index.php/IJGHR/article/view/2394
Lestari, S. P., Irdawati, I., & Syafitri, N. (2023). Case Study: Terapi Pursed Lips Breathing sebagai Intervensi Keperawatan untuk Status Oksigenasi Anak dengan Pneumonia. In Prosiding Seminar Nasional Keperawatan Universitas Muhammadiyah Surakarta (pp. 121-129).
Lodhi, R., Gupta, M., Kumar, R., & Rajalaxmi, V. (2025). Recent physiotherapeutic advancement for managing symptoms of pneumonia–a systematic review. Bulletin of Faculty of Physical Therapy, 30(1), 56.
Lubis, L., Siregar, P. S., Basri, B., Sucahyo, D., & Nurhayati, E. (2025). Effect of Chest Physiotherapy on Respiratory Effectiveness in Children with Pneumonia. Jurnal Kesmas Prima Indonesia, 9(2), 87-97.
Ma, Y., Fan, S., & Xi, J. (2025). Recent updates regarding the management and treatment of pneumonia in pediatric patients: a comprehensive review. Infection, 53(6), 2341-2359.
Mukhlisin, M., & Atsa’lawi, A. (2026). Humanistic Integration in Pesantren Education: Enhancing Moral and Social Character at Pondok Pesantren Lirboyo. TADIB: Jurnal Pendidikan Agama Islam, 4(1), 1-14.
Nurhayati, S., & Khotimah, N. I. H. H. (2023). Effectiveness of nebulization therapy with chest physiotherapy after nebulization on airway clearance in children with bronchopneumonia. International Journal of Global Operations Research, 4(2), 74-78.
Prasetyo, N. E., & Rusman, A. (2023). The Effectiveness of the 300 and 450 Semifowler Positions on Changes in Oxygen Saturation in Pneumonia Patients Installed Ventilator in ICU Room RSPI Sulianti Saroso. Jurnal Keperawatan Komprehensif (Comprehensive Nursing Journal), 9(SpecialEdition).
Rosadi, R., Wardojo, S. S. I., Rahmanto, S., & Yuliadarwati, N. M. (2022). The effectiveness of physiotherapy in children with pneumonia: a case study report. International Journal of Research in Medical Sciences, 10(4), 949-952.
Shkurka, E., Wray, J., Peters, M., & Shannon, H. (2024). Chest physiotherapy for mechanically ventilated children: a systematic review. Journal of Pediatric Intensive Care, 13(02), 109-118.
Sundari, E., & Rimbun, L. R. (2021). Pengaruh Posisi Prone pada Balita Dengan Pneumonia terhadap Peningkatan Saturasi Oksigen di Ruang PICU RSAB Harapan Kita Jakarta. Journal of Nursing and Health Science, 1(1), 22-26.
Utami, S., & Risca, F. (2021). Pemberian Posisi Semi Fowler 30 terhadap Saturasi Oksigen Pasien Covid-19 di RSUD KRMT Wongsonegoro Semarang. In Prosiding Seminar Nasional Unimus (Vol. 4).
World Health Organization. (2025). World Pneumonia Day 12 November 2025. Retrieved from: https://www.who.int/news/item/11-11-2025-world-pneumonia-day---12-november-2025
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