ASSESSMENT

When linked to a precise semiology that preceedes and guides the physiotherapic technical choice, the specific assessment builds an evaluation process of bronchial obstruction, that complements the medical diagnosis. It allows construction of strategic syndroms of the nCPT by indicating the site, the type and the nature of the bronchial obstruction.

This implies that diagnosis does not constitue the main element for choosing physiotherapic techniques.  The decision tree systematizes and simplifies the reasoning by limitating the technical choice to the four only possible ventilatory modes: a slow or forced inspiration, a slow or forced expiration.  The physiotherapic decision tree can be used as a thread to teach chest physical therapy.

Experience shown that, due to its specificity, this systematic assessment, is able to reveal discrete bronchial obstructions which basic clinical assessment can't, by basic mediate auscultation, if it is not accompagnied by physical manœuvres, called in French: "manœuvres d'appel".

When non detected, those discrete hypersecretions can be responsible for symptoms that can be hard to explain but lead to a lot of paraclinical exams, often expensive, sometimes aggressive, and not always sufficient to reassure the families.

This is why the specific physiotherapic assessment of bronchopulmonary obstruction is a precious complementary tool for medical diagnosis. It is now regularly used in our daily practice to examine newborns and young children, after a request introduced by the attending physician. This precise assessment helps guiding the technical intervention of the physiotherapist and justifies his action.

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