Chest physiotherapies for cystic fibrosis, acute bronchiolitis and patients undergoing mechanical ventilation have been reviewed (Flenady 2002; Perrotta 2005; Van der Schans 2000). However, the clinical effectiveness of chest physiotherapy for pneumonia is controversial. Some clinical studies have concluded that chest physiotherapy did not hasten the resolution of pneumonia (Graham 1978) or was not useful (Britton 1983; Britton 1985). Two studies suggested that larger or multi-centre trials were needed to confirm the findings (Ntoumenopoulos 2002; Tydeman 1989). Others concluded that chest physiotherapy had beneficial effects in patients with pulmonary infection (Hanying 2005). However, chest physiotherapy may be ineffective and even harmful. It may cause an increase in oxygen consumption (Horiuchi 1997; Weissman 1991; Weissman 1993), bronchospasm (Campbell 1975), induce hypertension, increase oxygen demand (Horiuchi 1997; Weissman 1993), cause hypoxaemia (Connors 1980; Poelaert 1991) and even lead to rib fractures (Chalumeau 2002).
To our knowledge, no systematic review or meta-analysis of chest physiotherapy for pneumonia has been published. This review aims to systematically review all randomised controlled trials (RCTs) which examine the effectiveness of chest physiotherapy for pneumonia in adults.