{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T04:40:29Z","timestamp":1767847229963,"version":"3.49.0"},"reference-count":42,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,10,13]],"date-time":"2023-10-13T00:00:00Z","timestamp":1697155200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Bronchiectasis is a chronic pulmonary disorder which is prevalent among Australian First Nations people in the Northern Territory (NT). Current guidelines recommend physiotherapy as part of multi-disciplinary management of children with bronchiectasis, however in our setting, involvement of physiotherapy remains unknown. We thus undertook a retrospective chart audit to examine physiotherapy management of First Nations children (&amp;lt;18 years) from remote First Nations communities in the Top End of the NT at the index bronchiectasis diagnosis and 12 months following diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Participants were identified from a larger prospective study of children investigated for bronchiectasis at Royal Darwin Hospital, NT (2007\u20132016). Children were included if they were First Nations, aged &amp;lt;18 years, had a radiological diagnosis of bronchiectasis on high resolution computed tomography scan and lived in a remote community serviced by NT Government health clinics. The medical records from NT Government hospitals, health clinics and where possible other medical service attendance were reviewed for physiotherapy referral and management at the time of bronchiectasis diagnosis and in the following 12 months in the community.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 143 children included, the mean age was 3.1 (standard deviation 2.4) years and 84 (58.7%) were males. At the index diagnosis, 76\/122 (62.3%) children were reviewed by a physiotherapist, consisting of airway clearance techniques (83.8%), physical activity\/exercise (81.7%) and caregiver education (83.3%), with only 7\/127 (5.5%) having evidence of referral for community-based physiotherapy. In the following 12 months, only 11\/143 (7.7%) children were reviewed by a physiotherapist, consisting of airway clearance techniques (54.5%), physical activity\/exercise (45.5%) and caregiver education (36.4%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This study demonstrates a significant gap in the provision of physiotherapy services in our setting and the need to develop a standardized pathway, to support the best practice management of children with bronchiectasis in remote Top End communities of the NT.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fped.2023.1230474","type":"journal-article","created":{"date-parts":[[2023,10,13]],"date-time":"2023-10-13T08:19:36Z","timestamp":1697185176000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Physiotherapy management of first nations children with bronchiectasis from remote top end communities of the northern territory: a retrospective chart audit"],"prefix":"10.3389","volume":"11","author":[{"given":"A","family":"Welford","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"GB","family":"McCallum","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M","family":"Hodson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H","family":"Johnston","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,10,13]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1186\/s12890-018-0629-1","article-title":"Bronchiectasis: an emerging global epidemic","volume":"18","author":"Chotirmall","year":"2018","journal-title":"BMC Pulm Med"},{"key":"B2","doi-asserted-by":"publisher","first-page":"715","DOI":"10.1016\/S2213-2600(18)30053-5","article-title":"Bronchiectasis: new therapies and new perspectives","volume":"6","author":"Chalmers","year":"2018","journal-title":"Lancet Respir Med"},{"key":"B3","doi-asserted-by":"publisher","first-page":"866","DOI":"10.1016\/S0140-6736(18)31554-X","article-title":"Bronchiectasis in children: diagnosis and treatment","volume":"392","author":"Chang","year":"2018","journal-title":"Lancet"},{"key":"B4","doi-asserted-by":"publisher","first-page":"450","DOI":"10.1002\/ppul.23380","article-title":"Pediatric bronchiectasis: no longer an orphan disease","volume":"51","author":"Goyal","year":"2016","journal-title":"Pediatr Pulmonol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"27","DOI":"10.3389\/fped.2017.00027","article-title":"The epidemiology of chronic suppurative lung disease and bronchiectasis in children and adolescents","volume":"5","author":"McCallum","year":"2017","journal-title":"Front Pediatr"},{"key":"B6","doi-asserted-by":"publisher","first-page":"902","DOI":"10.1097\/01.inf.0000142508.33623.2f","article-title":"Hospital-based case-control study of bronchiectasis in indigenous children in central Australia","volume":"23","author":"Valery","year":"2004","journal-title":"Pediatr Infect Dis J"},{"key":"B7","doi-asserted-by":"publisher","first-page":"880","DOI":"10.1016\/S0140-6736(18)31767-7","article-title":"Advances in bronchiectasis: endotyping, genetics, microbiome, and disease heterogeneity","volume":"392","author":"Flume","year":"2018","journal-title":"Lancet"},{"key":"B8","doi-asserted-by":"publisher","first-page":"215","DOI":"10.1016\/s0720-048x(02)00122-5","article-title":"Reversible bronchial dilatation in children: comparison of serial high-resolution computer tomography scans of the lungs","volume":"47","author":"Gaillard","year":"2003","journal-title":"Eur J Radiol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"743","DOI":"10.1111\/resp.13280","article-title":"Bronchiectasis in indigenous and non-indigenous residents of Australia and New Zealand","volume":"23","author":"Blackall","year":"2018","journal-title":"Respirology"},{"key":"B10","doi-asserted-by":"publisher","first-page":"975","DOI":"10.1002\/ppul.24696","article-title":"A decade on: follow-up findings of indigenous children with bronchiectasis","volume":"55","author":"McCallum","year":"2020","journal-title":"Pediatr Pulmonol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1183\/13993003.02990-2020","article-title":"European respiratory society guidelines for the management of children and adolescents with bronchiectasis","volume":"58","author":"Chang","year":"2021","journal-title":"Eur Respir J"},{"key":"B12","doi-asserted-by":"publisher","first-page":"725","DOI":"10.1111\/resp.13291","article-title":"\u2018Good enough\u2019is \u2018not enough\u2019when managing indigenous adults with bronchiectasis in Australia and New Zealand","volume":"23","author":"McCallum","year":"2018","journal-title":"Respirology"},{"key":"B13","doi-asserted-by":"publisher","first-page":"21","DOI":"10.5694\/mja14.00287","article-title":"Chronic suppurative lung disease and bronchiectasis in children and adults in Australia and New Zealand thoracic society of Australia and New Zealand guidelines","volume":"202","author":"Chang","year":"2015","journal-title":"Med J Aust"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1136\/thoraxjnl-2018-212463","article-title":"British thoracic society guideline for bronchiectasis in adults","volume":"74","author":"Hill","year":"2019","journal-title":"Thorax"},{"key":"B15","doi-asserted-by":"publisher","first-page":"700629","DOI":"10.1183\/13993003.00629-2017","article-title":"European respiratory society guidelines for the management of adult bronchiectasis","volume":"50","author":"Polverino","year":"2017","journal-title":"Eur Respir J"},{"key":"B16","doi-asserted-by":"publisher","first-page":"CD008351","DOI":"10.1002\/14651858.CD008351.pub3","article-title":"Airway clearance techniques for bronchiectasis","volume":"2015","author":"Lee","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"B17","doi-asserted-by":"publisher","first-page":"2","DOI":"10.3389\/fped.2017.00002","article-title":"Airway-clearance techniques in children and adolescents with chronic suppurative lung disease and bronchiectasis","volume":"24","author":"Lee","year":"2017","journal-title":"Front Pediatr"},{"key":"B18","doi-asserted-by":"publisher","first-page":"841","DOI":"10.1177\/039463200702000422","article-title":"Effects of a program of hospital-supervised chest physical therapy on lung function tests in children with chronic respiratory disease: 1-year follow-up","volume":"20","author":"Indinnimeo","year":"2007","journal-title":"Int J Immunopathol Pharmacol"},{"key":"B19","doi-asserted-by":"publisher","first-page":"1701926","DOI":"10.1183\/13993003.01926-2017","article-title":"Long-term benefits of airway clearance in bronchiectasis: a randomised placebo-controlled trial","volume":"51","author":"Mu\u00f1oz","year":"2018","journal-title":"Eur Respir J"},{"key":"B20","doi-asserted-by":"publisher","first-page":"1086","DOI":"10.1183\/09031936.00055509","article-title":"A randomised crossover trial of chest physiotherapy in non-cystic fibrosis bronchiectasis","volume":"34","author":"Murray","year":"2009","journal-title":"Eur Respir J"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1901610","DOI":"10.1183\/13993003.01610-2019","article-title":"Respiratory physiotherapy in the bronchiectasis guidelines: is there a loud voice we are yet to hear?","volume":"54","author":"Spinou","year":"2019","journal-title":"Eur Respir J"},{"key":"B22","doi-asserted-by":"publisher","first-page":"292","DOI":"10.1186\/s13063-022-06256-2","article-title":"Bronchiectasis-exercise as therapy (BREATH): rationale and study protocol for a multi-center randomized controlled trial","volume":"23","author":"Jones","year":"2022","journal-title":"Trials"},{"key":"B23","doi-asserted-by":"publisher","first-page":"210105","DOI":"10.1183\/20734735.0105-2021","article-title":"Management of children and adolescents with bronchiectasis: summary of the ERS clinical practice guideline","volume":"17","author":"Chang","year":"2021","journal-title":"Breathe"},{"key":"B24","doi-asserted-by":"publisher","first-page":"383","DOI":"10.1111\/resp.13642","article-title":"We won't find what we don't look for: identifying barriers and enablers of chronic wet cough in aboriginal children","volume":"25","author":"Laird","year":"2020","journal-title":"Respirology"},{"key":"B25","doi-asserted-by":"publisher","first-page":"1200","DOI":"10.1016\/j.chest.2021.04.057","article-title":"Comparison of profiles of first nations and non-first nations children with bronchiectasis over two 5-year periods in the northern territory, Australia","volume":"160","author":"McCallum","year":"2021","journal-title":"Chest"},{"key":"B26","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1016\/j.jbi.2008.08.010","article-title":"Research electronic data capture (REDCap)\u2014a metadata-driven methodology and workflow process for providing translational research informatics support","volume":"42","author":"Harris","year":"2009","journal-title":"J Biomed Inform"},{"key":"B27","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1186\/s12931-020-01484-z","article-title":"Outcome measures for airway clearance techniques in children with chronic obstructive lung diseases: a systematic review","volume":"21","author":"Lauwers","year":"2020","journal-title":"Respir Res"},{"key":"B28","doi-asserted-by":"publisher","first-page":"00122","DOI":"10.1183\/23120541.00122-2021","article-title":"Clinical and research priorities for children and young people with bronchiectasis: an international roadmap","volume":"7","author":"Chang","year":"2021","journal-title":"ERJ Open Res"},{"key":"B29","doi-asserted-by":"publisher","first-page":"e000409","DOI":"10.1136\/bmjsem-2018-000409","article-title":"Effects of exercise training on physical and psychosocial health in children with chronic respiratory disease: a systematic review and meta-analysis","volume":"4","author":"Joschtel","year":"2018","journal-title":"BMJ Open Sport Exerc Med"},{"key":"B30","doi-asserted-by":"publisher","first-page":"953429","DOI":"10.3389\/fped.2022.953429","article-title":"Effects of a therapeutic exercise program in children with non-cystic fibrosis bronchiectasis: a pilot randomized controlled trial","volume":"15","author":"Joschtel","year":"2022","journal-title":"Front Pediatr"},{"key":"B31","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1111\/resp.14479","article-title":"Thoracic society of Australia and New Zealand (TSANZ) position statement on chronic suppurative lung disease and bronchiectasis in children, adolescents and adults in Australia and New Zealand","volume":"28","author":"Chang","year":"2023","journal-title":"Respirology"},{"key":"B32","doi-asserted-by":"publisher","first-page":"548","DOI":"10.1186\/s12913-021-06564-4","article-title":"From \u201cstuck\u201d to satisfied: aboriginal people\u2019s experience of culturally safe care with interpreters in a northern territory hospital","volume":"21","author":"Kerrigan","year":"2021","journal-title":"BMC Health Serv Res"},{"key":"B33","doi-asserted-by":"publisher","first-page":"180","DOI":"10.5694\/mja2.50700","article-title":"Improving communication with aboriginal hospital inpatients: a quasi-experimental interventional study","volume":"213","year":"2020","journal-title":"Med J Aust"},{"key":"B34","unstructured":"MitchellAG\n            LowellA\n            RalphA\n          Report on the patient educator service at Royal Darwin Hospital, 2001-20092016"},{"key":"B35","doi-asserted-by":"publisher","first-page":"499","DOI":"10.5694\/j.1326-5377.2008.tb02144.x","article-title":"\u201cAll they said was my kidneys were dead\u201d: indigenous Australian patients\u2019 understanding of their chronic kidney disease","volume":"189","author":"Anderson","year":"2008","journal-title":"Med J Aust"},{"key":"B36","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1071\/HE14100","article-title":"Culturally appropriate flipcharts improve the knowledge of common respiratory conditions among northern territory indigenous families","volume":"26","author":"Mckay","year":"2015","journal-title":"Health Promot J Austr"},{"key":"B37","doi-asserted-by":"publisher","first-page":"925189","DOI":"10.3389\/fped.2022.925189","article-title":"Multi-lingual \u201casthma APP\u201d improves health knowledge of asthma among Australian first nations carers of children with asthma","volume":"30","author":"Versteegh","year":"2022","journal-title":"Front Pediatr"},{"key":"B38","volume-title":"CARPA Standard treatment manual","year":"2022"},{"key":"B39","doi-asserted-by":"publisher","first-page":"99","DOI":"10.1186\/s12960-019-0432-y","article-title":"Remote health workforce turnover and retention: what are the policy and practice priorities?","volume":"17","author":"Wakerman","year":"2019","journal-title":"Hum Resour Health"},{"key":"B40","unstructured":"WorleyP\n            ChampionS\n          Report for the Minister for Regional Health, Regional Communications and Local Government on the Improvement of Access, Quality and Distribution of Allied Health Services in Regional, Rural and Remote Australia2020"},{"key":"B41","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1177\/1479972316633414","article-title":"Rural and remote care: overcoming the challenges of distance","volume":"13","author":"Goodridge","year":"2016","journal-title":"Chron Respir Dis"},{"key":"B42","doi-asserted-by":"publisher","first-page":"1921","DOI":"10.1002\/ppul.24491","article-title":"Children with bronchiectasis have poorer lung function than those with cystic fibrosis and do not receive the same standard of care","volume":"54","author":"Prentice","year":"2019","journal-title":"Pediatr Pulmonol"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2023.1230474\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,13]],"date-time":"2023-10-13T08:19:40Z","timestamp":1697185180000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2023.1230474\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,13]]},"references-count":42,"alternative-id":["10.3389\/fped.2023.1230474"],"URL":"https:\/\/doi.org\/10.3389\/fped.2023.1230474","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,13]]},"article-number":"1230474"}}