Respiratory physical therapy for adult pneumonia in Japan: A nationwide survey highlighting variability in clinical practice

BACKGROUND: The current state of respiratory physical therapy for adult pneumonia in Japan is insufficiently characterized. This study aimed to elucidate the current practices of respiratory physical therapy in Japan, including its implementation specifics, clinical frameworks, and medical reimbursement, with the aim of optimization respiratory physical therapy for adult pneumonia. METHODS: A cross-sectional questionnaire survey comprising 21 questions was administered to members of the Japanese Society of Respiratory Physical Therapy. The survey items encompassed basic institutional information, existence of protocols, timing of rehabilitation prescriptions, clinical and educational systems for respiratory physical therapy (such as training systems), and content of respiratory physical therapy. RESULTS: The timing of rehabilitation prescriptions for adult pneumonia "varies depending on clinical decision-making by attending physicians" in 35.4% of institutions, and only 8.3% of facilities had established rehabilitation protocols. Furthermore, the most pressing issue concerning respiratory physical therapy for adult pneumonia was identified as "the lack of guidelines for respiratory physical therapy (pulmonary rehabilitation) for pneumonia," with 92 institutions citing this as the most significant problem. CONCLUSIONS: The practice of respiratory physical therapy for adult pneumonia in Japan varies across institutions, with a lack of reference materials, including clinical practice guidelines, potentially contributing to this variability. These findings highlight the need for further research and the development of optimized clinical guidance.