Early intervention of physiotherapy in pectus excavatum: two clinical cases in pediatrics

Abstract

The aim of this paper is to describe the effects of early physical therapy intervention on two children with pectus excavatum (PEX), according to analysis of postural parameters and features on chest radiograph. We conducted a case study with two children with PEX who were regularly followed up by the physiotherapy team of a university hospital. One of the cases was a girl aged one year and eight months with PEX broad type in the symmetrical deformity, and the second was a boy aged ten months with PEX broad type in the acute symmetric deformity. The treatment protocol was constituted of stretching of the pectoralis and serratus muscles, strengthening of the abdominal muscle, negative pressure maneuvers and follow up with guidance at home. An improvement in the infants' depression of the sternum and in the postural pattern was observed by means of the chest radiograph, without progression of PEX in both cases. We conclude that early intervention of physiotherapy in these two cases seemed to slow the progression of PEX, minimizing deformities. However, the effects of this therapy need to be addressed with better methodological quality, with larger samples and more precise evaluation methods, providing more substantial evidence for the physical therapy monitoring of children's PEX.