Adjunctive Therapies in Modern Clinical Practice: When Are They Truly Beneficial?

Abstract

Adjunctive therapies are widely incorporated into contemporary cardiorespiratory physiotherapy practice to complement conventional interventions and optimize patient outcomes. These may include positive expiratory pressure (PEP) therapy, oscillatory PEP devices, inspiratory muscle training, lung expansion techniques, airway clearance devices, positioning, and other supportive respiratory interventions. However, with an increasing range of techniques and devices available, an important clinical question remains: when are these therapies truly beneficial?

The effectiveness of adjunctive therapies depends not simply on the availability of a particular device or technique, but on appropriate patient selection, clearly identified clinical problems, treatment goals, underlying pathophysiology, and the strength of supporting evidence. Their use should therefore be guided by a comprehensive assessment and sound clinical reasoning rather than routine or protocol-driven application.

This presentation will explore the role of commonly used adjunctive therapies in modern cardiorespiratory physiotherapy practice, with emphasis on their indications, physiological rationale, current evidence, and practical clinical application. Consideration will also be given to situations where these interventions may provide limited additional benefit or contribute unnecessarily to treatment burden. Through an evidence-informed and patient-centred approach, clinicians will be encouraged to critically evaluate what to use, when to use it, for whom, and why.

Ultimately, adjunctive therapies should complement, not replace- fundamental physiotherapy management, with their value determined by meaningful clinical benefit to the individual patient.