Liz Webb is a Melbourne-based physiotherapist who’s always had an interest in cardiorespiratory physiotherapy and currently works at the Alfred Hospital in its outpatient respiratory clinic. 

In 2019, she began a PhD investigating physiotherapy interventions for adults and children with bronchiectasis, a condition that causes damage to the lungs and makes it more difficult to clear phlegm. 

‘I went from the acute complexity of ICU to doing some work on the wards and noticed that we were seeing a lot of these bronchiectasis patients who were coming in recurrently. 

'As with most physios who then undertake their PhD, I started asking questions that led me down a rabbit hole. 

Liz Webb APAM

‘It became apparent that what we could do was limited in an acute setting and there wasn’t a lot of research to guide prescription for these patients. 

'Even if we wanted to try to adjust what we were doing, we just didn’t have the resources and we also didn’t have the guidance from a physiotherapy prescription purpose.’ 

The study will explore the barriers and enablers of airway clearance and physical exercise, using child–parent dyads to gather information from the perspective of the child undergoing the treatments as well as the parent/carer for a wider family context.

Bronchiectasis used to be known as an ‘orphan disease’ in that it is relatively rare and was only thought to affect a small proportion of the population, yet it’s possible that there has been an underdiagnosis of it. 

It can develop after recurrent chest infections as a child, and diagnosis is usually performed through a high-resolution CT scan. 

‘A study from Queensland recently came out where they compared the CT scans before and after management. 

'They found that with optimal management in a time-sensitive way, which includes physiotherapy, you can actually reverse bronchiectasis in children. 

'But therapy engagement is really suboptimal; only 30–50 per cent of kids will undertake their airway clearance or their exercise. 

‘By investigating the patient perspective, we hope to understand why they’re not doing the airway clearance and exercise but also how these two interventions overlap and may be used in unison to be more time effective. 

'If we can get an idea of what’s happening on a day-to-day level from children and their families living with bronchiectasis, that could then guide strategies for clinical prescription in response to those barriers and enablers as well as guide future research. 

'To provide patient-centred care, we need to meet the patients where they’re at.’ 

The PRF Seeding Grant will enable Liz to conduct the research in a timesensitive fashion, funding independent researchers to undertake participant interviews, along with transcription of the interviews and assistance from a senior qualitative researcher. 

‘It was quite an honour to receive the PRF Seeding Grant. 

'I’m passionate about this area and I think the research will make a difference for these families.’