Introduction: Medical Clowns (MCs) are known to assist in reducing pain and alleviating anxiety. The objective of this study is to evaluate the ability of MCs to assist preschoolers in performing spirometry.
Methods: A prospective, randomized controlled trial. Children aged 3 to 6 years participated. First spirometry was performed with a technician. Later, children were randomly divided into 2 groups: the first performed a second spirometry with an MC. The second group repeated spirometry with the technician.
Results: 140 children were recruited, 97 (69%) boys. The groups did not differ in age, sex, ethnicity, or weight. Nor in mean FVC (MC 89.2%±16.7, control 89.5%±16.3) mean FEV1 (MC 91.3%±15.6, control 94.2%±16.8), and length of expiration (MC 1.58±0.43, control 1.7±0.44) in first spirometry. In second spirometry the control group had a similar slightly lower FVC and FEV1 and a slight improvement in length of expiration. The MC group had a significant improvement in all three parameters: FVC: MC 95.3%±15.5, control 89.3%±19.1, FEV1: MC 98.0%±15.6, control 91.8%±19.3, and length of expiration MC 19.6±0.55, control 1.84±0.52. The differences among the groups between first and second attempt were statistically significant (p value FVC 0.000, FEV1 0.000, length of expiration 0.003).
Discussion: MCs improved performance of spirometry among preschoolers. It is possible that laughter and relief of stress had a physiological effect. Further studies are required to better establish the ability of MCs to improve active participation and to better understand whether the mechanism of the improvement is better cooperation or true physiological change.
