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Pestelli MT, Grecchi B, Vottero E, Galli A, Nicolini A, Compalati E, Banfi P, Diaz DE Teran T, Gonzales M, D'Abrosca F, Lippi L, Ferraioli G, Sheridan S, Dimabuyu-Francisco M, Solidoro P. Effectiveness of a new "focused pulse" high-frequency chest wall oscillation in patients with moderate to severe COPD. Minerva Med 2024; 115:4-13. [PMID: 38261298 DOI: 10.23736/s0026-4806.23.08874-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2024]
Abstract
BACKGROUND Chest physiotherapy plays a crucial role in the treatment of COPD, although the optimal techniques for airway clearance have not been definitively established. Among the different techniques, high-frequency chest wall oscillation (HFCWO) has gained attention for its potential to create a widespread lung percussion, facilitating the removal of secretions and potentially clearing the peripheral bronchial tree. This study aims to assess the effectiveness of a novel "focused pulse" HFCWO in patients with moderate to severe COPD. METHODS Sixty patients were randomized to three groups: a group treated with the PEP technique, a group with "focused pulse "HFCWO" and a group with pharmacological therapy alone (control group). The primary outcomes were changes in respiratory function parameters, changes in dyspnea and quality of life scores as well as daily life activity and health status assessment. The secondary outcomes were the number of exacerbations and the number of practitioner or emergency department (ED) visits after 1, 3, and 6 months. RESULTS Sixty patients concluded the study with 20 patients allocated to each group. The two devices improved respiratory function tests, quality of life and health scores and dyspnea compared to the control group. Maximal expiratory pressure and diffusing lung carbon oxide were significantly improved in the focused pulse HFCWO group compared to the PEP group. Only pulse-focused HFCWO showed a statistically significant lower number of exacerbations and visits to ED or practitioner compared to the control group. CONCLUSIONS The focused pulse HFCWO technique improves daily life activities and lung function in patients with stable COPD. The device demonstrated significantly greater effectiveness in lowering COPD exacerbations as well as visits to ED or practitioner.
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Affiliation(s)
- Maria T Pestelli
- Physical Medicine and Rehabilitation, General Hospital, Sestri Levante, Genoa, Italy
| | - Bruna Grecchi
- Physical Medicine and Rehabilitation, General Hospital, Sestri Levante, Genoa, Italy
| | - Erica Vottero
- Physical Medicine and Rehabilitation, General Hospital, Sestri Levante, Genoa, Italy
| | - Alice Galli
- Physical Medicine and Rehabilitation, General Hospital, Sestri Levante, Genoa, Italy
| | - Antonello Nicolini
- Cardio-Pulmonary Rehabilitation Unit, IRCCS Don Gnocchi Foundation, Milan, Italy -
| | - Elena Compalati
- Cardio-Pulmonary Rehabilitation Unit, IRCCS Don Gnocchi Foundation, Milan, Italy
| | - Paolo Banfi
- Cardio-Pulmonary Rehabilitation Unit, IRCCS Don Gnocchi Foundation, Milan, Italy
| | - Teresa Diaz DE Teran
- Sleep and Ventilation Unit, Department of Pneumology, Marqués de Valdecilla University Hospital, Cantabria University, Santander, Spain
| | - Monica Gonzales
- Sleep and Ventilation Unit, Department of Pneumology, Marqués de Valdecilla University Hospital, Cantabria University, Santander, Spain
| | - Francesco D'Abrosca
- Department of Physical and Rehabilitative Medicine, University of Eastern Piedmont, Novara, Italy
- Infrastruttura Ricerca Formazione Innovazione (IRFI), SS Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
| | - Lorenzo Lippi
- Department of Physical and Rehabilitative Medicine, University of Eastern Piedmont, Novara, Italy
- Infrastruttura Ricerca Formazione Innovazione (IRFI), SS Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy
| | - Gianluca Ferraioli
- Respiratory Diseases Unit, Hospital of Sestri Levante, Sestri Levante, Genoa, Italy
| | | | | | - Paolo Solidoro
- Unit of Pneumology, Cardiovascular and Thoracic Department, Molinette Hospital, Città della Salute e della Scienza and University of Turin, Turin, Italy
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Effects of High-Frequency Chest Wall Oscillation Expectoration System on Pulmonary Rehabilitation and Cortisol Function in Patients with Severe AECOPD. DISEASE MARKERS 2022; 2022:3380048. [PMID: 35909888 PMCID: PMC9337934 DOI: 10.1155/2022/3380048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 06/18/2022] [Accepted: 07/08/2022] [Indexed: 11/18/2022]
Abstract
Objective To investigate the effect of high-frequency chest wall oscillatory expectoration system (HFCWO) on pulmonary rehabilitation and cortisol function in patients with severe acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods The 65 severe AECOPD patients admitted to our hospital from January 2019 to May 2020 were divided into group A with 33 cases and group B with 32 cases by random number table method. After 14 days of intervention, the improvement time of clinical symptoms in the two groups was recorded, and blood gas, lung function, inflammatory, and cortisol function-related indicators were evaluated before and after treatment. Results The remission time of expectoration, pulmonary signs, and hospital stay in group A were significantly shorter than those in group B (P < 0.05). Compared with before treatment, blood oxygen partial pressure (PaO2), forced vital capacity (FVC), forced expiratory volume at 1 s (EFV1), and EFV1/FVC increased significantly; blood carbon dioxide partial pressure (PaCO2), C-reactive protein (CRP), interleukin-6 (IL-6), white blood cell count (WBC), plasma cortisol (COR), and adrenocorticotropic hormone (ACTH) levels were significantly decreased, and the above indicators in group A increased or decreased more significantly than those in group B (P < 0.05); there was no significant difference in tolerance and adverse reactions between the two groups (P > 0.05). Conclusion HFCWO has good pulmonary rehabilitation effect in the treatment of severe AECOPD and can significantly improve the blood gas indexes, inflammation, and cortisol function of patients, which is safe and feasible.
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Çevik K, Arık S. Effect of Postural Drainage and Deep Breathing-Cough Exercises on Oxygen Saturation, Triflo Volume and Pulmonary Function Test in Patients with COPD. JOURNAL OF CLINICAL AND EXPERIMENTAL INVESTIGATIONS 2021. [DOI: 10.29333/jcei/11269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Polastri M, Clini EM, Nava S, Ambrosino N. Manual Massage Therapy for Patients with COPD: A Scoping Review. ACTA ACUST UNITED AC 2019; 55:medicina55050151. [PMID: 31108862 PMCID: PMC6572655 DOI: 10.3390/medicina55050151] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 02/12/2019] [Accepted: 05/15/2019] [Indexed: 11/16/2022]
Abstract
Background and objectives: Manual massage therapy is a therapeutic option for the treatment of several pathological conditions affecting the musculoskeletal system. It has been pointed out that massage might be beneficial for chronic obstructive pulmonary disease (COPD) patients thanks to therapeutic effects primarily related to hyperemia (increased skin temperature and blood flow), and activation of the lymphatic system. The present study reports current evidence on the systemic effects of manual massage in patients with COPD. Materials and Methods: A scoping review was conducted on five major databases. The search went through all databases since their inception until December 2018. Results: Seventy-eight citations were retrieved; after the selection process was completed, seven articles were considered eligible. In patients receiving manual massage, improvements were observed in Forced Expiratory Volume in 1 s, dyspnea perception, and in the 6-min walking test. Conclusions: To date, the use of manual massage in patients with COPD is not supported by substantial evidence in the literature: indeed, it is proposed as a therapeutic option in association with other interventions such as physical exercise.
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Affiliation(s)
- Massimiliano Polastri
- Medical Department of Continuity of Care and Disability, Physical Medicine and Rehabilitation, St. Orsola University Hospital, 40138 Bologna, Italy.
| | - Enrico Maria Clini
- Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, 41121 Modena, Italy.
| | - Stefano Nava
- Department of Specialistic, Diagnostic and Experimental Medicine (DIMES), University of Bologna, 40138 Bologna, Italy.
| | - Nicolino Ambrosino
- Istituti Clinici Scientifici Maugeri, IRCCS, Pulmonary Rehabilitation Institute of Montescano, 27040 Montescano, Italy.
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Tymruk-Skoropad K. Методи дослідження ефективності фізичної терапії та легеневої реабілітації осіб з хронічним обструктивним захворюванням легень (аналіз систематичних оглядів). HEALTH, SPORT, REHABILITATION 2018. [DOI: 10.34142/hsr.2018.04.03.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
Abstract
Вступ. У більшості сучасних протоколів легеневої реабілітації та менеджменту пацієнтів із ХОЗЛ подано рекомендації щодо діагностичних методів дослідження та обґрунтування показників з урахуванням стратегії лікування. Недостатніми є рекомендації щодо методів дослідження та показників, які доцільно використовувати як критерії ефективності фізіотерапевтичного втручання. Мета дослідження. Проаналізувати методи дослідження, що найчастіше використовують для оцінювання ефективності фізичної терапії та легеневої реабілітації осіб з хронічним обструктивним захворюванням легень. Матеріали і методи дослідження. Проаналізовано 8 систематичних оглядів веб-бібліотеки Cochrane, присвячених фізичній терапії та легеневій реабілітації, які базувалися на аналізі 145 рандомізованих досліджень. Визначено методи дослідження та показники, використані для оцінювання результатів і ефективності фізичної терапії та легеневої реабілітації. Результати. Проаналізовано 550 методів дослідження та показників. Висновки. Більшість методів обстежень, використаних у рандомізованих дослідженнях, які стосуються легеневої реабілітації та фізичної терапії пацієнтів з ХОЗЛ, можна умовно розподілити на такі групи оцінювання: 1) якість життя та його компоненти, прояв симптомів захворювання; 2) рівень фізичної працездатності та витривалості, рухової сфери; 3) стан кардіореспіраторної системи; 4) інтегральні показники; 5) показники госпіталізації, загострень і смертності; 6) показники інформованості, грамотності й освіченості пацієнтів. Жоден окремий метод дослідження не може відобразити різноманіття патогенетичних проявів ХОЗЛ або належно описати характер чи важкість захворювання, дати інформацію про ефективність фізичної терапії. Для всебічного реабілітаційного оцінювання пацієнтів із ХОЗЛ доцільно застосовувати хоча б по одному із методів дослідження з кожної виокремленої групи.
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Prevalence, patterns, and predictors of massage practitioner utilization: Results of a US nationally representative survey. Musculoskelet Sci Pract 2017; 32:31-37. [PMID: 28802839 DOI: 10.1016/j.msksp.2017.07.003] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2017] [Revised: 07/05/2017] [Accepted: 07/12/2017] [Indexed: 12/27/2022]
Abstract
BACKGROUND The use of massage therapy is common, especially in patients with musculoskeletal pain. The purpose of this study was to examine the prevalence, utilization, socio-demographic and health-related predictors of massage practitioner consultations in the US population. METHODS Cross-sectional data from the 2012 National Health Interview Survey for adults (n = 34,525). RESULTS Prevalence of massage practitioner utilization were 12.8% (lifetime) and 6.8% (last 12 months). Compared to non-users, those who used massage in the last year were more likely: female, at least high school educated, annual income ≥ US$ 15,000, diagnosed with spinal pain or arthritis, report moderate physical activity level as compared to low level, and consume alcohol as compared to being abstinent. Massage was mainly used for general wellness or disease prevention (56.3%), but also for specific, typically musculoskeletal, health problems (41.9%) for which 85.2% reported massage helped to some or a great deal. Most (59.1%) did not disclose massage use to their health care provider, despite 69.4% reporting massage therapy combined with medical treatment would be helpful. CONCLUSIONS Approximately 7% (15.4 million) of US adults used massage therapy in the past year, mainly for general disease prevention, wellness or musculoskeletal pain. The majority of respondents reported positive outcomes of massage on specific health problems and overall well-being. Massage utilization was rarely covered by health insurance. Despite the majority of massage users considered massage therapy combined with medical care helpful, most did not disclose massage therapy use to their health care provider.
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