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Nangliya R, Yadav V, Nandanwar SP. Novelty of Physiotherapy Management in a Classic Case of Chronic Obstructive Pulmonary Disease in an 84-Year-Old Male Patient with Hypertension and Well-Controlled Hypothyroidism: A Case Report. Cureus 2024; 16:e57318. [PMID: 38690482 PMCID: PMC11060019 DOI: 10.7759/cureus.57318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 03/31/2024] [Indexed: 05/02/2024] Open
Abstract
Chronic obstructive pulmonary disease (COPD) often coexists with hypertension and hypothyroidism, posing challenges in management. Physiotherapy is crucial for improving respiratory function and quality of life in COPD patients. This case report details the physiotherapy management of an 84-year-old male with COPD, hypertension, and well-controlled hypothyroidism. The patient presented with worsening cough, breathlessness, and barrel chest. Diagnostic investigations confirmed COPD with respiratory alkalosis, hypoxemia, and well-controlled hypothyroidism. Pharmaceutical management was initiated alongside intensive physiotherapy interventions. A two-week rehabilitation program was tailored to the patient's COPD condition. It included deep breathing exercises, relaxation techniques, and aerobic activities to improve respiratory function and exercise tolerance. Physiotherapy sessions focused on patient education with medical treatment. Significant improvements were noted in dyspnea grading, perceived exertion rate, and thoracic excursion post-rehabilitation. Follow-up assessments showed sustained benefits with improved daily activities and reduced dyspnea. This case underscores the efficacy of multidisciplinary management, highlighting the essential role of physiotherapy in optimizing outcomes for COPD patients with comorbidities.
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Affiliation(s)
- Radha Nangliya
- Department of Cardiovascular and Respiratory Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Vaishnavi Yadav
- Department of Cardiovascular and Respiratory Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Sojwal P Nandanwar
- Department of Cardiovascular and Respiratory Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Duprez F, Crombin M, Daubechies I, Devries N, Durant V, El Khalil M, Audag N. [Update on manual bronchial clearance techniques (adults and adolescents)]. Rev Mal Respir 2024; 41:43-50. [PMID: 38057240 DOI: 10.1016/j.rmr.2023.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 10/07/2023] [Indexed: 12/08/2023]
Abstract
In adults and teenagers, airway clearance physiotherapy techniques (ACPT) are various and numerous. However, they for still awaiting scientific validation. Among ACPTs, Slow Expiration with the Glottis Opened in the Lateral Posture (ELTGOL), Autogenic Drainage (DA), and Active Cycling Breathing Technique (ACBT) present a Grade B level of evidence with weak recommendations. Even though these maneuvers are widely applied, precise description of chest physiotherapy (CP) is largely absent from the scientific literature; it is difficult to standardize its implementation and reproduce the results; scientific validation and faithful execution of the techniques are consequently problematic. In this paper, the authors aim to depict each of the three CP techniques as precisely as possible; with this in mind, graphic modeling of the different respiratory exercises is presented in such a way that they can be easily learned, applied and reproduced by physiotherapists.
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Affiliation(s)
- F Duprez
- Unité de recherche et d'innovation Condorcet-Epicura (URICE), hôpital Epicura, 63, rue de Mons, 7301 Tournai-Hornu, Belgique; Haute école master en sciences de la motricité, groupe kinésithérapie respiratoire, Condorcet, Tournai, Belgique.
| | - M Crombin
- Haute école master en sciences de la motricité, groupe kinésithérapie respiratoire, Condorcet, Tournai, Belgique
| | - I Daubechies
- Haute école master en sciences de la motricité, groupe kinésithérapie respiratoire, Condorcet, Tournai, Belgique
| | - N Devries
- Haute école master en sciences de la motricité, groupe kinésithérapie respiratoire, Condorcet, Tournai, Belgique
| | - V Durant
- Haute école master en sciences de la motricité, groupe kinésithérapie respiratoire, Condorcet, Tournai, Belgique
| | - M El Khalil
- Haute école master en sciences de la motricité, groupe kinésithérapie respiratoire, Condorcet, Tournai, Belgique
| | - N Audag
- Service de kinésithérapie et ergothérapie, cliniques universitaires Saint-Luc. Bruxelles, Belgique; Institut de recherche expérimentale et clinique (IREC), pôle de pneumologie, ORL et dermatologie, groupe de recherche en kinésithérapie respiratoire, université catholique de Louvain, Bruxelles, Belgique
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Alghamdi SM, Alzahrani A, Alshahrani YM, Al Ruwaithi AA, Aldhahir AM, Alsulayyim AS, Siraj RA, Almansour AH, Alasmari AM, Alqahtani JS, Alanazi AM, Jaishi ST, Allehyani BA, Hopkinson NS. Perception and clinical practice regarding mucus clearance devices with chronic obstructive pulmonary disease: a cross-sectional study of healthcare providers in Saudi Arabia. BMJ Open 2023; 13:e074849. [PMID: 37709318 PMCID: PMC10503362 DOI: 10.1136/bmjopen-2023-074849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 08/30/2023] [Indexed: 09/16/2023] Open
Abstract
OBJECTIVES Clearing secretions from the airway can be difficult for people with chronic obstructive pulmonary disease (COPD). Mucus clearance devices (MCDs) are an option in disease management to help with this, but healthcare provider awareness and knowledge about them as well as current clinical practice in Saudi Arabia are not known. DESIGN A cross-sectional online survey consisting of four themes; demographics, awareness, recommendations and clinical practice, for MCDs with COPD patients. SETTING Saudi Arabia. PARTICIPANTS 1188 healthcare providers including general practitioners, family physicians, pulmonologists, nursing staff, respiratory therapists and physiotherapists. PRIMARY OUTCOME MEASURES Healthcare providers' level of awareness about MCDs, and the identification of current clinical practices of COPD care in Saudi Arabia. RESULTS 1188 healthcare providers (44.4% female) completed the survey. Regarding devices, 54.2% were aware of the Flutter, 23.8% the Acapella and 5.4% the positive expiratory pressure mask. 40.7% of the respondents identified the Acapella, and 22.3% the Flutter as first choice for COPD management. 75% would usually or always consider their use in COPD patients reporting daily difficulty clearing mucus, whereas 55.9% would sometimes or usually consider the use of MCDs with COPD patients who produced and were able to clear mucus with cough. In clinical practice, 380 (32%) of the respondents would prescribe MCDs, 378 (31.8%) would give MCDs without prescriptions, 314 (26.4%) would not provide them at all and 116 (9.8%) would only advise patients about them. CONCLUSION Healthcare providers are aware of the existence of MCDs and their benefits for sputum clearance and believe that MCDs are beneficial for sputum clearance in some COPD patients. TRIAL REGISTRATION NUMBER ISRCTN44651852.
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Affiliation(s)
- Saeed Mardy Alghamdi
- Department of Clinical Technology, Respiratory Care Program, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Abdulaziz Alzahrani
- Department of Clinical Technology, Respiratory Care Program, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Yousef M Alshahrani
- Department of Clinical Technology, Emergency Medical Services Program, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Abdulhadi A Al Ruwaithi
- Department of Clinical Technology, Emergency Medical Services Program, Umm Al-Qura University, Makkah, Saudi Arabia
| | | | | | - Rayan A Siraj
- Department of Respiratory Therapy, King Faisal University, Al-Hasa, Saudi Arabia
| | - Abdulelah H Almansour
- Department of Family Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Ali M Alasmari
- Department of Respiratory Therapy, College of Medical Rehabilitation Services, Taibah University, Madinah, Saudi Arabia
| | - Jaber S Alqahtani
- Department of Respiratory Care, Prince Sultan Military College of Health Sciences, Dammam, Saudi Arabia
| | - Abdullah M Alanazi
- Department of Respiratory Care, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Siraj T Jaishi
- Al-Noor Specialist Hospital, Saudi Arabia Ministry of Health, Makkah, Saudi Arabia
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Ides KM, De Backer WA, Lanclus M, Leemans G, Dierckx W, Lauwers E, Vissers D, Steckel J, De Backer JW. The effect of posture on airflow distribution, airway geometry and air velocity in healthy subjects. BMC Pulm Med 2022; 22:477. [PMID: 36522658 PMCID: PMC9753395 DOI: 10.1186/s12890-022-02276-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 12/06/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Gravity, and thus body position, can affect the regional distribution of lung ventilation and blood flow. Therefore, body positioning is a potential tool to improve regional ventilation, thereby possibly enhancing the effect of respiratory physiotherapy interventions. In this proof-of-concept study, functional respiratory imaging (FRI) was used to objectively assess effects of body position on regional airflow distribution in the lungs. METHODS Five healthy volunteers were recruited. The participants were asked during FRI first to lie in supine position, afterwards in standardized right lateral position. RESULTS In right lateral position there was significantly more regional ventilation also described as Imaging Airflow Distribution in the right lung than in the left lung (P < 0.001). Air velocity was significantly higher in the left lung (P < 0.05). In right lateral position there was significantly more airflow distribution in the right lung than in the left lung (P < 0.001). Significant changes were observed in airway geometry resulting in a decrease in imaged airway volume (P = 0.024) and a higher imaged airway resistance (P = 0.029) in the dependent lung. In general, the effect of right lateral position caused a significant increase in regional ventilation (P < 0.001) in the dependent lung when compared with the supine position. CONCLUSIONS Changing body position leads to significant changes in regional lung ventilation, objectively assessed by FRI The volume based on the imaging parameters in the dependent lung is smaller in the lateral position than in the supine position. In right lateral decubitus position, airflow distribution is greater in dependent lung compared to the nondependent lung. TRIAL REGISTRATION The trial has been submitted to www. CLINICALTRIALS gov with identification number NCT01893697 on 07/02/2013.
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Affiliation(s)
- Kris M. Ides
- grid.411414.50000 0004 0626 3418Department of Pediatric Medicine, Antwerp University Hospital, drie eikenstraat 655, 2650 Edegem, Belgium ,grid.5284.b0000 0001 0790 3681Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium ,grid.5284.b0000 0001 0790 3681Cosys-Lab, Antwerp University, Flanders Make Lommel, Groenenborgerlaan 171, 2020 Antwerp, Belgium ,Medimprove Multidisciplinairy Private Practice, Groeningenlei 132C, 2550 Kontich, Belgium
| | - Wilfried A. De Backer
- grid.5284.b0000 0001 0790 3681Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium ,Medimprove Multidisciplinairy Private Practice, Groeningenlei 132C, 2550 Kontich, Belgium
| | - Maarten Lanclus
- grid.428659.4FLUIDDA Inc, 228 EAST 45TH Street STE 9E, New York, USA
| | - Glenn Leemans
- grid.5284.b0000 0001 0790 3681Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Wendel Dierckx
- grid.5284.b0000 0001 0790 3681Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium ,Medimprove Multidisciplinairy Private Practice, Groeningenlei 132C, 2550 Kontich, Belgium
| | - Eline Lauwers
- grid.476361.1FLUIDDA NV, Groeningenlei 132, 2550 Kontich, Belgium ,grid.411414.50000 0004 0626 3418Department of Pediatric Medicine, Antwerp University Hospital, drie eikenstraat 655, 2650 Edegem, Belgium ,grid.5284.b0000 0001 0790 3681Laboratory of Experimental Medicine and Pediatrics, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Dirk Vissers
- grid.5284.b0000 0001 0790 3681Faculty of Medicine and Health Sciences, University of Antwerp, Universiteitsplein 1, 2610 Wilrijk, Belgium
| | - Jan Steckel
- grid.5284.b0000 0001 0790 3681Cosys-Lab, Antwerp University, Flanders Make Lommel, Groenenborgerlaan 171, 2020 Antwerp, Belgium
| | - Jan W. De Backer
- grid.428659.4FLUIDDA Inc, 228 EAST 45TH Street STE 9E, New York, USA
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Pyszora A, Lewko A. Non-pharmacological Management in Palliative Care for Patients With Advanced COPD. Front Cardiovasc Med 2022; 9:907664. [PMID: 35924211 PMCID: PMC9339631 DOI: 10.3389/fcvm.2022.907664] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 05/31/2022] [Indexed: 11/13/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) is a disabling condition associated with progressive airflow limitation and lung tissue damage; its main symptoms are breathlessness, fatigue, cough, and sputum production. In the advanced stage of the disease, these symptoms may severely impact on a person's physical and psychological functioning, with some also developing chronic respiratory failure, associated with blood gas abnormalities. Non-pharmacological interventions can improve quality of life and functioning in the management of people living with advanced COPD. This article will provide an overview of common non-pharmacological methods used in the symptomatic management of severe COPD, including: breathlessness and fatigue management strategies, anxiety management, pulmonary rehabilitation (PR) and physical activity (PA), neuromuscular electrical stimulation (NMES), airway clearance techniques (ACTs), nutrition and non-invasive ventilation (NIV). The importance of a holistic and multi-disciplinary approach to people living with COPD will be discussed.
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Affiliation(s)
- Anna Pyszora
- Palliative Care Department, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, Torun, Poland
- *Correspondence: Anna Pyszora
| | - Agnieszka Lewko
- Faculty of Health and Life Sciences, Coventry University, Coventry, United Kingdom
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Fernandes O, D'Silva C, Mascarenhas DG, Rebello SR. Comparison of Lung Flute and threshold positive expiratory pressure devices for airway clearance in patients with chronic obstructive pulmonary disease: a randomised clinical trial. INTERNATIONAL JOURNAL OF THERAPY AND REHABILITATION 2021. [DOI: 10.12968/ijtr.2020.0028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background/Aims Mucus hypersecretion and altered lung functions leads to adverse clinical outcomes in chronic obstructive pulmonary disease. The aim of this study was to compare the effects of the Lung Flute and threshold positive expiratory pressure devices on sputum quantity and pulmonary functions in chronic obstructive pulmonary disease patients. Methods A total of 50 patients with chronic obstructive pulmonary disease were randomly divided into two groups. Group 1 used the Lung Flute device and group 2 used a threshold positive expiratory pressure device. Sputum quantity was measured post-intervention on a daily basis. Forced expiratory volume in the first second, forced vital capacity, and peak expiratory flow rate were evaluated on day 1 and day 6. Results The mean sputum quantity in group 1 was 11.40 ml and it was 11.04 ml in group 2. Between-group comparison demonstrated a significant improvement in forced expiratory volume in the first second for group 1 compared to group 2 (P<0.005). Conclusions The Lung Flute was found to be slightly more effective than the threshold positive expiratory pressure device for airway clearance and also had a positive effect on pulmonary functions in patients with chronic obstructive pulmonary disease.
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Affiliation(s)
- Orein Fernandes
- Department of Physiotherapy, Father Muller College of Allied Health Sciences Mangalore, Mangalore, India
| | - Cherishma D'Silva
- Department of Physiotherapy, Father Muller College of Allied Health Sciences Mangalore, Mangalore, India
| | - Don Gregory Mascarenhas
- Department of Physiotherapy, Father Muller College of Allied Health Sciences Mangalore, Mangalore, India
| | - Sydney Roshan Rebello
- Department of Physiotherapy, Father Muller College of Allied Health Sciences Mangalore, Mangalore, India
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7
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O'Sullivan KJ, Power V, Linnane B, McGrath D, Fogarty H, Ryan M, White R, Noonan C, Mulloy E, O'Sullivan LW, Dunne CP. An initial evaluation of the safety of a disposable oscillating positive expiratory pressure device in patients with chronic obstructive pulmonary disease: a sort-term pilot study. BMC Pulm Med 2021; 21:326. [PMID: 34666748 PMCID: PMC8524222 DOI: 10.1186/s12890-021-01689-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 10/08/2021] [Indexed: 12/24/2022] Open
Abstract
Background Handheld oscillating positive expiratory pressure (OPEP) devices have been a mainstay of treatment for patients with hypersecretory conditions such as cystic fibrosis (CF) and chronic obstructive pulmonary disease (COPD) since the 1970s. Current devices are reusable and require regular cleaning and disinfection to prevent harbouring potentially pathogenic organisms. Adherence to cleaning regimens for respiratory devices is often poor and in response to this, a prototype disposable OPEP device—the ‘UL-OPEP’ (University of Limerick—Oscillating Positive Expiratory Pressure device)—was developed to mitigate the risk of contamination by pathogens. The device was previously evaluated successfully in a group of paediatric CF patients. The aim of the current study was to initially evaluate the safety of the prototype in patients with COPD over a period of 1 month to ensure no adverse events, negative impacts on lung function, exercise tolerance, or quality of life. Data on user experience of the device were also collected during post-study follow-up. Methods A sample of 50 volunteer participants were recruited from pulmonary rehabilitation clinics within the local hospital network. The patients were clinically stable, productive, and not current or previous users of OPEP devices. Participants were invited to use a prototype disposable OPEP device daily for a period of 1 month. Pre- and post-study lung function was assessed with standard spirometry, and exercise tolerance with the 6-min-walk-test (6MWT). Quality of life was assessed using the St. George’s Respiratory Questionnaire (SGRQ), and user experience of the prototype device evaluated using a post-study questionnaire. Results 24 Participants completed the study: 9 were female. Overall median age was 67.5 years, range 53–85 years. Lung function, 6-min walk test, and SGRQ scores showed no significant change post-study. User feedback was positive overall. Conclusions The results indicate that the UL-OPEP is safe to use in patients with COPD. No adverse events were recorded during the study or in the follow-up period of 2 weeks. The device did not negatively impact patients’ lung function, exercise tolerance, or quality of life during short term use (1 month), and usability feedback received was generally positive. Larger, longer duration studies will be required to evaluate efficacy. Registration The study was approved as a Clinical Investigation by the Irish Health Products Regulatory Authority (CRN-2209025-CI0085).
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Affiliation(s)
- Kevin J O'Sullivan
- Rapid Innovation Unit - Confirm Centre for Smart Manufacturing, School of Design and Health Research Institute, University of Limerick, Limerick, Ireland
| | - Valerie Power
- Rapid Innovation Unit - Confirm Centre for Smart Manufacturing, School of Design and Health Research Institute, University of Limerick, Limerick, Ireland
| | - Barry Linnane
- Centre for Interventions in Infection, Inflammation and Immunity (4i) and School of Medicine, University of Limerick, Limerick, Ireland.,University Hospital Limerick, Dooradoyle, Limerick, Ireland.,National Children's Research Centre, Crumlin, Dublin 12, Ireland.,Paediatric Cystic Fibrosis Department, University Hospital Limerick (UHL), Limerick, Ireland
| | - Deirdre McGrath
- Centre for Interventions in Infection, Inflammation and Immunity (4i) and School of Medicine, University of Limerick, Limerick, Ireland.,University Hospital Limerick, Dooradoyle, Limerick, Ireland
| | - Hilda Fogarty
- Centre for Interventions in Infection, Inflammation and Immunity (4i) and School of Medicine, University of Limerick, Limerick, Ireland
| | | | - Rebecca White
- University Hospital Limerick, Dooradoyle, Limerick, Ireland
| | | | | | - Leonard W O'Sullivan
- Rapid Innovation Unit - Confirm Centre for Smart Manufacturing, School of Design and Health Research Institute, University of Limerick, Limerick, Ireland
| | - Colum P Dunne
- Centre for Interventions in Infection, Inflammation and Immunity (4i) and School of Medicine, University of Limerick, Limerick, Ireland.
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Pancera S, Buraschi R, Bianchi LNC, Porta R, Negrini S, Arienti C. Effectiveness of Continuous Chest Wall Vibration With Concurrent Aerobic Training on Dyspnea and Functional Exercise Capacity in Patients With Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial. Arch Phys Med Rehabil 2021; 102:1457-1464. [PMID: 33781780 DOI: 10.1016/j.apmr.2021.03.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 03/12/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate the effects of continuous chest wall vibration with concurrent aerobic training in addition to a 4-week pulmonary rehabilitation program on dyspnea and functional exercise capacity in patients with chronic obstructive pulmonary disease (COPD). DESIGN Randomized, single-blind, placebo-controlled trial. SETTING The Cardiopulmonary Rehabilitation Unit of a tertiary referral subacute rehabilitation center. PARTICIPANTS A sample of 146 consecutive patients with COPD (Global Initiative for Chronic Obstructive Lung Disease II-III-IV) were assessed for eligibility. The final sample of 40 patients (N=40) was randomized into 3 groups (intervention, sham intervention, control). INTERVENTIONS All groups carried out 5 sessions per week for 4 weeks of standard pulmonary rehabilitation treatment. The 2 daily 30-minute sessions included aerobic training and resistance training or airway clearance techniques. The intervention group performed the aerobic training with the addition of continuous chest wall vibration applied during cycling, whereas the sham intervention group received continuous chest wall vibration as a placebo during cycling. MAIN OUTCOME MEASURES Six-minute walk distance (6MWD) and Barthel Index based on dyspnea (BID). RESULTS A total of 36 participants completed the study (69±7 years; forced expiratory volume in 1 second percentage of predicted, 40.15%±15.97%). Intention to treat analysis showed no significant differences between groups for 6MWD and BID. However, the increase in 6MWD was a clinically important difference in the intervention group (42.57±43.87m, P=.003), with a moderate effect size (d=0.58). CONCLUSIONS Continuous chest wall vibration with concurrent aerobic training in addition to a standard pulmonary rehabilitation program might improve functional exercise capacity compared with usual care, but there were no effects on dyspnea, respiratory muscle function, or quality of life in patients with COPD.
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Affiliation(s)
| | | | | | | | - Stefano Negrini
- Department of Biomedical, Surgical and Dental Sciences, University of Milan "La Statale", Milan; IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
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Shen MD, Guo LR, Li YW, Gao RT, Sui X, Du Z, Xu LQ, Shi HY, Ni YY, Zhang X, Pang Y, Zhang W, Yu TZ, Li F. Role of the active cycle of breathing technique combined with phonophoresis for the treatment of patients with chronic obstructive pulmonary disease (COPD): study protocol for a preliminary randomized controlled trial. Trials 2021; 22:228. [PMID: 33757568 PMCID: PMC7988997 DOI: 10.1186/s13063-021-05184-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 03/11/2021] [Indexed: 11/16/2022] Open
Abstract
Background Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory lung disease characterized by coughing, the production of excess sputum, and dyspnea. Patients with excessively thick sputum may have frequent attacks or develop more serious disease. The guidelines recommend airway clearance for patients with excessive sputum who are hospitalized with COPD. The active cycle of breathing technique is the most common non-pharmacological airway clearance technique used by physiotherapists. However, the effectiveness of the technique is not always guaranteed. Active cycle of breathing techniques require the initial dilution of the sputum, usually by inhalation drugs, which may have limited effects. Recent studies have found that phonophoresis decreases inflammation, suggesting the potential of the combined usage of active cycle of breathing techniques and phonophoresis. Therefore, the aim of this study is to explore the effectiveness and safety of combining active cycle of breathing technique and phonophoresis in treating COPD patients. Methods and analysis We propose a single-blind randomized controlled trial using 75 hospitalized patients diagnosed with COPD with excessive sputum production. The patients will be divided into three groups. The intervention group will receive active cycle of breathing techniques combined with phonophoresis. The two comparison groups will be treated with active cycle of breathing techniques and phonophoresis, respectively. The program will be implemented daily for 1 week. The primary outcomes will be changes in sputum viscosity and production, lung function, and pulse oximetry. Secondary outcomes include the assessment of COPD and anxiety, measured by the COPD Assessment Test scale and the Anxiety Inventory for Respiratory Disease, respectively; self-satisfaction; the degree of cooperation; and the length of hospital stay. All outcome measures, with the exception of sputum production and additional secondary outcomes, will be assessed at the commencement of the study and after 1 week’s intervention. Analysis of variance will be used to investigate differences between the groups, and a p-value of less than 0.05 (two-tailed) will be considered statistically significant. Discussion This study introduces a combination of active cycle of breathing techniques and phonophoresis to explore the impact of these interventions on patients hospitalized with COPD. If this combined intervention is shown to be effective, it may prove to be a better treatment for patients with COPD. Trial registration The trial was registered prospectively on the Chinese Clinical Trial Registry on 24 December 2019.ClinicalTrials.gov ChiCTR1900028506. Registered on December 2019.
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Affiliation(s)
- M D Shen
- School of Nursing, Jilin University, No 965, Xin Jiang Avenue, Changchun, 130000, Jilin Province, China
| | - L R Guo
- School of Nursing, Jilin University, No 965, Xin Jiang Avenue, Changchun, 130000, Jilin Province, China
| | - Y W Li
- School of Nursing, Jilin University, No 965, Xin Jiang Avenue, Changchun, 130000, Jilin Province, China
| | - R T Gao
- School of Nursing, Jilin University, No 965, Xin Jiang Avenue, Changchun, 130000, Jilin Province, China
| | - X Sui
- School of Nursing, Jilin University, No 965, Xin Jiang Avenue, Changchun, 130000, Jilin Province, China
| | - Z Du
- School of Nursing, Jilin University, No 965, Xin Jiang Avenue, Changchun, 130000, Jilin Province, China
| | - L Q Xu
- School of Nursing, Jilin University, No 965, Xin Jiang Avenue, Changchun, 130000, Jilin Province, China
| | - H Y Shi
- School of Nursing, Jilin University, No 965, Xin Jiang Avenue, Changchun, 130000, Jilin Province, China
| | - Y Y Ni
- School of Nursing, Jilin University, No 965, Xin Jiang Avenue, Changchun, 130000, Jilin Province, China
| | - X Zhang
- School of Nursing, Jilin University, No 965, Xin Jiang Avenue, Changchun, 130000, Jilin Province, China
| | - Y Pang
- School of Nursing, Jilin University, No 965, Xin Jiang Avenue, Changchun, 130000, Jilin Province, China
| | - W Zhang
- School of Nursing, Jilin University, No 965, Xin Jiang Avenue, Changchun, 130000, Jilin Province, China
| | - T Z Yu
- School of Nursing, Jilin University, No 965, Xin Jiang Avenue, Changchun, 130000, Jilin Province, China
| | - F Li
- School of Nursing, Jilin University, No 965, Xin Jiang Avenue, Changchun, 130000, Jilin Province, China.
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10
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Shen M, Li Y, Ding X, Xu L, Li F, Lin H. Effect of active cycle of breathing techniques in patients with chronic obstructive pulmonary disease: a systematic review of intervention. Eur J Phys Rehabil Med 2020; 56:625-632. [DOI: 10.23736/s1973-9087.20.06144-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Leemans G, Belmans D, Van Holsbeke C, Kushnarev V, Sugget J, Ides K, Vissers D, De Backer W. A Functional Respiratory Imaging Approach to the Effect of an Oscillating Positive Expiratory Pressure Device in Chronic Obstructive Pulmonary Disease. Int J Chron Obstruct Pulmon Dis 2020; 15:1261-1268. [PMID: 32581531 PMCID: PMC7280059 DOI: 10.2147/copd.s242191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 05/03/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose Chronic obstructive pulmonary disease (COPD) patients are prone to suffer from chronic bronchitis, which ultimately affects their quality of life and overall prognosis. Oscillating positive expiratory pressure (oPEP) devices are designed to aid in the mucus clearance by generating positive pressure pulses in the airways. The main aim of this study was to analyze the impact of a specific oPEP device - Aerobika® - on top of standard of care medication in COPD patients' lung dynamics and drug deposition. Patients and Methods In this single-arm pilot study, patients were assessed using standard spirometry tests and functional respiratory imaging (FRI) before and after a period of 15±3 days of using the oPEP device twice daily (before their standard medication). Results The utilization of the oPEP device led to a significant increase of 2.88% in specific airway volume after two weeks (1.44 (SE: 0.18) vs 1.48 (SE: 0.19); 95% CI = [0.03%,5.81%]; p=0.048). Moreover, the internal airflow distribution (IAD) was affected by the treatment: patients' changes ranged from -6.74% to 4.51%. Furthermore, IAD changes at the lower lobes were also directly correlated with variations in forced expiratory volume in one second and peak expiratory flow; conversely, IAD changes at the upper lobes were inversely correlated with these clinical parameters. Interestingly, this change in IAD was significantly correlated with changes in lobar drug deposition (r 2=0.30, p<0.001). Conclusion Our results support that the Aerobika device utilization leads to an improved airflow, which in turn causes a shift in IAD and impacts the drug deposition patterns of the concomitant medication in patients with COPD.
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Affiliation(s)
- Glenn Leemans
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Wilrijk, Belgium.,FLUIDDA nv, Antwerp, Kontich, Belgium
| | | | | | | | - Jason Sugget
- Trudell Medical International, London, Ontario, Canada
| | - Kris Ides
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Wilrijk, Belgium
| | - Dirk Vissers
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Wilrijk, Belgium
| | - Wilfried De Backer
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Wilrijk, Belgium
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12
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Liverani B, Nava S, Polastri M. An integrative review on the positive expiratory pressure (PEP)-bottle therapy for patients with pulmonary diseases. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2019; 25:e1823. [PMID: 31762162 DOI: 10.1002/pri.1823] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Revised: 09/19/2019] [Accepted: 11/01/2019] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND PURPOSE Positive expiratory pressure (PEP)-bottle device delivers a PEP within a range of 10-20 cmH2 O. PEP treatment is applied to different pathological conditions also in combination with other physiotherapeutic techniques. The primary aim of the present review was to investigate the effects of PEP-bottle therapy in patients with pulmonary diseases and, secondarily, to provide a physiological analysis of its use. METHODS The databases PubMed, Scopus, Web of Science, Cinahl, and Cochrane Library were searched for citations published from their inception until May 2019. Adult participants (>18 years) with pulmonary disease who underwent PEP-bottle treatment, with no restriction on gender, were included in the study. There were no restrictions about the therapeutic settings and the condition of the disease (either acute or chronic). RESULTS The literature review returned 97 citations. After duplicates removal, the remaining 77 articles have been screened: 66 have been assessed as not eligible at first because the abstract did not meet the inclusion criteria. Eleven articles were left after the first two steps of selection: four have been excluded after full-text reading. CONCLUSION PEP-bottle therapy has been proved to improve lung volume, to reduce hyperinflation, and to remove secretions. The device delivers a pressure equal to the water column only if the inner diameter of the tubing and the width of the air escape orifice are equal or greater than 8 mm, and the length of tubing ranges between 20 and 80 cm. The cost of a PEP-bottle device is significantly lower if compared with other commercially available devices having the same therapeutic purposes.
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Affiliation(s)
- Benedetta Liverani
- Department of Clinical, Integrated and Experimental Medicine (DIMES), Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Stefano Nava
- Department of Clinical, Integrated and Experimental Medicine (DIMES), Alma Mater Studiorum-University of Bologna, Bologna, Italy.,Respiratory and Critical Care Unit, St Orsola University Hospital, Bologna, Italy
| | - Massimiliano Polastri
- Department of Continuity of Care and Disability, Physical Medicine and Rehabilitation, St Orsola University Hospital, Bologna, Italy
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13
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Hajian B, De Backer J, Vos W, Van Holsbeke C, Clukers J, De Backer W. Functional respiratory imaging (FRI) for optimizing therapy development and patient care. Expert Rev Respir Med 2018; 10:193-206. [PMID: 26731531 DOI: 10.1586/17476348.2016.1136216] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Functional imaging techniques offer the possibility of improved visualization of anatomical structures such as; airways, lobe volumes and blood vessels. Computer-based flow simulations with a three-dimensional element add functionality to the images. By providing valuable detailed information about airway geometry, internal airflow distribution and inhalation profile, functional respiratory imaging can be of use routinely in the clinic. Three dimensional visualization allows for highly detailed follow-up in terms of disease progression or in assessing effects of interventions. Here, we explore the usefulness of functional respiratory imaging in different respiratory diseases. In patients with asthma and COPD, functional respiratory imaging has been used for phenotyping these patients, to predict the responder and non-responder phenotype and to evaluate different innovative therapeutic interventions.
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Affiliation(s)
- Bita Hajian
- a Department of Respiratory Medicine , University Hospital Antwerp , Edegem , Belgium
| | | | - Wim Vos
- b FLUIDDA nv , Kontich , Belgium
| | | | - Johan Clukers
- a Department of Respiratory Medicine , University Hospital Antwerp , Edegem , Belgium
| | - Wilfried De Backer
- a Department of Respiratory Medicine , University Hospital Antwerp , Edegem , Belgium
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14
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D'Abrosca F, Garabelli B, Savio G, Barison A, Appendini L, Oliveira LVF, Baiardi P, Balbi B. Comparing airways clearance techniques in chronic obstructive pulmonary disease and bronchiectasis: positive expiratory pressure or temporary positive expiratory pressure? A retrospective study. Braz J Phys Ther 2017; 21:15-23. [PMID: 28442070 PMCID: PMC5537431 DOI: 10.1016/j.bjpt.2016.12.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 10/28/2015] [Accepted: 03/29/2016] [Indexed: 11/10/2022] Open
Abstract
Patients with chronic hypersecretion (CH) of tracheobronchial mucus are a clinical challenge. They have an impaired quality of life, frequent exacerbations, and hospitalizations with need of antibiotics and other type of expensive treatments. Chest physical therapy evolved along the last decades and new techniques are currently used to help patients clear the airways efficiently. Among these airway clearance techniques (ACTs), the use of positive expiratory pressure (PEP) is considered one of the most effective. We report the retrospective evaluation of 162 patients with CH due to chronic obstructive pulmonary disease or bronchiectasis undergoing ACT in our Pulmonary Rehabilitation Department. They were treated either with PEP or with a new PEP device called UNIKO®, which applies PEP in a temporary manner (TPEP). Comparing the two groups of patients, both treatments (i.e., PEP and TPEP) were followed by great improvements in physiological parameters of spirometry and gas exchange. However, subdividing patients, it was evident that TPEP had better effects than PEP in patients with emphysema and in patients on long-term oxygen treatment, while PEP was superior at least in some parameters in patients on mechanical ventilation. This study, albeit retrospective and calling for controlled clinical trials, suggests that different ACTs can be applied in different populations of patients.
Background Airway clearance techniques include positive expiratory pressure, commonly used in our clinical practice, and a recently introduced temporary positive expiratory pressure device called UNIKO®. It is unclear which one provides the best benefit to patients. Objectives The aim of this observational 4-year study was to retrospectively compare the efficacy of and specific indications for temporary positive expiratory pressure compared to positive expiratory pressure in a standard rehabilitation program. Method We retrospectively collected data from 162 subjects (107 males, mean age 70 ± 9 years, 97 with primary diagnosis of chronic obstructive pulmonary disease, 65 with bronchiectasis), 51 treated with temporary positive expiratory pressure and 111 with positive expiratory pressure. Results Subjects showed significant improvement in ratio of partial pressure arterial oxygen and fraction of inspired oxygen (p < 0.001), forced vital capacity, forced expiratory volume in one second, peak expiratory flow, arterial oxygen saturation, and partial pressure arterial oxygen with no significant difference between positive expiratory pressure and temporary positive expiratory pressure groups apart from forced expiratory flow, which increased only in the positive expiratory pressure group. Evaluating specific subgroups, temporary positive expiratory pressure was more effective than positive expiratory pressure in improving gas transfer in subjects with emphysema and in those on oxygen therapy, as the effective supplement oxygen flow decreased significantly (p = 0.034 and 0.046 respectively for temporary positive expiratory pressure vs. positive expiratory pressure). In subjects on mechanical ventilation, positive expiratory pressure was superior to temporary positive expiratory pressure in increasing forced expiratory flow (p = 0.018). Conclusion The physiological parameters of both groups improved significantly and similarly. Subgroup analysis suggests that temporary positive expiratory pressure could provide some advantage to subjects with emphysema and those on oxygen therapy, while positive expiratory pressure would benefit patients on mechanical ventilation. Randomized clinical trials are necessary to confirm our preliminary results indicating that different subgroups/phenotypes can benefit more from one type of treatment.
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Affiliation(s)
- Francesco D'Abrosca
- Divisione di Pneumologia Riabilitativa, Fondazione Salvatore Maugeri, I.R.C.C.S., Centro Medico di Veruno, Veruno, NO, Italy; Fondazione IRCCS Ca' Granda - Ospedale Maggiore Policlinico Milano, Milano, MI, Italy.
| | - Barbara Garabelli
- Divisione di Pneumologia Riabilitativa, Fondazione Salvatore Maugeri, I.R.C.C.S., Centro Medico di Veruno, Veruno, NO, Italy; NEMO Center - Centro Clinico NEMO, Ospedale Niguarda Cà Granda, Milano, Milano, MI, Italy
| | - Gloria Savio
- Divisione di Pneumologia Riabilitativa, Fondazione Salvatore Maugeri, I.R.C.C.S., Centro Medico di Veruno, Veruno, NO, Italy
| | - Agnese Barison
- Divisione di Pneumologia Riabilitativa, Fondazione Salvatore Maugeri, I.R.C.C.S., Centro Medico di Veruno, Veruno, NO, Italy
| | - Lorenzo Appendini
- Divisione di Pneumologia Riabilitativa, Fondazione Salvatore Maugeri, I.R.C.C.S., Centro Medico di Veruno, Veruno, NO, Italy
| | - Luis V F Oliveira
- Programa de Pós-Graduação em Ciências da Reabilitação, Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil
| | - Paola Baiardi
- Direzione Scientifica Centrale, Fondazione Salvatore Maugeri, I.R.C.C.S., Pavia, PV, Italy
| | - Bruno Balbi
- Divisione di Pneumologia Riabilitativa, Fondazione Salvatore Maugeri, I.R.C.C.S., Centro Medico di Veruno, Veruno, NO, Italy
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15
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Cabillic M, Gouilly P, Reychler G. [Manual airway clearance techniques in adults and adolescents: What level of evidence?]. Rev Mal Respir 2016; 35:495-520. [PMID: 27086120 DOI: 10.1016/j.rmr.2015.12.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND The aim of this systematic literature review was to grade the levels of evidence of the most widely used manual airway clearance techniques. METHODS A literature search was conducted over the period 1995-2014 from the Medline, PEDro, ScienceDirect, Cochrane Library, REEDOC and kinedoc databases, with the following keywords: "postural drainage", "manual vibrations", "manual chest percussion", "directed cough", "increased expiratory flow", "ELTGOL", "autogenic drainage" and "active cycle of breathing technique". RESULTS Two-hundred and fifty-six articles were identified. After removing duplicates and reading the titles and abstracts, 63 articles were selected, including 9 systematic reviews. This work highlights the lack of useful scientific data and the difficulty of determining levels of evidence for manual airway clearance techniques. Techniques were assessed principally with patients with sputum production (cystic fibrosis, DDB, COPD, etc.). It also shows the limited pertinence of outcome measures to quantify congestion and hence the efficacy of airway clearance techniques. CONCLUSION The 1994 consensus conference summary table classifying airway clearance techniques according to physical mechanism provides an interesting tool for assessment, grouping together techniques having identical mechanisms of action. From the findings of the present systematic review, it appears that only ELTGOL, autogenic drainage and ACBT present levels of evidence "B". All other techniques have lower levels of evidence. LEVEL OF EVIDENCE II.
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Affiliation(s)
- Michel Cabillic
- IFMK de Rennes (IFPEK), 12, rue Jean-louis-Bertrand, 35000 Rennes, France; IFMK de Nantes (IFM3R), 54, rue de la Baugerie, 44230 Saint-Sébastien-sur-Loire, France.
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16
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Davidson AC, Banham S, Elliott M, Kennedy D, Gelder C, Glossop A, Church AC, Creagh-Brown B, Dodd JW, Felton T, Foëx B, Mansfield L, McDonnell L, Parker R, Patterson CM, Sovani M, Thomas L. BTS/ICS guideline for the ventilatory management of acute hypercapnic respiratory failure in adults. Thorax 2016; 71 Suppl 2:ii1-35. [DOI: 10.1136/thoraxjnl-2015-208209] [Citation(s) in RCA: 195] [Impact Index Per Article: 24.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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17
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Osadnik CR, McDonald CF, Holland AE. Advances in airway clearance technologies for chronic obstructive pulmonary disease. Expert Rev Respir Med 2014; 7:673-85. [PMID: 24224510 DOI: 10.1586/17476348.2013.847368] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Techniques to promote clearance of sputum from the airways (airway clearance techniques; ACTs) have existed in clinical practice for more than a century. This review examines current evidence and clinical recommendations regarding ACTs for individuals with chronic obstructive pulmonary disease. Comparisons between this literature and reports of current practice suggest that discrepancies may exist in relation to the clinical management of sputum in individuals with COPD. The novel application of newer technologies has enhanced our ability to assess the complex physiological processes underpinning airway clearance therapy. The potential for physiologically tailored ACT prescription may, however, depend on the capacity for translation of such technology from the research setting into the clinical environment. Future directions regarding this common form of therapy will be discussed, including identification of the key research priorities to optimize evidence-based practice in this area.
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18
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Esguerra-Gonzalez A, Ilagan-Honorio M, Fraschilla S, Kehoe P, Lee AJ, Marcarian T, Mayol-Ngo K, Miller PS, Onga J, Rodman B, Ross D, Sommer S, Takayanagi S, Toyama J, Villamor F, Weigt SS, Gawlinski A. CNE article: pain after lung transplant: high-frequency chest wall oscillation vs chest physiotherapy. Am J Crit Care 2013; 22:115-24. [PMID: 23455861 DOI: 10.4037/ajcc2013869] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Background Chest physiotherapy and high-frequency chest wall oscillation (HFCWO) are routinely used after lung transplant to facilitate removal of secretions. To date, no studies have been done to investigate which therapy is more comfortable and preferred by lung transplant recipients. Patients who have less pain may mobilize secretions, heal, and recover faster. Objectives To compare effects of HFCWO versus chest physiotherapy on pain and preference in lung transplant recipients. Methods In a 2-group experimental, repeated-measures design, 45 lung transplant recipients (27 single lung, 18 bilateral) were randomized to chest physiotherapy (10 AM, 2 PM) followed by HFCWO (6 PM, 10 PM; group 1, n=22) or vice versa (group 2, n=23) on postoperative day 3. A verbal numeric rating scale was used to measure pain before and after treatment. At the end of the treatment sequence, a 4-item patient survey was administered to assess treatment preference, pain, and effectiveness. Data were analyzed with χ(2) and t tests and repeated-measures analysis of variance. Results A significant interaction was found between mean difference in pain scores from before to after treatment and treatment method; pain scores decreased more when HFCWO was done at 10 AM and 6 PM (P =.04). Bilateral transplant recipients showed a significant preference for HFCWO over chest physiotherapy (11 [85%] vs 2 [15%], P=.01). However, single lung recipients showed no significant difference in preference between the 2 treatments (11 [42%] vs 14 [54%]). Conclusions HFCWO seems to provide greater decreases in pain scores than does chest physiotherapy. Bilateral lung transplant recipients preferred HFCWO to chest physiotherapy. HFCWO may be an effective, feasible alternative to chest physiotherapy. (American Journal of Critical Care. 2013;22:115-125).
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Affiliation(s)
- Angeli Esguerra-Gonzalez
- Angeli Esguerra-Gonzalez, Monina Ilagan-Honorio, Ai Jin Lee, Taline Marcarian, Kristina Mayol-Ngo, Betty Rodman, Susan Sommer, and Filma Villamor are nurses in the cardiothoracic intensive care unit at Ronald Reagan University of California Los Angeles Medical Center
| | - Monina Ilagan-Honorio
- Angeli Esguerra-Gonzalez, Monina Ilagan-Honorio, Ai Jin Lee, Taline Marcarian, Kristina Mayol-Ngo, Betty Rodman, Susan Sommer, and Filma Villamor are nurses in the cardiothoracic intensive care unit at Ronald Reagan University of California Los Angeles Medical Center
| | - Stephanie Fraschilla
- Stephanie Fraschilla and Jay Onga are transplant coordinators for the heart and lung transplant program at Ronald Reagan University of California Los Angeles Medical Center
| | - Priscilla Kehoe
- Priscilla Kehoe is the director of research and Sumiko Takayanagi is a senior statistician in the School of Nursing at the University of California Los Angeles
| | - Ai Jin Lee
- Angeli Esguerra-Gonzalez, Monina Ilagan-Honorio, Ai Jin Lee, Taline Marcarian, Kristina Mayol-Ngo, Betty Rodman, Susan Sommer, and Filma Villamor are nurses in the cardiothoracic intensive care unit at Ronald Reagan University of California Los Angeles Medical Center
| | - Taline Marcarian
- Angeli Esguerra-Gonzalez, Monina Ilagan-Honorio, Ai Jin Lee, Taline Marcarian, Kristina Mayol-Ngo, Betty Rodman, Susan Sommer, and Filma Villamor are nurses in the cardiothoracic intensive care unit at Ronald Reagan University of California Los Angeles Medical Center
| | - Kristina Mayol-Ngo
- Angeli Esguerra-Gonzalez, Monina Ilagan-Honorio, Ai Jin Lee, Taline Marcarian, Kristina Mayol-Ngo, Betty Rodman, Susan Sommer, and Filma Villamor are nurses in the cardiothoracic intensive care unit at Ronald Reagan University of California Los Angeles Medical Center
| | - Pamela S. Miller
- Pamela S. Miller is a postdoctoral scholar in the School of Nursing at the University of California San Francisco
| | - Jay Onga
- Stephanie Fraschilla and Jay Onga are transplant coordinators for the heart and lung transplant program at Ronald Reagan University of California Los Angeles Medical Center
| | - Betty Rodman
- Angeli Esguerra-Gonzalez, Monina Ilagan-Honorio, Ai Jin Lee, Taline Marcarian, Kristina Mayol-Ngo, Betty Rodman, Susan Sommer, and Filma Villamor are nurses in the cardiothoracic intensive care unit at Ronald Reagan University of California Los Angeles Medical Center
| | - David Ross
- David Ross is a physician, professor, and medical director of the lung and heart-lung transplant program and S. Samuel Weigt is a physician and assistant professor in the Division of Pulmonary and Critical Care Medicine at David Geffen School of Medicine at University of California Los Angeles Medical Center
| | - Susan Sommer
- Angeli Esguerra-Gonzalez, Monina Ilagan-Honorio, Ai Jin Lee, Taline Marcarian, Kristina Mayol-Ngo, Betty Rodman, Susan Sommer, and Filma Villamor are nurses in the cardiothoracic intensive care unit at Ronald Reagan University of California Los Angeles Medical Center
| | - Sumiko Takayanagi
- Priscilla Kehoe is the director of research and Sumiko Takayanagi is a senior statistician in the School of Nursing at the University of California Los Angeles
| | - Joy Toyama
- Joy Toyama is a DrPH student in the Department of Biostatistics and a graduate student researcher in the School of Nursing at the University of California Los Angeles
| | - Filma Villamor
- Angeli Esguerra-Gonzalez, Monina Ilagan-Honorio, Ai Jin Lee, Taline Marcarian, Kristina Mayol-Ngo, Betty Rodman, Susan Sommer, and Filma Villamor are nurses in the cardiothoracic intensive care unit at Ronald Reagan University of California Los Angeles Medical Center
| | - S. Samuel Weigt
- David Ross is a physician, professor, and medical director of the lung and heart-lung transplant program and S. Samuel Weigt is a physician and assistant professor in the Division of Pulmonary and Critical Care Medicine at David Geffen School of Medicine at University of California Los Angeles Medical Center
| | - Anna Gawlinski
- Anna Gawlinski is the director of research and evidence-based practice at Ronald Reagan University of California Los Angeles Medical Center and adjunct professor in the School of Nursing at the University of California Los Angeles
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Ides K, Vos W, De Backer L, Vissers D, Claes R, Leemans G, Ongena K, Peters O, De Backer W. Acute effects of intrapulmonary percussive ventilation in COPD patients assessed by using conventional outcome parameters and a novel computational fluid dynamics technique. Int J Chron Obstruct Pulmon Dis 2012; 7:667-71. [PMID: 23055715 PMCID: PMC3459658 DOI: 10.2147/copd.s29847] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2012] [Indexed: 11/23/2022] Open
Abstract
Objective: Chest physiotherapy enhances sputum evacuation in COPD patients. It can be applied as a single technique or as a combination of techniques including intrapulmonary percussive ventilation (IPV). Recently developed assessment techniques may provide new insights into the effect of airway clearance techniques. Participants: Five moderate to severe COPD patients (three females and two males; mean forced expiratory volume in 1 second of 39.49% predicted) who were admitted in the hospital for an acute exacerbation were included in this study. Methods: A novel imaging technique was used, together with other conventional techniques, to visualize the short-term effects of a single IPV treatment in COPD patients. Results: No significant changes were noted in the lung function parameters or arterial blood gases measured within 1 hour after the end of the IPV session. Computed tomography images detected changes in the airway patency after the IPV treatment compared with before treatment. Local resistances, calculated for the three-dimensional models, showed local changes in airway resistance. Conclusion: The effects of a single IPV session can be visualized by functional imaging. This functional imaging allows a calculation of changes in local airway resistance and local changes in airway volume in COPD patients without affecting conventional lung function parameters.
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Affiliation(s)
- Kris Ides
- Department of Health Science, Artesis University College of Antwerp, Merksem, Belgium.
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20
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Cross J. Chest physiotherapy during an acute exacerbation of chronic obstructive pulmonary disease. Chron Respir Dis 2012; 9:73-5. [PMID: 22653291 DOI: 10.1177/1479972312445572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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