T1: Muñoz et al., 2018(1414 Muñoz G, Gracia J, Buxó M, Alvarez A, Vendrell M. Long-term benefits of airway clearance in bronchiectasis: a randomised placebo-controlled trial. Eur Respir J. 2018;51(1):1701926. https://doi.org/10.1183/13993003.01926-2017 https://doi.org/10.1183/13993003.01926-2...
) Randomized controlled trial |
Evaluate the effectiveness of the ELTGOL technique in respiratory function and elimination of secretions(1414 Muñoz G, Gracia J, Buxó M, Alvarez A, Vendrell M. Long-term benefits of airway clearance in bronchiectasis: a randomised placebo-controlled trial. Eur Respir J. 2018;51(1):1701926. https://doi.org/10.1183/13993003.01926-2017 https://doi.org/10.1183/13993003.01926-2...
). n = 44. Experimental group (EG): n = 22; age: 63.1±13.5 years. Control (CG)/placebo group: n = 22; age: 66.8±8.4 years(1414 Muñoz G, Gracia J, Buxó M, Alvarez A, Vendrell M. Long-term benefits of airway clearance in bronchiectasis: a randomised placebo-controlled trial. Eur Respir J. 2018;51(1):1701926. https://doi.org/10.1183/13993003.01926-2017 https://doi.org/10.1183/13993003.01926-2...
). |
EG: ELTGOL technique with thoracoabdominal compressions(1414 Muñoz G, Gracia J, Buxó M, Alvarez A, Vendrell M. Long-term benefits of airway clearance in bronchiectasis: a randomised placebo-controlled trial. Eur Respir J. 2018;51(1):1701926. https://doi.org/10.1183/13993003.01926-2017 https://doi.org/10.1183/13993003.01926-2...
). CG / placebo: stretching exercises for the upper limbs(1414 Muñoz G, Gracia J, Buxó M, Alvarez A, Vendrell M. Long-term benefits of airway clearance in bronchiectasis: a randomised placebo-controlled trial. Eur Respir J. 2018;51(1):1701926. https://doi.org/10.1183/13993003.01926-2017 https://doi.org/10.1183/13993003.01926-2...
). |
- Greater clearance of secretions within 24 hours after the first assessment and fewer exacerbations in the EG; - Significant improvement in quality of life (QL) and impact of coughing on the EG(1414 Muñoz G, Gracia J, Buxó M, Alvarez A, Vendrell M. Long-term benefits of airway clearance in bronchiectasis: a randomised placebo-controlled trial. Eur Respir J. 2018;51(1):1701926. https://doi.org/10.1183/13993003.01926-2017 https://doi.org/10.1183/13993003.01926-2...
). |
T2: Ozalp et al., 2018(1515 Ozalp O, Inal-Ince D, Cakmak A, Calik-Kutukcu E, Saglam M, Savci S, et al. High-intensity inspiratory muscle training in bronchiectasis: a randomized controlled trial. Respirology. 2018;24(3):246-53. https://doi.org/10.1111/resp.13397 https://doi.org/10.1111/resp.13397...
) Randomized controlled trial |
Evaluate the impact of high intensity inspiratory muscle training (H-IMT)(1515 Ozalp O, Inal-Ince D, Cakmak A, Calik-Kutukcu E, Saglam M, Savci S, et al. High-intensity inspiratory muscle training in bronchiectasis: a randomized controlled trial. Respirology. 2018;24(3):246-53. https://doi.org/10.1111/resp.13397 https://doi.org/10.1111/resp.13397...
). n = 45. EG: n = 23; age: 42.22±14.3 years. CG: n=22; age: 45.95±11.26 years old(1515 Ozalp O, Inal-Ince D, Cakmak A, Calik-Kutukcu E, Saglam M, Savci S, et al. High-intensity inspiratory muscle training in bronchiectasis: a randomized controlled trial. Respirology. 2018;24(3):246-53. https://doi.org/10.1111/resp.13397 https://doi.org/10.1111/resp.13397...
). |
Experimental group: H-IMT with gradual increase in intensity throughout training(1515 Ozalp O, Inal-Ince D, Cakmak A, Calik-Kutukcu E, Saglam M, Savci S, et al. High-intensity inspiratory muscle training in bronchiectasis: a randomized controlled trial. Respirology. 2018;24(3):246-53. https://doi.org/10.1111/resp.13397 https://doi.org/10.1111/resp.13397...
). Control group: low intensity inspiratory muscle training, maintaining the same intensity(1515 Ozalp O, Inal-Ince D, Cakmak A, Calik-Kutukcu E, Saglam M, Savci S, et al. High-intensity inspiratory muscle training in bronchiectasis: a randomized controlled trial. Respirology. 2018;24(3):246-53. https://doi.org/10.1111/resp.13397 https://doi.org/10.1111/resp.13397...
). |
- Lower values on the dyspnea scale; higher values in the social aspects of the QoL scale and higher number of hospitalizations in the EG; - Decrease in fatigue in both groups(1515 Ozalp O, Inal-Ince D, Cakmak A, Calik-Kutukcu E, Saglam M, Savci S, et al. High-intensity inspiratory muscle training in bronchiectasis: a randomized controlled trial. Respirology. 2018;24(3):246-53. https://doi.org/10.1111/resp.13397 https://doi.org/10.1111/resp.13397...
). |
T3: Liao et al., 2015(1616 Liao L-Y, Chen K-M, Chung W-S, Chien J-Y. Efficacy of a respiratory rehabilitation exercise training package in hospitalized elderly patients with acute exacerbation of COPD: a randomized control trial. Int J Chron Obstruct Pulmon Dis. 2015;10(1):1703-9. http://doi.org/10.2147/COPD.S90673 http://doi.org/10.2147/COPD.S90673...
) Randomized controlled trial |
Evaluate the effects of FRR regarding dyspnea, cough, exercise tolerance, and sputum production(1616 Liao L-Y, Chen K-M, Chung W-S, Chien J-Y. Efficacy of a respiratory rehabilitation exercise training package in hospitalized elderly patients with acute exacerbation of COPD: a randomized control trial. Int J Chron Obstruct Pulmon Dis. 2015;10(1):1703-9. http://doi.org/10.2147/COPD.S90673 http://doi.org/10.2147/COPD.S90673...
). n = 61. EG: n = 30; age: 68 years (44%-89%). CG: n=31; age: 70 years (52%-91%)(1616 Liao L-Y, Chen K-M, Chung W-S, Chien J-Y. Efficacy of a respiratory rehabilitation exercise training package in hospitalized elderly patients with acute exacerbation of COPD: a randomized control trial. Int J Chron Obstruct Pulmon Dis. 2015;10(1):1703-9. http://doi.org/10.2147/COPD.S90673 http://doi.org/10.2147/COPD.S90673...
). |
Experimental group (components of FRR): health education, postural drainage associated with percussion, breathing with semi-closed lips, mobilization of the upper limbs and walking training / mobilization of the lower limbs with breathing control(1616 Liao L-Y, Chen K-M, Chung W-S, Chien J-Y. Efficacy of a respiratory rehabilitation exercise training package in hospitalized elderly patients with acute exacerbation of COPD: a randomized control trial. Int J Chron Obstruct Pulmon Dis. 2015;10(1):1703-9. http://doi.org/10.2147/COPD.S90673 http://doi.org/10.2147/COPD.S90673...
). Control group: usual health care and health education sessions(1616 Liao L-Y, Chen K-M, Chung W-S, Chien J-Y. Efficacy of a respiratory rehabilitation exercise training package in hospitalized elderly patients with acute exacerbation of COPD: a randomized control trial. Int J Chron Obstruct Pulmon Dis. 2015;10(1):1703-9. http://doi.org/10.2147/COPD.S90673 http://doi.org/10.2147/COPD.S90673...
). |
- Dyspnea and coughing spells decreased, and exercise tolerance and the ability to expectorate increased in the EG(1616 Liao L-Y, Chen K-M, Chung W-S, Chien J-Y. Efficacy of a respiratory rehabilitation exercise training package in hospitalized elderly patients with acute exacerbation of COPD: a randomized control trial. Int J Chron Obstruct Pulmon Dis. 2015;10(1):1703-9. http://doi.org/10.2147/COPD.S90673 http://doi.org/10.2147/COPD.S90673...
). |
T4: Dwyer et al., 2017(1717 Dwyer TJ, Zainuldin R, Daviskas E, Bye PTP, Alison JA. Effects of treadmill exercise versus Flutter® on respiratory flow and sputum properties in adults with cystic fibrosis: a randomised, controlled, cross-over trial. BMC Pulm Med. 2017;17(14):14. https://doi.org/10.1186/s12890-016-0360-8 https://doi.org/10.1186/s12890-016-0360-...
) Randomized controlled crossover trial |
Evaluate the effects of exercises performed on a treadmill and with the Flutter®for airway clearance(1717 Dwyer TJ, Zainuldin R, Daviskas E, Bye PTP, Alison JA. Effects of treadmill exercise versus Flutter® on respiratory flow and sputum properties in adults with cystic fibrosis: a randomised, controlled, cross-over trial. BMC Pulm Med. 2017;17(14):14. https://doi.org/10.1186/s12890-016-0360-8 https://doi.org/10.1186/s12890-016-0360-...
). n = 25. Age: 30±8 years (19%-48%)(1717 Dwyer TJ, Zainuldin R, Daviskas E, Bye PTP, Alison JA. Effects of treadmill exercise versus Flutter® on respiratory flow and sputum properties in adults with cystic fibrosis: a randomised, controlled, cross-over trial. BMC Pulm Med. 2017;17(14):14. https://doi.org/10.1186/s12890-016-0360-8 https://doi.org/10.1186/s12890-016-0360-...
). |
Treadmill intervention: 20 minutes of constant exercise(1717 Dwyer TJ, Zainuldin R, Daviskas E, Bye PTP, Alison JA. Effects of treadmill exercise versus Flutter® on respiratory flow and sputum properties in adults with cystic fibrosis: a randomised, controlled, cross-over trial. BMC Pulm Med. 2017;17(14):14. https://doi.org/10.1186/s12890-016-0360-8 https://doi.org/10.1186/s12890-016-0360-...
). Flutter®intervention: breathing 15 times through the device, followed by deep breathing, coughing and huffing. Cycle repeated 6 times(1717 Dwyer TJ, Zainuldin R, Daviskas E, Bye PTP, Alison JA. Effects of treadmill exercise versus Flutter® on respiratory flow and sputum properties in adults with cystic fibrosis: a randomised, controlled, cross-over trial. BMC Pulm Med. 2017;17(14):14. https://doi.org/10.1186/s12890-016-0360-8 https://doi.org/10.1186/s12890-016-0360-...
). Control intervention: sitting quietly for 20 minutes(1717 Dwyer TJ, Zainuldin R, Daviskas E, Bye PTP, Alison JA. Effects of treadmill exercise versus Flutter® on respiratory flow and sputum properties in adults with cystic fibrosis: a randomised, controlled, cross-over trial. BMC Pulm Med. 2017;17(14):14. https://doi.org/10.1186/s12890-016-0360-8 https://doi.org/10.1186/s12890-016-0360-...
). Participants were randomly assigned to the three interventions, performing them(1717 Dwyer TJ, Zainuldin R, Daviskas E, Bye PTP, Alison JA. Effects of treadmill exercise versus Flutter® on respiratory flow and sputum properties in adults with cystic fibrosis: a randomised, controlled, cross-over trial. BMC Pulm Med. 2017;17(14):14. https://doi.org/10.1186/s12890-016-0360-8 https://doi.org/10.1186/s12890-016-0360-...
). |
- The treadmill and Flutter®intervention revealed identical and significant improvements in the expiratory flow peak and in the reduction of the mechanism preventing expectoration; - The Flutter®created a expiratory air flow trend; - The treadmill intervention promoted sputum hydration(1717 Dwyer TJ, Zainuldin R, Daviskas E, Bye PTP, Alison JA. Effects of treadmill exercise versus Flutter® on respiratory flow and sputum properties in adults with cystic fibrosis: a randomised, controlled, cross-over trial. BMC Pulm Med. 2017;17(14):14. https://doi.org/10.1186/s12890-016-0360-8 https://doi.org/10.1186/s12890-016-0360-...
). |
T5: Nicolini et al., 2018(1818 Nicolini A, Grecchi B, Ferrari-Bravo M, Barlascini C. Safety and effectiveness of the high-frequency chest wall oscillation vs intrapulmonary percussive ventilation in patients with severe COPD. Int J Chron Obstruct Pulmon Dis. 2018;13:617-25. http://doi.org/10.2147/COPD.S145440 http://doi.org/10.2147/COPD.S145440...
) Randomized controlled trial |
Evaluate whether pharmacological therapy in combination with two percussion techniques produce additional benefits in terms of respiratory function and performance of activities of daily living (ADL)(1818 Nicolini A, Grecchi B, Ferrari-Bravo M, Barlascini C. Safety and effectiveness of the high-frequency chest wall oscillation vs intrapulmonary percussive ventilation in patients with severe COPD. Int J Chron Obstruct Pulmon Dis. 2018;13:617-25. http://doi.org/10.2147/COPD.S145440 http://doi.org/10.2147/COPD.S145440...
). n = 63. IPV group: n = 20; age 72.8±6.1 years. HFCWO group: n=21; age: 73.8±5.9 years. GC: n=22; age: 74.9±2.7 years(1818 Nicolini A, Grecchi B, Ferrari-Bravo M, Barlascini C. Safety and effectiveness of the high-frequency chest wall oscillation vs intrapulmonary percussive ventilation in patients with severe COPD. Int J Chron Obstruct Pulmon Dis. 2018;13:617-25. http://doi.org/10.2147/COPD.S145440 http://doi.org/10.2147/COPD.S145440...
). |
IPV group (intrapulmonary percussive ventilation): pharmacological treatment along with the IPV device(1818 Nicolini A, Grecchi B, Ferrari-Bravo M, Barlascini C. Safety and effectiveness of the high-frequency chest wall oscillation vs intrapulmonary percussive ventilation in patients with severe COPD. Int J Chron Obstruct Pulmon Dis. 2018;13:617-25. http://doi.org/10.2147/COPD.S145440 http://doi.org/10.2147/COPD.S145440...
). HFCWO (high-frequency chest wall oscillation) group: pharmacological treatment along with the HFCWO device(1818 Nicolini A, Grecchi B, Ferrari-Bravo M, Barlascini C. Safety and effectiveness of the high-frequency chest wall oscillation vs intrapulmonary percussive ventilation in patients with severe COPD. Int J Chron Obstruct Pulmon Dis. 2018;13:617-25. http://doi.org/10.2147/COPD.S145440 http://doi.org/10.2147/COPD.S145440...
). Control group: pharmacological treatment(1818 Nicolini A, Grecchi B, Ferrari-Bravo M, Barlascini C. Safety and effectiveness of the high-frequency chest wall oscillation vs intrapulmonary percussive ventilation in patients with severe COPD. Int J Chron Obstruct Pulmon Dis. 2018;13:617-25. http://doi.org/10.2147/COPD.S145440 http://doi.org/10.2147/COPD.S145440...
). |
- Significant improvement in the IPV and HFCWO groups in relation to dyspnea and performance of ADL and pulmonary function (arterial blood gas values); - Significant improvement in maximal inspiratory and expiratory pressure in the IPV group, as well as greater efficiency in airway clearance and pulmonary muscle strengthening; - Similar results in cytological alterations of sputum with a decrease in inflammatory cells(1818 Nicolini A, Grecchi B, Ferrari-Bravo M, Barlascini C. Safety and effectiveness of the high-frequency chest wall oscillation vs intrapulmonary percussive ventilation in patients with severe COPD. Int J Chron Obstruct Pulmon Dis. 2018;13:617-25. http://doi.org/10.2147/COPD.S145440 http://doi.org/10.2147/COPD.S145440...
). |
T6: Marques et al., 2020(1919 Marques A, Pinho C, Francesco S, Martins P, Neves J, Oliveira A. A randomized controlled trial of respiratory physiotherapy in lower respiratory tract infections. Respir Med. 2020;162:105861. https://doi.org/10.1016/j.rmed.2019.105861 https://doi.org/10.1016/j.rmed.2019.1058...
) Randomized controlled trial |
To verify the effects of FRR, compared to traditional pharmacological care of the symptoms and functionality of people with lower respiratory tract infection (LRTI)(1919 Marques A, Pinho C, Francesco S, Martins P, Neves J, Oliveira A. A randomized controlled trial of respiratory physiotherapy in lower respiratory tract infections. Respir Med. 2020;162:105861. https://doi.org/10.1016/j.rmed.2019.105861 https://doi.org/10.1016/j.rmed.2019.1058...
). n = 115. EG: n = 55; age: 56.02±18.5 years. CG: n=60; age: 54.1±17.3 years old(1919 Marques A, Pinho C, Francesco S, Martins P, Neves J, Oliveira A. A randomized controlled trial of respiratory physiotherapy in lower respiratory tract infections. Respir Med. 2020;162:105861. https://doi.org/10.1016/j.rmed.2019.105861 https://doi.org/10.1016/j.rmed.2019.1058...
). |
Experimental group: conventional pharmacological treatment combined with FRR, which includes: breath control (breathing with semi-closed lips, rest and relaxation positions, and diaphragmatic breathing); CIFE and ELTGOL; ACBT technique, exercise training (mobilization of the trunk and upper and lower limbs, muscle strengthening, and stretching exercises) and health education sessions(1919 Marques A, Pinho C, Francesco S, Martins P, Neves J, Oliveira A. A randomized controlled trial of respiratory physiotherapy in lower respiratory tract infections. Respir Med. 2020;162:105861. https://doi.org/10.1016/j.rmed.2019.105861 https://doi.org/10.1016/j.rmed.2019.1058...
). Control group: conventional pharmacological treatment(1919 Marques A, Pinho C, Francesco S, Martins P, Neves J, Oliveira A. A randomized controlled trial of respiratory physiotherapy in lower respiratory tract infections. Respir Med. 2020;162:105861. https://doi.org/10.1016/j.rmed.2019.105861 https://doi.org/10.1016/j.rmed.2019.1058...
). |
- Both groups improved in all studied variables except for the values obtained in the modified Borg scale; - Improvement in terms of pulmonary crackle, oxygen saturation values, mMRC scale, and 6-minute walk test in the EG(1919 Marques A, Pinho C, Francesco S, Martins P, Neves J, Oliveira A. A randomized controlled trial of respiratory physiotherapy in lower respiratory tract infections. Respir Med. 2020;162:105861. https://doi.org/10.1016/j.rmed.2019.105861 https://doi.org/10.1016/j.rmed.2019.1058...
). |
T7: Nicolini et al., 2017(2020 Nicolini A, Mascardi V, Grecchi B, Ferrari-Bravo M, Banfi P, Barlascini C. Comparison of effectiveness of temporary positive expirayory pressure versus oscillatory positive expiratory pressure in severe COPD patients. Clin Respir J. 2017;12(3):1274-82. https://doi.org/10.1111/crj.12661 https://doi.org/10.1111/crj.12661...
) Randomized controlled trial |
To compare the effectiveness of two devices that use PEP in reducing exacerbations and improving respiratory function(2020 Nicolini A, Mascardi V, Grecchi B, Ferrari-Bravo M, Banfi P, Barlascini C. Comparison of effectiveness of temporary positive expirayory pressure versus oscillatory positive expiratory pressure in severe COPD patients. Clin Respir J. 2017;12(3):1274-82. https://doi.org/10.1111/crj.12661 https://doi.org/10.1111/crj.12661...
). n = 120. T-PEP group: n = 40; age: 72.15±1.2 years. O-PEP group: n=40; age: 70.67±2.1 years. CG: n=40; age: 71.13±1.9(2020 Nicolini A, Mascardi V, Grecchi B, Ferrari-Bravo M, Banfi P, Barlascini C. Comparison of effectiveness of temporary positive expirayory pressure versus oscillatory positive expiratory pressure in severe COPD patients. Clin Respir J. 2017;12(3):1274-82. https://doi.org/10.1111/crj.12661 https://doi.org/10.1111/crj.12661...
). |
O-PEP group: pharmacological therapy along with an oscillatory positive expiratory pressure (O-PEP) generator device(2020 Nicolini A, Mascardi V, Grecchi B, Ferrari-Bravo M, Banfi P, Barlascini C. Comparison of effectiveness of temporary positive expirayory pressure versus oscillatory positive expiratory pressure in severe COPD patients. Clin Respir J. 2017;12(3):1274-82. https://doi.org/10.1111/crj.12661 https://doi.org/10.1111/crj.12661...
). T-PEP group: pharmacological therapy along with a device that generates temporary positive expiratory pressure (T-PEP)(2020 Nicolini A, Mascardi V, Grecchi B, Ferrari-Bravo M, Banfi P, Barlascini C. Comparison of effectiveness of temporary positive expirayory pressure versus oscillatory positive expiratory pressure in severe COPD patients. Clin Respir J. 2017;12(3):1274-82. https://doi.org/10.1111/crj.12661 https://doi.org/10.1111/crj.12661...
). Control group: pharmacological therapy(2020 Nicolini A, Mascardi V, Grecchi B, Ferrari-Bravo M, Banfi P, Barlascini C. Comparison of effectiveness of temporary positive expirayory pressure versus oscillatory positive expiratory pressure in severe COPD patients. Clin Respir J. 2017;12(3):1274-82. https://doi.org/10.1111/crj.12661 https://doi.org/10.1111/crj.12661...
). |
- Only the T-PEP group statistically reduced exacerbations; - The use of the two devices resulted in improvements in the dyspnea scale, in pulmonary function, and in the COPD assessment test; - Both interventions were well tolerated(2020 Nicolini A, Mascardi V, Grecchi B, Ferrari-Bravo M, Banfi P, Barlascini C. Comparison of effectiveness of temporary positive expirayory pressure versus oscillatory positive expiratory pressure in severe COPD patients. Clin Respir J. 2017;12(3):1274-82. https://doi.org/10.1111/crj.12661 https://doi.org/10.1111/crj.12661...
). |
T8: Dwyer et al., 2019(2121 Dwyer TJ, Daviskas E, Zainuldin R, Verschuer J, Eberl S, Bye PTP, et al. Effects of exercise and airway clearance (positive expiratory pressure) on mucus clearance in cystic fibrosis: a randomised cross-over trial. Eur Respir J. 2019;53(4):1801793. https://doi.org/10.1183/13993003.01793-2018 https://doi.org/10.1183/13993003.01793-2...
) Randomized controlled crossover trial |
To compare the effect of exercise on a treadmill with the use of PEP in cleaning the airways at rest(2121 Dwyer TJ, Daviskas E, Zainuldin R, Verschuer J, Eberl S, Bye PTP, et al. Effects of exercise and airway clearance (positive expiratory pressure) on mucus clearance in cystic fibrosis: a randomised cross-over trial. Eur Respir J. 2019;53(4):1801793. https://doi.org/10.1183/13993003.01793-2018 https://doi.org/10.1183/13993003.01793-2...
). n = 15. Age: 27 years (18%-48%)(2121 Dwyer TJ, Daviskas E, Zainuldin R, Verschuer J, Eberl S, Bye PTP, et al. Effects of exercise and airway clearance (positive expiratory pressure) on mucus clearance in cystic fibrosis: a randomised cross-over trial. Eur Respir J. 2019;53(4):1801793. https://doi.org/10.1183/13993003.01793-2018 https://doi.org/10.1183/13993003.01793-2...
). |
Treadmill intervention: 20 minutes of constant exercise(2121 Dwyer TJ, Daviskas E, Zainuldin R, Verschuer J, Eberl S, Bye PTP, et al. Effects of exercise and airway clearance (positive expiratory pressure) on mucus clearance in cystic fibrosis: a randomised cross-over trial. Eur Respir J. 2019;53(4):1801793. https://doi.org/10.1183/13993003.01793-2018 https://doi.org/10.1183/13993003.01793-2...
). Intervention with PEP: breathing 15 times through the device, followed by deep breathing, coughing, and huffing. Cycle repeated 6 times for 20 minutes(2121 Dwyer TJ, Daviskas E, Zainuldin R, Verschuer J, Eberl S, Bye PTP, et al. Effects of exercise and airway clearance (positive expiratory pressure) on mucus clearance in cystic fibrosis: a randomised cross-over trial. Eur Respir J. 2019;53(4):1801793. https://doi.org/10.1183/13993003.01793-2018 https://doi.org/10.1183/13993003.01793-2...
). Control intervention: breath control sitting calmly for 20 minutes(2121 Dwyer TJ, Daviskas E, Zainuldin R, Verschuer J, Eberl S, Bye PTP, et al. Effects of exercise and airway clearance (positive expiratory pressure) on mucus clearance in cystic fibrosis: a randomised cross-over trial. Eur Respir J. 2019;53(4):1801793. https://doi.org/10.1183/13993003.01793-2018 https://doi.org/10.1183/13993003.01793-2...
). Participants were randomly assigned to the three interventions for participation(2121 Dwyer TJ, Daviskas E, Zainuldin R, Verschuer J, Eberl S, Bye PTP, et al. Effects of exercise and airway clearance (positive expiratory pressure) on mucus clearance in cystic fibrosis: a randomised cross-over trial. Eur Respir J. 2019;53(4):1801793. https://doi.org/10.1183/13993003.01793-2018 https://doi.org/10.1183/13993003.01793-2...
). |
- Exercise on a treadmill increased the clearance of secretions but was significantly less effective than intervention with PEP; - After the treadmill intervention, less sputum was eliminated from the central region of the lung compared to the PEP intervention; - PEP enabled more coughing spells than intervention on the treadmill(2121 Dwyer TJ, Daviskas E, Zainuldin R, Verschuer J, Eberl S, Bye PTP, et al. Effects of exercise and airway clearance (positive expiratory pressure) on mucus clearance in cystic fibrosis: a randomised cross-over trial. Eur Respir J. 2019;53(4):1801793. https://doi.org/10.1183/13993003.01793-2018 https://doi.org/10.1183/13993003.01793-2...
). |
T9: Simoni et al., 2019(2222 Simoni LHS, Santos DO, Souza HCD, Baddini-Martinez JA, Santos MK, Gastaldi AC. Acute effects of oscillatory PEP and thoracic compression on secretion removal and impedance of the respiratory system in non-cystic fibrosis bronchiectasis. Respir Care. 2019;64(7):818-27. https://doi.org/10.4187/respcare.06025 https://doi.org/10.4187/respcare.06025...
) Randomized controlled crossover trial |
Evaluate the short-term effect of O-PEP and chest compressions on airway clearance(2222 Simoni LHS, Santos DO, Souza HCD, Baddini-Martinez JA, Santos MK, Gastaldi AC. Acute effects of oscillatory PEP and thoracic compression on secretion removal and impedance of the respiratory system in non-cystic fibrosis bronchiectasis. Respir Care. 2019;64(7):818-27. https://doi.org/10.4187/respcare.06025 https://doi.org/10.4187/respcare.06025...
). n = 40. EG: n = 20; age: 57±14 years old. CG: n=20; age: 56±10 years old(2222 Simoni LHS, Santos DO, Souza HCD, Baddini-Martinez JA, Santos MK, Gastaldi AC. Acute effects of oscillatory PEP and thoracic compression on secretion removal and impedance of the respiratory system in non-cystic fibrosis bronchiectasis. Respir Care. 2019;64(7):818-27. https://doi.org/10.4187/respcare.06025 https://doi.org/10.4187/respcare.06025...
). |
Two groups were created: people with bronchiectasis (bronchiectasis group / EG) and healthy people (control group). Each group performed three sessions randomly, that is, three types of intervention: O-PEP (Flutter®) intervention; lower back reeducation intervention; control intervention (sitting quietly)(2222 Simoni LHS, Santos DO, Souza HCD, Baddini-Martinez JA, Santos MK, Gastaldi AC. Acute effects of oscillatory PEP and thoracic compression on secretion removal and impedance of the respiratory system in non-cystic fibrosis bronchiectasis. Respir Care. 2019;64(7):818-27. https://doi.org/10.4187/respcare.06025 https://doi.org/10.4187/respcare.06025...
). |
- The lower back reeducation intervention increased the amount of sputum eliminated, but O-PEP was more effective in the EG; - In the EG, there was a decrease in resistance to air passage through the airways; - There were no significant differences in acceptance, tolerance, dyspnea, and oxygen saturation(2222 Simoni LHS, Santos DO, Souza HCD, Baddini-Martinez JA, Santos MK, Gastaldi AC. Acute effects of oscillatory PEP and thoracic compression on secretion removal and impedance of the respiratory system in non-cystic fibrosis bronchiectasis. Respir Care. 2019;64(7):818-27. https://doi.org/10.4187/respcare.06025 https://doi.org/10.4187/respcare.06025...
). |