A randomised controlled equivalence trial to determine the effectiveness and cost–utility of manual chest physiotherapy techniques in the management of exacerbations of chronic obstructive pulmonary disease (MATREX)

Cross, Jane; Elender, Frances; Barton, Gary; Clark, Allan; Shepstone, Lee; Blyth, Andrew; Bachmann, Max; Harvey, Ian

doi:10.3310/hta14230

Cited by 21 publications

(26 citation statements)

References 213 publications

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“…Five studies followed subjects for one to 6 months postdischarge. [14][15][16][17][18] The following sections summarize the results of studies that met our criteria, and are categorized by intervention and comparison in those studies, including primarily hospitalized, non-postoperative subjects (Table 4) and those focused on postoperative subjects (Table 5). Several studies of ICU populations included both postoperative subjects and subjects hospitalized for medical therapies.…”

Section: Resultsmentioning

confidence: 99%

“…The Management of Exacerbations of COPD (MATREX) RCT allocated subjects hospitalized with COPD to either CPT plus ACBT or ACBT alone. 15 CPT included manual positioning, percussion during thoracic expansion, and vibration upon expiration, and ACBT techniques included forced expiration. The number and duration of CPT treatments was up to the discretion of the therapist, although the CPT treatments themselves were standardized.…”

Section: Studies Evaluating Cpt In Non-postoperative Subjectsmentioning

confidence: 99%

“…We rated the quality of the outcomes of stay, exacerbations/ readmissions, and harms of airway clearance techniques as fair, and the quality of the outcomes of dyspnea, exercise tolerance, and quality of life as poor. 15 Syed et al included 35 adults with bronchiectasis in a crossover RCT that compared short-term CPT to ACBT. 25 They used a convenience sample of subjects undergoing medical therapy for bronchiectasis, allocating them to either CPT (percussion and vibration in various postural drainage positions, cough, and deep breathing techniques in 20 -30 min sessions every 3 h) or ACBT (huffing, deep breathing, and relaxed breathing cycles for a maximum of 30 min in various postural drainage positions).…”

Section: Studies Evaluating Cpt In Non-postoperative Subjectsmentioning

confidence: 99%

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Nonpharmacologic Airway Clearance Techniques in Hospitalized Patients: A Systematic Review

et al. 2013

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SummaryNonpharmacologic airway clearance techniques are used to reduce the sequelae of obstructive secretions. We systematically reviewed comparative studies of nonpharmacologic interventions that health professionals can employ to achieve mucus clearance in hospitalized or postoperative patients without cystic fibrosis, over the age of 12 months. We searched MEDLINE and other databases from 1990 to 2012 to identify relevant literature. Two reviewers independently assessed each study against predetermined inclusion/exclusion criteria. Two reviewers also independently extracted data regarding subject and intervention characteristics and outcomes, and assigned overall quality ratings. The 32 studies meeting the review criteria included 24 randomized controlled trials, 7 crossover randomized controlled trials, and one prospective cohort study. Studies were typically small and together included a total of 2,453 subjects (mean 76/study). Studies generally examined chest physical therapy/physiotherapy modalities in postoperative or critically ill subjects or those with COPD. Interventions, comparators, and populations varied considerably across studies, hampering our ability to draw firm conclusions. Interventions, including conventional chest physical 2160RESPIRATORY CARE • DECEMBER 2013 VOL 58 NO 12 therapy/physiotherapy, intrapulmonary percussive ventilation, and positive expiratory pressure, typically provided small benefits in pulmonary function, gas exchange, oxygenation, and need for/duration of ventilation, among other outcomes, but differences between groups were generally small and not significant. Harms of the techniques were not consistently reported, though airway clearance techniques were generally considered safe in studies that did comment on adverse effects. Further research with clearly characterized populations and interventions is needed to understand the potential benefits and harms of these techniques.

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Section: Resultsmentioning

confidence: 99%

Section: Studies Evaluating Cpt In Non-postoperative Subjectsmentioning

confidence: 99%

Section: Studies Evaluating Cpt In Non-postoperative Subjectsmentioning

confidence: 99%

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Nonpharmacologic Airway Clearance Techniques in Hospitalized Patients: A Systematic Review

et al. 2013

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“…Cross and colleagues 31,35 and Osadnik and colleagues 27 showed no difference between groups in outcomes, whereas other studies were associated with a positive effect on dyspnea, FEV1%, and exacerbations at 6 months. 22 The main reason for this disparity is likely to be the different modalities of techniques and outcomes; however, all the articles included measures of functional status.…”

Section: Chest Physical Therapymentioning

confidence: 94%

“…The authors divided the different treatment modalities into several groups: seven studies included chest physical therapy, 22,27,29,31,32,35,38 one study used breathing techniques, 28 three studies included physical exercise, 26,30,36 two studies used electrostimulation, 33,34 three studies included a combination of treatment modalities, [23][24][25] and one study included standard physical therapy (not specified). 37 …”

Section: Treatment Modalitiesmentioning

confidence: 99%

Results of Physiotherapy Treatments in Exacerbations of Chronic Obstructive Pulmonary Disease: A Systematic Review

Torres‐Sánchez

Cruz-Ramírez

Cabrera‐Martos

et al. 2017

Physiotherapy Canada

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Purpose: The objective of this study was to review clinical trials of the effectiveness of physiotherapy compared with standard care, focused mainly on the functional status of patients hospitalized for acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods: Search strategies were developed for each of the databases (PubMed, Scopus, and Web of Science). The study eligibility criteria were as follows: (1) The objective was to assess the effect and efficacy of physiotherapy compared with standard care (which included only medical and pharmacological treatment); (2) adults subjects had AECOPD; (3) one of the outcome measures was functional status, defined as an individual's ability to perform the normal daily activities required to meet basic needs, fulfill usual roles, and maintain health and well-being; (4) it was a clinical trial; (5) it was written in English; (6) it was published between January 2009 and February 2016; and (7) the full-text article was available. Results: The review revealed that for patients hospitalized for AECOPD, exercise, neuromuscular electrical stimulation, breathing exercises, and chest therapy significantly improved their functional status compared with standard care. Conclusions: A variety of physiotherapy modalities have been shown to improve functional status compared with standard care among patients hospitalized for AECOPD; other outcome measures also showed improvements.Key Words: chronic obstructive pulmonary disease; hospitalization; cardiorespiratory physiotherapy; rehabilitation; systematic review. RÉ SUMÉObjectif : recenser les essais cliniques sur l'efficacité de la physiothé rapie par rapport aux soins conventionnels pour é valuer l'é tat fonctionnel des patients hospitalisé s pour exacerbations aiguë s de la maladie pulmonaire obstructive chronique (EAMPOC). Mé thodologie : des straté gies de recherche ont é té mises au point pour chaque banque de donné es (PubMed, Scopus et Web of Science). Critè res d'admissibilité des é tudes : (1) l'é tude vise à é valuer l'effet et l'efficacité de la physiothé rapie par rapport aux soins conventionnels (traitement mé dical et mé dicamenteux seulement); (2) les sujets adultes souffrent d'EAMPOC; (3) un des ré sultats mesuré s est l'é tat fonctionnel, dé fini comme la faculté d'une personne à accomplir les activité s quotidiennes né cessaires pour ré pondre à ses besoins fondamentaux, assumer ses rô les habituels et maintenir sa santé et son bien-ê tre; (4) il s'agit d'un essai clinique; (5) l'article est ré digé en anglais; (6) l'é tude a é té publié e entre janvier 2009 et fé vrier 2016; (7) le texte inté gral de l'article est disponible. Ré sultats : le recensement ré vè le que l'exercice, la stimulation é lectrique neuromusculaire, les exercices de respiration et la physiothé rapie respiratoire amé liorent de fac¸on significative l'é tat fonctionnel de patients hospitalisé s pour EAMPOC par rapport aux soins conventionnels. Conclusions : divers soins de physiothé rapie ont prouvé leur efficacité pour...

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Airway clearance techniques for chronic obstructive pulmonary disease

Osadnik

McDonald

Jones³

et al. 2012

Cochrane Database of Systematic Reviews

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A randomised controlled equivalence trial to determine the effectiveness and cost–utility of manual chest physiotherapy techniques in the management of exacerbations of chronic obstructive pulmonary disease (MATREX)

Abstract: Current Controlled Trials ISRCTN13825248.

Cited by 21 publications

References 213 publications

Nonpharmacologic Airway Clearance Techniques in Hospitalized Patients: A Systematic Review

Nonpharmacologic Airway Clearance Techniques in Hospitalized Patients: A Systematic Review

Results of Physiotherapy Treatments in Exacerbations of Chronic Obstructive Pulmonary Disease: A Systematic Review

Airway clearance techniques for chronic obstructive pulmonary disease

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