Beyond postural drainage and percussion: Airway clearance in people with cystic fibrosis

Pryor, Jennifer; Tannenbaum, Esta-Lee; Scott, Sandra; Burgess, J.C.; Cramer, Derek; Gyi, Khin M.; Hodson, Margaret E.

doi:10.1016/j.jcf.2010.01.004

Cited by 69 publications

(86 citation statements)

References 23 publications

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“…It is likely that to optimize adherence to treatment and consequently improvements in morbidity and mortality, the patient should be involved in the selection of his/her airway clearance regimen [20].…”

Section: Discussionmentioning

confidence: 99%

Effect of Combination of Acapella Device and Breathing Exercises on Treatment of Pulmonary Complications After Upper Abdominal Surgeries

Allam¹

2016

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Abstract:Introduction: Background. Upper abdominal surgery alters postoperative pulmonary function, as observed by impairment of lung volumes such as total lung capacity, vital capacity. Impaired clearance of sputum results in a vicious cycle of colonization and infection of bronchi with pathogenic organisms, dilation of bronchi and further production of sputum. The aim was to investigate the effect of combination of Acapella device and breathing exercises on treatment of post operative pulmonary complications after upper abdominal surgeries. Subjects and methods: Sixty patients underwent upper abdominal surgery were assigned randomly into two equal groups; their ages ranged from 20-50 years. The study group received breathing exercises, Acapella device and traditional chest physical therapy program (postural drainage. percussion, vibration, cough training and early ambulation). Control group received traditional chest physical therapy program (postural drainage. percussion, vibration, cough training and early ambulation). All groups received three sessions per week for four successful weeks. The data were collected before and after the same period of treatment for both groups. Evaluation procedures were carried out to measure pulmonary function: Forced vital capacity (FVC) and Forced expiratory volume in one second (FEV1) using electronic spirometer. Results: Post treatment results showed that there was a significant improvement difference in FVC and FEV1 in both groups in favor of the study group. Percentage of improvement of FVC in the study group was 42.28%, while it was 16.31%in the control group. Percentage of improvement of FEV1 in the study group was 49.05%, while it was 20.79%in the control group. Conclusion: Combination of Acapella device and breathing exercises were considered to be an effective modality for treatment of postoperative pulmonary complications and removal of secretions after upper abdominal surgeries.

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Section: Discussionmentioning

confidence: 99%

Effect of Combination of Acapella Device and Breathing Exercises on Treatment of Pulmonary Complications After Upper Abdominal Surgeries

Allam¹

2016

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Section: Discussionmentioning

confidence: 99%

Response of Forced Expiratory Volume/Forced Vital Capacity Ratio to Acapella Device and Breathing Exercises After Upper Abdominal Surgeries

Allam¹,

Khalaf²,

Thabet³

et al. 2016

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Abstract:Background: A major decline in pulmonary function is observed on the first day after upper abdominal surgery.This decline can reduce vital and inspiratory capacity and can culminate in restrictive lung diseases that cause atelectasis, reduced diaphragm movement, and respiratory insufficiency. The aim was to compare the effect of Acapella device and breathing exercises with traditional chest physiotherapy program on forced expiratory volume/ forced vital capacity ratio after upper abdominal surgeries. Subjects and methods: Thirty patients underwent upper abdominal surgery were assigned randomly into two equal groups; their ages ranged from 20-50 years. The study group received breathing exercises, Acapella device and traditional chest physical therapy program (postural drainage. percussion, vibration, cough training and early ambulation). Control group received traditional chest physical therapy program (postural drainage. percussion, vibration, cough training and early ambulation). All groups received three sessions per week for four successful weeks. The data were collected before and after the same period of treatment for both groups. Evaluation procedures were carried out to measure forced expiratory volume/ forced vital capacity ratio (FEV1/FVC ratio) using electronic spirometer. Results: Post treatment results showed that there was a significant difference in FEV1/FVC ratio in both groups in favor of the study group. Percentage of improvement of FEV1/ FVC ratio in the study group was 10.17%, while it was 2.96% in the control group. Conclusion: Acapella device and breathing exercises were more effective in improvement of FEV1/FVC % than traditional chest physical therapy after upper abdominal surgeries.

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“…Three of the four recent randomised controlled trials on airway clearance techniques used PEP or oscillating PEP in one of the comparator arms [13][14][15]. Given their level of use across different countries and the relative evidence of benefit, all future randomised control trials on airway clearance techniques should consider using PEP or oscillating PEP as a comparator.…”

Section: Levels Of Airway Clearance Technique Use In the Ukmentioning

confidence: 99%

Airway clearance techniques used by people with cystic fibrosis in the UK

et al. 2015

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Please cite this article as: Hoo ZH, Daniels T, Wildman MJ, Teare MD, Bradley JM, Airway clearance techniques used by people with cystic fibrosis in the UK, Physiotherapy (2015), http://dx.doi.org/10.1016/j.physio. 2015.01.008 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Setting and participants All people with CF in the UK aged ≥11 years (n=6372). ResultsOf the 6372 people on the UK CF registry in 2011, 89% used airway clearance techniques.The most commonly used primary techniques were forced expiratory techniques (28%) and oscillating positive expiratory pressure (PEP) (23%). Postural drainage and high-frequency chest wall oscillation were used by 4% and 1% of people with CF, respectively. The male:female ratio of individuals who used exercise as their primary airway clearance technique was 2:1, compared with 1:1 for other techniques. Individuals with more severe lung disease tended to use devices such as non-invasive ventilation or high-frequency chest wall oscillation.Conclusions Forced expiratory techniques and oscillating PEP are the most common airway clearance techniques used by people with CF in the UK, and postural drainage and high-frequency chest wall oscillation are the least common techniques. This is significant in terms of planning airway clearance technique trials, where postural drainage has been used traditionally as the comparator. The use of airway clearance techniques varies between countries, but the reasons for these differences are unknown.

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Beyond postural drainage and percussion: Airway clearance in people with cystic fibrosis

Abstract: In different countries either one or several airway clearance regimens are used. This study provides evidence in support of current practices.

Cited by 69 publications

References 23 publications

Effect of Combination of Acapella Device and Breathing Exercises on Treatment of Pulmonary Complications After Upper Abdominal Surgeries

Effect of Combination of Acapella Device and Breathing Exercises on Treatment of Pulmonary Complications After Upper Abdominal Surgeries

Response of Forced Expiratory Volume/Forced Vital Capacity Ratio to Acapella Device and Breathing Exercises After Upper Abdominal Surgeries

Airway clearance techniques used by people with cystic fibrosis in the UK

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