Chest physiotherapy compared to no chest physiotherapy for cystic fibrosis

Schans, Cees P. van der; Prasad, Ammani; Main, Eleanor

doi:10.1002/14651858.cd001401

Cited by 81 publications

(43 citation statements)

References 71 publications

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“…Therefore, if increasing expiratory flow contributes to the mechanisms for secretion clearance, vibration is likely to be more effective for secretion clearance than the other physiotherapy interventions. The efficacy of vibration for secretion clearance needs to be investigated with radio-aerosol clearance studies [7].…”

Section: Discussionmentioning

confidence: 99%

“…These physiotherapy interventions are proposed to aid secretion movement to the central airways, from where they can be expectorated by forced expiratory manoeuvres. Although physiotherapy has been shown to be more effective for secretion clearance than no intervention, there appears to be no difference between the physiotherapy interventions [6,7]. In addition, the physiological mechanisms by which many of these physiotherapy interventions aid secretion clearance are unknown.…”

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confidence: 99%

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Physiological effects of vibration in subjects with cystic fibrosis

McCarren

Alison²

2006

Eur Respir J

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The physiological mechanisms by which vibration and other physiotherapy interventions may clear secretions in subjects with cystic fibrosis are unknown. The main aim of this study was to compare the expiratory flow rates and frequencies of airflow oscillation of vibration to those of Acapella1, Flutter1, positive expiratory pressure and percussion.Respiratory flow rates were measured during interventions, the order of which was randomised. The oscillation of the airflow of the interventions was determined by frequency spectral analysis.In 18 young adult subjects with cystic fibrosis, the mean peak expiratory flow rate of vibration was greater than Flutter1, percussion, Acapella1 and positive expiratory pressure. The mean¡SD of the oscillation of the airflow of vibration (8.4¡0.4 Hz) was lower than Acapella1 (13.5¡1.7 Hz) and Flutter1 (11.3¡1.5 Hz) but similar to percussion (7.3¡0.3 Hz).Theoretically, the higher peak expiratory flow rate of vibration compared to the other physiotherapy interventions may promote secretion clearance. In addition, the frequency of oscillation of vibration was within the range demonstrated to increase mucus transport. This study has provided some evidence for the physiological rationale for the use of vibration to aid secretion clearance.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Physiological effects of vibration in subjects with cystic fibrosis

McCarren

Alison²

2006

Eur Respir J

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“…These include the Borg scale, the Modified Medical Research Council Scale (MRC), the use of a VAS to assess dyspnea, a 15-count breathlessness score, the Phonation test, and the University of California at San Diego (UCSD) Shortness of Breath Questionnaire (SOBQ) (72)(73)(74)(75). These scores have been developed to assess dyspnea after exercise and dyspnea related to activities of daily living.…”

Section: Table 3 Overview Of Selected Instruments That Assess Signs mentioning

confidence: 99%

Patient-reported Outcomes in Cystic Fibrosis

Goss¹,

Quittner²

2007

Proceedings of the American Thoracic Society

116

107

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Over the past 20 years, there has been tremendous progress in the area of patient-reported outcomes (PROs). A PRO instrument is defined as any measure of a patient's health status that is elicited directly from the patient and assesses how the patient "feels or functions with respect to his or her health condition." The advances seen in clinical research regarding PROs has been mirrored in research in cystic fibrosis (CF). A large number of instruments have been used for both therapeutic and nontherapeutic clinical research for many chronic conditions. This review will summarize a history of the development of PROs and how PROs are viewed by the U.S. Food and Drug Administration. We will then review the current state of the art of patient-reported outcomes in CF, specifically addressing the evaluation of different PRO instruments in terms of their reliability and validity. Finally, we will delineate further areas for development of PROs in CF. We believe that the future of CF research will incorporate a more diverse selection of PRO outcome measures; these outcome measures ultimately may be incorporated into clinical care to standardize symptom assessment and provide information regarding the need for specific clinical interventions to improve the quality of care delivered to these patients.

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“…[1][2][3] Airway clearance therapy aims to improve mucociliary clearance through the removal of tenacious obstructing mucus from the airways, thus improving ventilation. [3][4][5] Indeed, Cochrane reviews 1,[5][6][7] have concluded that airway clearance techniques have the short-term effect of increasing mucus transport, and there appears to be no advantage of either conventional chest physiotherapy or oscillating devices over other airway clearance techniques in the primary outcome measure of lung function.…”

Section: Introductionmentioning

confidence: 99%