Comparison of manual and mechanical chest percussion in hospitalized patients with cystic fibrosis

Bauer, Martin; McDougal, Julie; Schoumacher, Robert

doi:10.1016/s0022-3476(94)70313-2

Cited by 29 publications

(17 citation statements)

References 7 publications

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“…This technique is often combined with manual techniques, such as chest percussion or vibrations, with the technique application adjusted for the child’s age (23, 24). The application of force to the chest wall creates changes in the intrapleural pressure, which are transmitted through the thoracic cage and assist in dislodging secretions.…”

Section: Types Of Techniquesmentioning

confidence: 99%

Airway-Clearance Techniques in Children and Adolescents with Chronic Suppurative Lung Disease and Bronchiectasis

2017

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Common symptoms of chronic suppurative lung disease or bronchiectasis in children and adolescents are chronic cough with sputum production, retention of excess secretions in dilated airways, and a history of recurrent infections. Clinical management includes the prescription of airway-clearance techniques (ACTs) to facilitate mucociliary clearance, optimize sputum expectoration, relieve symptoms, and improve well-being. A wide range of ACTs are available for selection, and these strategies may be applied in isolation or in combination. The choice of technique will depend in part on the age of the child, their clinical state, and factors which may influence treatment adherence. While the evidence base for ACTs in children and adolescent with these conditions is not robust, the current available evidence in addition to clinical expertise provides guidance for technique prescription and clinical effect. An overview of the most commonly applied ACTs, including their physiological rationale and discussion of factors influencing prescription in children and adolescents is outlined in this review.

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Section: Types Of Techniquesmentioning

confidence: 99%

Airway-Clearance Techniques in Children and Adolescents with Chronic Suppurative Lung Disease and Bronchiectasis

2017

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“…In fact, with regard to design and working principle the D-Actor 200 appears very similar to the Swiss DolorClast but very different to that of vibrating massage devices such as the Vibracare. Furthermore, to our knowledge the Vibracare has so far only been studied for percussion treatment of patients with cystic fibrosis [ 42 ] and children with cerebral palsy suffering from lung infections [ 43 ], but not for treatments of diseases of the musculoskeletal system and cellulite. On the other hand, the D-Actor 200 must not be applied over air-filled tissue such as the lung.…”

Section: Introductionmentioning

confidence: 99%

Radial Shock Wave Devices Generate Cavitation

et al. 2015

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BackgroundConflicting reports in the literature have raised the question whether radial extracorporeal shock wave therapy (rESWT) devices and vibrating massage devices have similar energy signatures and, hence, cause similar bioeffects in treated tissues.Methods and FindingsWe used laser fiber optic probe hydrophone (FOPH) measurements, high-speed imaging and x-ray film analysis to compare fundamental elements of the energy signatures of two rESWT devices (Swiss DolorClast; Electro Medical Systems, Nyon, Switzerland; D-Actor 200; Storz Medical, Tägerwillen, Switzerland) and a vibrating massage device (Vibracare; G5/General Physiotherapy, Inc., Earth City, MO, USA). To assert potential bioeffects of these treatment modalities we investigated the influence of rESWT and vibrating massage devices on locomotion ability of Caenorhabditis elegans (C. elegans) worms.ResultsFOPH measurements demonstrated that both rESWT devices generated acoustic waves with comparable pressure and energy flux density. Furthermore, both rESWT devices generated cavitation as evidenced by high-speed imaging and caused mechanical damage on the surface of x-ray film. The vibrating massage device did not show any of these characteristics. Moreover, locomotion ability of C. elegans was statistically significantly impaired after exposure to radial extracorporeal shock waves but was unaffected after exposure of worms to the vibrating massage device.ConclusionsThe results of the present study indicate that both energy signature and bioeffects of rESWT devices are fundamentally different from those of vibrating massage devices.Clinical RelevancePrior ESWT studies have shown that tissues treated with sufficient quantities of acoustic sound waves undergo cavitation build-up, mechanotransduction, and ultimately, a biological alteration that “kick-starts” the healing response. Due to their different treatment indications and contra-indications rESWT devices cannot be equated to vibrating massage devices and should be used with due caution in clinical practice.

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“…Sputum expectoration, aided by chest physiotherapy (CPT), postural drainage, percussion and coughing, have been standard therapy for many years [1,2]. Self-administered physiotherapy techniques, including the forced expiration technique (FET), active cycle of breathing technique (ACBT), autogenic drainage and the use of a positive expiratory pressure (PEP) mask provide personal independence for the patient and have largely replaced earlier techniques [3][4][5][6][7][8][9][10][11]. It is uncertain whether any of these newer methods, or combinations of different techniques, are better than others [1,[11][12][13][14].…”

Section: Effects Of Flutter and Pep Mask Physiotherapy On Symptoms Andmentioning

confidence: 99%

Effects of flutter and PEP mask physiotherapy on symptoms and lung function in children with cystic fibrosis

Winden¹,

Visser²,

Hop³

et al. 1998

Eur Respir J

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Recently, the flutter was introduced as a new device to improve sputum expectoration. Preliminary data suggested a significant improvement in expectoration and lung function during flutter treatment in patients with cystic fibrosis (CF). The aim of the present study was to compare the effects of the flutter and the positive expiratory pressure (PEP) mask on symptoms and lung function in children with CF. In a crossover randomized study 22 patients with CF (mean age 12 yrs, range 7-17 yrs) performed physiotherapy using either the flutter or the PEP mask twice a day during two treatment periods of 2 weeks, separated by a one week wash-out period, in a random sequence. Lung function parameters (peak expiratory flow, forced vital capacity (FVC), forced expiratory volume in one second, maximal midexpiratory flow, maximal expiratory flow at 25% of FVC, thoracic gas volume, total lung capacity, residual volume/total lung capacity, airway resistance and specific airway conductance) and changes in transcutaneous oxygen haemoglobin saturation were assessed before and after the first supervised session and at the end of each treatment period. Throughout the study peak flow was measured and symptoms were scored daily. No significant changes in any lung function parameter occurred after a single session or after 2 weeks of physiotherapy with either method. There was no difference in acceptability and subjective efficacy. In conclusion, any superiority of the flutter over the positive expiratory pressure mask technique for expectoration could not be confirmed during 2 weeks of daily treatment in children with cystic fibrosis. Both methods are well accepted by children and do not change lung function. Long-term comparison of both methods, including expectoration measurements, seems to be required for further evaluation of the potential success of physiotherapy in cystic fibrosis.

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Comparison of manual and mechanical chest percussion in hospitalized patients with cystic fibrosis

Cited by 29 publications

References 7 publications

Airway-Clearance Techniques in Children and Adolescents with Chronic Suppurative Lung Disease and Bronchiectasis

Airway-Clearance Techniques in Children and Adolescents with Chronic Suppurative Lung Disease and Bronchiectasis

Radial Shock Wave Devices Generate Cavitation

Effects of flutter and PEP mask physiotherapy on symptoms and lung function in children with cystic fibrosis

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