Efeitos da ELTGOL e do Flutter® nos volumes pulmonares dinâmicos e estáticos e na remoção de secreção de pacientes com bronquiectasia

Guimarães, Fernando Silva; Moço, V.J.R.; Menezes, Sara L. S.; Dias, Claudia Mazza; Salles, Raquel Esteves Brandão; Lopes, Agnaldo José

doi:10.1590/s1413-35552012005000016

Cited by 24 publications

(15 citation statements)

References 23 publications

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“…Every session lasted 30 minutes and every patient had a treatment twice per day (morning and late afternoon). Chest Physiotherapy (CPT) consisted of a group of respiratory physiotherapy techniques like, slow expiratory with glottis opened in lateral position (ELTGOL) [24], positive expiratory pressure (PEP) mask [25] or PEP bottle [26] and vibratory positive expiratory pressure therapy system [27] (Acapella choice, Smiths Medical, England). Every session lasted 45 minutes and every patient had a treatment twice per day (morning and late afternoon).…”

Section: Methodsmentioning

confidence: 99%

Effectiveness of treatment with high-frequency chest wall oscillation in patients with bronchiectasis

Nicolini¹,

Cardini²,

Landucci³

et al. 2013

BMC Pulm Med

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BackgroundHigh-frequency airway clearance (HFCWC) assist devices generate either positive or negative trans-respiratory pressure excursions to produce high-frequency, small-volume oscillations in the airways.HFCWC can lead to changes in volume of 15–57 ml and in flow up to 1.6 L/s, which generate minimal coughing to mobilize secretions. The typical treatment lasts 20–30 minutes, and consists of short periods of compression at different frequencies, separated by coughing.The aim of this study was to find the more efficacious treatment in patients with bronchiectasis: traditional techniques of chest physiotherapy (CPT) versus high frequency oscillation of the chest wall in patients with bronchiectasis.Methods37 patients were enrolled. Seven of them were excluded. Computer randomization divided the patients into three groups:– 10 patients treated with HFCWO by using the Vest® Airway Clearance System;– 10 patients treated with traditional techniques of air way clearance (PEP bottle, PEP mask, ELTGOL, vibratory positive expiratory pressure);– 10 patients received medical therapy only (control group).To be eligible for enrollment, participants had to be between 18 and 85 years old and have a diagnosis of bronchiectasis, confirmed on high resolution computed tomography. Exclusion criteria: lack of informed consent, signs of exacerbation, cystic fibrosis. Before the treatment, each patient had blood tests, sputum volume and cell count, pulmonary function tests and on the quality of life inventories (MMRC, CAT, BCSS). The results were processed through the covariance analysis, performed with the R-Project statistical program. It has been considered a positive result p <005.ResultsBoth treatments (traditional CPT and HFCWO) showed a significant improvement in some biochemical and functional respiratory tests as well as in the quality of life compared to the control group. The use of HFCWO compared to CPT also produced a significant improvement in blood inflammation parameter C-RP (p ≤0.019), parameters of lung functionality associated with bronchial obstruction (FVC, FEV1) (p ≤0.006 and p ≤0.001), and in the dyspnea. Improvement in quality of life scales was noted. (BCSS, CAT) (both p ≤0.001). No significant changes of total cell counts in sputum samples were observed in the two groups. In the HFCWO group a significant reduction of neutrophils percentage (p≤0.002) and a significant increase of macrophages percentage (p ≤0.012).ConclusionsThe HFCWO technique provides an improvement both in pulmonary function and quality of life related parameters in patients with chronic hypersecretive disease. Since those patients need daily airway clearance, this treatment should be included among the principal options in chest physiotherapy. The study was registered as ChiCTR-TRC-12002134 at http://www.chictr.org.

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Section: Methodsmentioning

confidence: 99%

Effectiveness of treatment with high-frequency chest wall oscillation in patients with bronchiectasis

Nicolini¹,

Cardini²,

Landucci³

et al. 2013

BMC Pulm Med

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“…This justifies the amount of volume exhaled during the technique, which was higher than 80%, based on the mean ERV of the subject. End-expiratory lung volume and residual volume have been studied after pursed-lip breathing 17,18 (an expiratory exercise that prolongs the expiratory phase) and ELTGOL, 6 but not ERV, as in the present study.…”

Section: Discussionmentioning

confidence: 91%

“…Several techniques have been described to improve the expiratory phase and avoid premature airway closure in obstructive subjects; 6,[17][18][19][20] one such technique is ELTGOL. The slow expiration with open glottis performed during ELTGOL increases expiratory time.…”

Section: Discussionmentioning

confidence: 99%

“…Several authors have studied ELTGOL in subjects with chronic lung diseases. [3][4][5][6][7] Martins et al 3 reported an increase in mucus clearance in the peripheral area in subjects with COPD after ELTGOL by radio aerosol inhalation, even though Kodric et al 7 observed limited benefits (no difference at hospital discharge) in subjects with COPD with exacerbations compared to a control group.…”

Section: Introductionmentioning

confidence: 99%

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Expiratory Reserve Volume During Slow Expiration With Glottis Opened in Infralateral Decubitus Position (ELTGOL) in Chronic Pulmonary Disease: Technique Description and Reproducibility

et al. 2014

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BACKGROUND: There has not been a detailed description of expiratory reserve volume (ERV) during slow expiration with glottis open in infralateral decubitus position (ELTGOL, for ExpirationLente Totale Glotte Ouverte en infraLatéral) and its reproducibility. The aim of this study was to determine ERV during ELTGOL and to evaluate ERV intra-observer and inter-observer reliability. METHODS: In this prospective study, subjects were 30 -70 y of age with chronic lung disease. ELTGOL (an active-passive or active physiotherapy technique) was applied in random order by 3 observers: 2 trained physiotherapists (PT 1 and PT 2) and the subject him/herself. Two ELTGOL compressions (A and B) were applied by PT 1, PT 2, and the subject. RESULTS: Thirty-two subjects were evaluated with moderate lung obstruction, . CONCLUSIONS: ELTGOL mobilized more than 80% of ERV in subjects with moderate airway obstruction; there is no difference in ERV exhaled during the technique applied by a physiotherapist or by the subject. ELTGOL is a reproducible technique, determined by inter-and intra-observer testing.

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“…CPD may result in losses on other important functions such as voice, since they affect the respiratory system and compromise the airflow, which actively participates in vocal production, and when compromised, it can change some aspects of speech such as intensity, volume and voice quality 6,31 . Bronchiectasis is a CPD that causes change in ventilatory mechanics, such as loss of respiratory muscle strength, changes in lung volume and capacity, as a result of abnormal and irreversible dilatation of the bronchi, as a result of the destruction of the walls of the airways due to constant infections and inflammation 25,32 . According to some authors it is presented by different etiologies and may be suppurative and obstructive character 33 .…”

Section: Discussionmentioning

confidence: 99%

Qualidade de vida em voz na doença pulmonar crônica

et al. 2015

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RESUMO: Objetivo: analisar a qualidade de vida relacionada à voz autorreferida por indivíduos com doença pulmonar crônica. Métodos: estudo transversal, exploratório, quantitativo, com informações obtidas a partir da aplicação de questionário de qualidade de vida em voz em usuários de um ambulatório de fisioterapia integrado em hospital universitário no interior do Rio Grande do Sul, no período de março a novembro de 2012. Resultados: participaram 19 sujeitos, 12 (63,20%) do sexo masculino e 7 (36,80%) do sexo feminino. Sobre a faixa etária, 14 (73,70%) eram adultos e cinco (26,30%) idosos, sendo essa diferença estatisticamente significante. Quanto à doença pulmonar crônica, dez (52,60%) tinham bronquiectasia, seis (31,60%) doença pulmonar obstrutiva crônica e três (15,80%) asma. A média do questionário Qualidade de Vida em Voz Total foi de 85,8 ± 5,8 pontos. Não houve diferença estatística entre os três domínios do questionário e as variáveis sexo, idade e diagnóstico médico. Conclusão: predomínio percentual do sexo masculino e faixa etária adulta-meia idade, sendo essa última estatisticamente significante e diagnóstico médico de bronquiectasia. A média do questionário total foi de 85,8 ± 5,8 pontos. Não foram encontradas significância estatística na comparação do domínios do questionário com as variáveis sexo, idade e doença pulmonar. Tal fato pode ser explicado pela elaboração de estratégias de comunicação como forma de minimizar os efeitos da doença pulmonar na produção vocal. Sugere-se a realização de outras pesquisas abordando o mesmo tema, porém com amostras maiores a fim de verificar a significância estatística das variáveis estudadas.

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Efeitos da ELTGOL e do Flutter® nos volumes pulmonares dinâmicos e estáticos e na remoção de secreção de pacientes com bronquiectasia

Cited by 24 publications

References 23 publications

Effectiveness of treatment with high-frequency chest wall oscillation in patients with bronchiectasis

Effectiveness of treatment with high-frequency chest wall oscillation in patients with bronchiectasis

Expiratory Reserve Volume During Slow Expiration With Glottis Opened in Infralateral Decubitus Position (ELTGOL) in Chronic Pulmonary Disease: Technique Description and Reproducibility

Qualidade de vida em voz na doença pulmonar crônica

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