Effect of manual chest wall compression in participants with chronic obstructive pulmonary disease

Abstract

[Purpose] Pulmonary rehabilitation is appropriate for most individuals with chronic obstructive pulmonary disease (COPD). Pulmonary rehabilitation consists of conditioning and exercise therapy. Conditioning includes relaxation, breathing exercises, and manual chest wall compression during expiration (CWC). CWC improves the symptoms in individuals with respiratory disease who have undergone mechanical ventilation. However, evidence supporting the effectiveness of CWC for COPD has been insufficient. This study aimed to determine physiological responses to CWC in participants with COPD. [Participants and Methods] Twenty-nine participants with COPD were included in the study. Manual CWC techniques were performed in a comfortable position chosen by the participants (sitting, forward-leaning (sitting), or semi-Fowler’s). Ventilatory parameters, occlusion airway pressure (P0.1), and dyspnea were assessed using a visual analog scale and were compared before and during CWC. [Results] During manual CWC, oxygen consumption, carbon dioxide production, end-tidal carbon dioxide concentration, and dyspnea were significantly decreased; however, P0.1 was not affected. [Conclusion] Manual CWC for COPD had an immediate physiological effect, including a decrease in dyspnea that may have been facilitated by a reduced workload of the respiratory muscles. Thus, manual CWC may be effective for dyspnea by reducing oxygen consumption in the respiratory muscles.

Changes in Diaphragm Thickness and 6-min Walking Distance Improvement After Inspiratory Muscle Training in Patients With Chronic Obstructive Pulmonary Disease

“…In addition, as no signi cant difference was observed in P 0.1 , we considered that the improvement in respiratory function by IMT was probably attributed to improvements in peripheral rather than in central functions. This was also supported by a previous study using P 0.1 before and after manual chest wall compression in patients with COPD, which showed that VO 2 , VCO 2 , and dyspnea severity signi cantly decreased after chest compression, whereas P 0.1 and P 0.1 /PImax did not change [54]. Improvement in respiratory function and dyspnea because of manual chest wall compression may be attributed to peripheral rather than central improvement [54].…”

Modified Manual Chest Compression for Prevention and Treatment of Respiratory Depression in Patients Under Deep Sedation During Upper Gastrointestinal Endoscopy: Two Randomized Controlled Trials

“…21 To date, manual chest compression on the middle of the chest with less than half the force used for CPR has been found to be effective and safe in the management of laryngospasm in children, 10 and manual chest compression on the bilateral lower rib cage has been reported to facilitate decreased dyspnea in patients with chronic obstructive pulmonary disease (COPD). 22 Therefore, we developed the MMCC protocol performed at the right chest wall of sedated patients with spontaneous breathing who were placed in the left lateral position during gastroscopy in our center. In our protocol, the force of pressing was adjusted by volunteers' comfortable feedback, which was only 1 of 10 that used for CPR.…”

Changes in diaphragm thickness and 6-min walking distance improvement after inspiratory muscle training in patients with chronic obstructive pulmonary disease: Clinical trial

“…As an index of this respiratory central output, there is airway-occlusion pressure at 0.1 s after the start of inspiratory flow (P 0.1 ) [ 9 ]. We used P 0.1 to investigate whether the relaxation posture affects P 0.1 and whether manual chest wall compression affects P 0.1 in elderly COPD [ 10 , 11 ]. No significant difference was found in P 0.1 in the two studies, suggesting that relaxation posture and manual chest wall compression did not affect respiratory central output.…”