In-phase Chest Wall Vibration Decreases Dyspnea During Arm Elevation in Chronic Obstructive Pulmonary Disease Patients.

Abstract

In-phase chest wall vibration (IPV) is knownto decrease dyspnea in patients with chronic obstructive pulmonary disease (COPD) at rest and during leg exercise. In the present study, the effects of IPV (100 Hz) on dyspnea and arm fatigue during upper extremity activity were studied in 9 patients with COPD(mean FEV1? 0.95 /). Dyspnea and arm fatigue (modified Borg scale) and ventilatory variables were measured during arm elevation (AE) with weights lifted straight above the head with and without IPV. Mean dyspnea during AE was 3.3 without IPV and 2.1 with IPV (p<0.05), but, arm fatigue, oxygen saturation and end-tidal Fco2 were not affected by IPV. Minute ventilation during AEwas significantly increased with IPV in 5 of 9 patients. The results suggest that IPV decreases dyspnea during AE.

An Official American Thoracic Society Statement: Update on the Mechanisms, Assessment, and Management of Dyspnea

“…A number of other strategies have been investigated for their potential role in the relief of breathlessness. Several small studies have shown that chest wall vibration reduces dyspnea in patients with COPD (272)(273)(274)(275). However, the timing and site of application of the vibratory stimulus are important variables, and to date there is no commercially available device for delivering chest wall vibration.…”

Inspiratory High Frequency Airway Oscillation Attenuates Resistive Loaded Dyspnea and Modulates Respiratory Function in Young Healthy Individuals

“…Intriguingly, neural drive changes to the respiratory accessory muscles [48] have been implicated in the development of acute dyspnoea and COPD [49] , [50] . Indeed, vibration-induced augmentation of afferent feedback from the parasternal intercostal muscle spindles using vibration, reduces breathlessness in COPD [35] , [45] , [51] – [53] , that may also, by lowering central neural drive for a given output force, represent improved respiratory mechanical efficiency [54] , [55] . However, the timing and site of application of a vibratory stimulus appear important but whose optimal characteristics and form of delivery are unknown [7] .…”

Nonpharmacological management of dyspnea

“…Chest-wall vibration has been tested in patients with COPD [11,12] and progressive neurologic disorders [13]. There are practical limitations to consider as most of the studies for COPD were performed in a laboratory with therapists attaching vibrators to specific intercostal spaces with the goal of changing respiratory sensation.…”