Ineffective cough and mechanical mucociliary clearance techniques

Fernández-Carmona, A.; Olivencia-Peña, L.; Yuste-Ossorio, M.E.; Peñas-Maldonado, L.

doi:10.1016/j.medine.2017.12.005

Cited by 9 publications

(11 citation statements)

References 45 publications

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“…PCF, MEP, gastric pressure during the cough maneuver and maximal insufflation capacity are used for functional assessment of cough. It is known that PCF is an easy and accessible outcome measure, and it is used frequently 4 . In the present study, the primary outcome measure was PCF.…”

Section: Discussionmentioning

confidence: 98%

“…In the present study, the primary outcome measure was PCF. It was reported that PCF was at least 270 L/min for effective cough, and if PCF was less than 270 L/min, programs to increase cough should be added in the treatment 4 . Most patients have scores below the lowest value for effective cough before training.…”

Section: Discussionmentioning

confidence: 99%

“…Cough consists of three phases physiologically: the inspiratory, compressive, and expiratory phase. The compressive and expiratory phases depend on expiratory muscle strength and adequate control of upper airways 3,4 …”

Section: Introductionmentioning

confidence: 99%

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Effect of expiratory muscle training on peak cough flow in children and adolescents with cystic fibrosis: A randomized controlled trial

Emirza

Aslan

Kılınç

et al. 2021

Pediatric Pulmonology

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Background Cough is an important defense and airway clearance mechanism for removing thick and viscous secretions in cystic fibrosis (CF). The primary aim of this study was to investigate the effect of expiratory muscle training (EMT) on peak cough flow (PCF) and secondly on respiratory muscle functions, functional exercise capacity, and quality of life (QoL) in CF. Methods Thirty patients were randomized as training and sham groups. Both groups were trained with the EMT protocol, which involved twice per day for at least 5 days per week for 6 weeks. The training intensity in the training group was 30% of the maximal expiratory pressure (MEP). In the sham group, it remained at the lowest pressure (5 cmH2O). The primary outcome was PCF. The secondary outcomes were MEP, maximal inspiratory pressure (MIP), spirometric measures, six‐minute walking distance (6MWD), and QoL (Cystic Fibrosis Questionnaire‐Revised). Results Twenty‐eight patients completed the study. Changes in PCF (p = .041) and MEP (p = .003) were higher in the training group than the sham group. Also, treatment burden (p = .008), digestive symptoms (p = .019), and vitality (p = .042) in QoL were more improved in the training group. MIP (p = .028) and 6MWD (p = .035) changed significantly only in the training group. Spirometric measurements did not change (p > .05). Conclusions The results of the study show that EMT could improve PCF, MEP, treatment burden, digestive symptoms, and vitality domains of QoL in patients with CF. Moreover, MIP and functional exercise capacity improved in the training group with EMT.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

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Effect of expiratory muscle training on peak cough flow in children and adolescents with cystic fibrosis: A randomized controlled trial

Emirza

Aslan

Kılınç

et al. 2021

Pediatric Pulmonology

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“…Coughing is a normal mechanism of the body that allows the airway to remain free of foreign objects and to expel secretions produced by the lungs (10). When impaired, cough can cause infections and atelectasis (10,11,13). Atelectasis is a collapse of a major lung segment and can occur when the residual functional capacity is lower than the volume at which dependent airways close (14,15).…”

Section: Introductionmentioning

confidence: 99%

“…They have also been associated with a high risk of morbidity and mortality and complications such as delayed pneumothorax, hemothorax and pneumonia have been reported (1,4,5). It is also known that patients with mTIs and rib fractures can experience non-negligible pain (1,2,6,7), which can lead to reduced pulmonary function, decreased mucous clearance and decreased cough capacity (4,(8)(9)(10)(11)(12). Coughing is a normal mechanism of the body that allows the airway to remain free of foreign objects and to expel secretions produced by the lungs (10).…”

Section: Introductionmentioning

confidence: 99%

Does reduced cough capacity in minor thoracic injury is associated with atelectasis development?

Hegg

Batomen

Thériault

et al. 2021

Preprint

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Context: Minor thoracic injury causes non-negligible pain that could reduce the cough capacity and can cause infectious problems and atelectasis. Objectives: To describe the association between atelectasis and cough capacity, and to assess the concordance of cough capacity perceptions between health professionals and the patient. Design:The data were collected from 2006 to 2012 in 4 Canadian emergency departments (ED). Participants: Patients with a chief complaint of minor thoracic injury, ≥ 16 years old, discharged home from the ED after an evaluation by the attending physician, were included. They have three visits, at the ED, 7-day and 14-day follow-up. The initial ED visit included medical evaluation, data collection and mandatory chest and rib radiography. Main outcome measures: The presence of atelectasis was noted at the initial ED and subsequent visits.Participants cough capacity was noted by a physician, a nurse and the patients himself at subsequentvisits and classified as good, diminished, weak /absent.Results: Among the 1474 patients, 8.89% (95% CI: 7.55 - 10.47), 7.33% (95% CI: 6.04 – 8.89) and 4.63% (95% CI: 3.51 – 6.09) had atelectasis at the initial visit, 7-day and 14-day follow-up visit respectively. Except for patients with weak or absent cough capacity at the 7-day visit, which had a 2.89 (95%CI: 2.05 – 4.05) folds atelectasis proportion relative to those with a good cough capacity, they were no associations between cough capacity and atelectasis. The weighted kappa coefficient suggests a moderate to substantial agreement between the cough capacity measured by patients and nurses (0.52 to 0.65).Conclusion: There was not strong evidence of an association between atelectasis and cough capacity and the best agreement between cough capacity perception was between nurses and patients.

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Aerobic exercise capacity, cough strength, posture, and depression in primary ciliary dyskinesia

FIRAT

Boşnak-Güçlü

Eyüboğlu

et al. 2022

Pediatric Pulmonology

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Introduction: Assessment of exercise capacity is important for information about lung function and prognosis in primary ciliary dyskinesia (PCD). In addition, deterioration in the pulmonary system may affect cough efficiency, posture, and thoracoabdominal mobility. In turn, this deterioration may also disturb the psychological function of patients with PCD. Therefore, this study aimed to compare exercise capacity, cough strength, thoracoabdominal mobility, posture, and depression in children with PCD and healthy peers.Methods: Twenty-seven patients with PCD and 28 healthy peers were included.Aerobic exercise capacity (3-min step test), cough strength (peak expiratory flow meter), thoracoabdominal mobility (upper chest, lower chest, and abdomen), posture (Corbin postural assessment scale), and depression (Children's Depression Inventory) were evaluated.Results: Patients' number of steps completed, cough strength, and thoracoabdominal mobility were significantly decreased; total posture and depression scores were higher compared with healthy controls (p< 0.05). There was a significant relationship between cough strength and maximal expiratory strength (r = 0.541, p= 0.004) and total number of steps (r = 0.509, p= 0.007) in the patients. Conclusion: Aerobic exercise capacity, cough strength, and thoracoabdominal mobility were impaired, posture was deteriorated, and depression perception elevated in children with PCD compared to healthy peers. Furthermore, aerobic exercise capacity and maximal expiratory strength are related to cough strength in these patients. Rehabilitation programs including aerobic and resistive exercise training, deep breathing and postural exercise, and nutrition counseling may improve these results and better be investigated. Trial registration: Clinicaltrials.gov: NCT03370029; December 12, 2017.

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Ineffective cough and mechanical mucociliary clearance techniques

Cited by 9 publications

References 45 publications

Effect of expiratory muscle training on peak cough flow in children and adolescents with cystic fibrosis: A randomized controlled trial

Effect of expiratory muscle training on peak cough flow in children and adolescents with cystic fibrosis: A randomized controlled trial

Does reduced cough capacity in minor thoracic injury is associated with atelectasis development?

Aerobic exercise capacity, cough strength, posture, and depression in primary ciliary dyskinesia

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