The Short-Term Effect of Breathing Tasks Via an Incentive Spirometer on Lung Function Compared With Autogenic Drainage in Subjects With Cystic Fibrosis

Sokol, G. V.; Vilozni, Daphna; Hakimi, R.; Lavie, Moran; Sarouk, Ifat; Bar, Bat-El; Dagan, Amit; Ofek, Miryam; Efrati, Ori

doi:10.4187/respcare.04008

Cited by 7 publications

(7 citation statements)

References 21 publications

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“…The short-term effects of airway clearance on FEV 1 and FVC in our study are discordant with the results of other studies using various maneuvers. Thus, no significant change in FEV 1 and FVC was observed with the ELTGOL technique [ 12 ], whereas improvements were seen after supervised chest physiotherapy with a positive expiratory pressure (PEP) mask [ 32 ] or an incentive spirometer, but not after AD [ 33 ]. In our study, although the FEV 1 and FVC improvements were statistically significant, they may be irrelevant in clinical practice based on a minimal clinically important difference (MCID) of 100 mL for FEV 1 [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

The immediate effects of a single autogenic drainage session on ventilatory mechanics in adult subjects with cystic fibrosis

et al. 2018

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IntroductionThe aim of this study was to gain insight into the physiological changes occurring in subjects with cystic fibrosis (CF) after autogenic drainage (AD). Changes in respiratory system resistance (Rrs), reactance (Xrs), and spirometry were analyzed in adult CF subjects after a single AD physiotherapy session.MethodsThis prospective observational study was conducted during the annual check-up of adult CF subjects in stable condition. Spirometry and Rrs and Xrs measurements using the forced oscillations technique at 5, 11, and 19 hertz (Hz) were performed before and 30 min after a 20-min AD session. Control CF subjects were tested at baseline and 50 min without AD. Results are expressed as mean ± standard deviation or median [interquartile range].ResultsThirty subjects were included in the physiotherapy group (age 29 [25–34] years, forced expiratory volume in 1 s (FEV1) 40.3 [30.1–57.9]% predicted) and 11 in the control group (age 31 [28.5–36.5] years, FEV1 43.6 [31.1–51.9] % predicted). No significant changes in any parameter were observed in the control group. AD modestly but significantly increased the forced vital capacity (FVC) and FEV1 (p<0.001). Inspiratory resistance was also significantly improved by AD: Rrs5 from 5.74±2.39 to 5.24±2.17 cmH2O/L/s, p<0.05; Rrs11 from 4.83±1.98 to 4.32±1.7 cmH2O/L/s, p = 0.003; and Rrs19 from 4.18 [3.46–5.07] to 3.86 [2.76–4.98] cmH2O/L/s, p<0.001. In contrast, AD had no significant effects on frequency dependence of resistance (Rrs5–Rrs19) or expiratory resistance. Inspiratory Xrs5, but not ΔXrs5 (expiratory—inspiratory Xrs), was improved by AD (p<0.05). Moderate correlations were detected between the improvement in FEV1 and FVC and inspiratory resistance (r = 0.53, p = 0.005 and r = 0.44, p = 0.02, respectively).ConclusionA single session of AD improved inspiratory airway resistance, except in the distal airways. The forced oscillations technique provides a new tool for understanding the pathophysiological effects of airway clearance physiotherapy in CF.

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Section: Discussionmentioning

confidence: 99%

The immediate effects of a single autogenic drainage session on ventilatory mechanics in adult subjects with cystic fibrosis

et al. 2018

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“…The mean age and body mass index, low FEV1 % pred. and FEV1/FVC ratio reflects disease severity in the general population with poor lung function and nutritional status, especially those with CF (73% of the study population) [8,11,18,19]. This predominance of CF patients in our study reflects the target population likely to use the medical device under investigation.…”

Section: Discussionmentioning

confidence: 73%

Safety and Efficacy of an Innovative Airway Clearance Device Versus Manual Chest Physiotherapy Techniques For Airway Secretion Clearance: a Feasibility Study

2020

Eur J Respir Med

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Airway clearance therapy is an important treatment strategy in patients with respiratory disease and impaired mucociliary transport (e.g. cystic fibrosis [CF]) [1-4]. Airway clearance techniques (ACTs) supplement the mucociliary clearance system in the presence of disease-related impairment [2], and are important for maintaining respiratory health [4]. Current airway clearance interventions are based mainly on physical or mechanical measures to move air behind mucosal obstruction, and modulation of expiratory airflow to enhance movement of secretions to more proximal airways for more effective clearance [2]. ACTs in obstructive lung diseases encompasses very various interventions including 1/ manual chest physiotherapy (CP): conventional CP (postural drainage, percussion, vibration, forced expiration technique, directed cough), autogenic drainage and active cycle breathing technique, and 2/ airway clearance devices (ACD) as Positive Expiratory Pressure (PEP), oscillating PEP and high frequency chest wall oscillations [2, 5]. ACTs have been shown to have beneficial short-term effects in increasing transport mucus away [5, 11] with no clear differences in effectiveness between techniques [6-10,12,22].Whatever the approach, the overall goal of airway clearance therapy is to improve mucus clearance, thus decreasing the risk of bronchial infection, attenuating disease progression and lung function decline, and improving quality of life [4,[11][12][13]. However, strategies such as CP are intensive and time-consuming, may require assistance from a physiotherapist or caregiver, and can be uncomfortable for patients [5]. Furthermore, these strategies require time and effort from the patient and their caregivers, and adherence to CP may be suboptimal in adults with CF [14], and compliance with CP is comparatively low in this group (53%) [15].

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“…6 The operative procedures of the patients included in previous studies were lung surgery, 14,15 esophageal surgery, 16 coronary artery bypass grafting, 17 abdominal surgery 18,19 (including laparoscopic surgery 20 ), bariatric surgery for obese patients, 21 and brain surgery. 22 Furthermore, there were clinical trials that were undertaken in patients with stroke, 23 spinal cord injury, 24 cystic fibrosis, 25 and sickle cell disease. 26 Most of the previous studies, including meta-analyses, in the perioperative setting did not show any significant improvement in patient outcomes with IS, 17,18,27 whereas some studies indicated the effectiveness of IS.…”

Section: Discussionmentioning

confidence: 99%

Incentive spirometry to prevent pulmonary complications after chest trauma: a retrospective observational study

Dote

Homma

Sakuraya

et al. 2020

Acute Medicine & Surgery

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The Short-Term Effect of Breathing Tasks Via an Incentive Spirometer on Lung Function Compared With Autogenic Drainage in Subjects With Cystic Fibrosis

Cited by 7 publications

References 21 publications

The immediate effects of a single autogenic drainage session on ventilatory mechanics in adult subjects with cystic fibrosis

The immediate effects of a single autogenic drainage session on ventilatory mechanics in adult subjects with cystic fibrosis

Safety and Efficacy of an Innovative Airway Clearance Device Versus Manual Chest Physiotherapy Techniques For Airway Secretion Clearance: a Feasibility Study

Incentive spirometry to prevent pulmonary complications after chest trauma: a retrospective observational study

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