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Oscillating Positive Expiratory Pressure on Respiratory Resistance in Chronic Obstructive Pulmonary Disease With a Small Amount of Secretion: A Randomized Clinical Trial

Title: Oscillating Positive Expiratory Pressure on Respiratory Resistance in Chronic Obstructive Pulmonary Disease With a Small Amount of Secretion: A Randomized Clinical Trial
Authors: Gastaldi, AC
Paredi, P
Talwar, A
Meah, S
Barnes, PJ
Usmani, OS
Item Type: Journal Article
Abstract: Abstract: This study aims to evaluate the acute effects of an oscillating positive expiratory pressure device (flutter) on airways resistance in patients with chronic obstructive pulmonary disease (COPD). Randomized crossover study: 15 COPD outpatients from Asthma Lab–Royal Brompton Hospital underwent spirometry, impulse oscillometry (IOS) for respiratory resistance (R) and reactance (X), and fraction exhaled nitric oxide (FeNO) measures. Thirty minutes of flutter exercises: a “flutter-sham” procedure was used as a control, and airway responses after a short-acting bronchodilator were also assessed. Respiratory system resistance (R): in COPD patients an increase in X5insp (-0.21 to -0.33 kPa/L/s) and Fres (24.95 to 26.16 Hz) occurred immediately after flutter exercises without bronchodilator. Following 20 min of rest, a decrease in the R5, [DELTA]R5, R20, X5, and Ax was observed, with R5, R20, and X5 values lower than baseline, with a moderate effect size; there were no changes in FeNO levels or spirometry. The use of flutter can decrease the respiratory system resistance and reactance and expiratory flow limitation in stable COPD patients with small amounts of secretions.
Issue Date: 31-Oct-2015
Date of Acceptance: 28-Sep-2015
URI: http://hdl.handle.net/10044/1/39158
DOI: http://dx.doi.org/10.1097/MD.0000000000001845
ISSN: 0025-7974
Publisher: Wolters Kluwer
Journal / Book Title: Medicine
Volume: 94
Issue: 42
Copyright Statement: This is an open access article distributed under the Creative Commons Attribution-Non Commercial License, where it is permissible to download, share and reproduce the work in any medium, provided it is properly cited. The work cannot be used commercially.
Sponsor/Funder: National Institute for Health Research
Funder's Grant Number: CDF-2011-04-053
Keywords: Science & Technology
Life Sciences & Biomedicine
Medicine, General & Internal
General & Internal Medicine
STANDARD CHEST PHYSIOTHERAPY
MUCUS-CLEARANCE DEVICE
FIBROSIS LUNG-DISEASE
EXHALED NITRIC-OXIDE
CYSTIC-FIBROSIS
FLUTTER DEVICE
PHYSICAL-THERAPY
WALL OSCILLATION
BRONCHIECTASIS
MANAGEMENT
Aged
Cross-Over Studies
Exercise Therapy
Humans
Positive-Pressure Respiration
Pulmonary Disease, Chronic Obstructive
Sputum
Arthritis & Rheumatology
1103 Clinical Sciences
Publication Status: Published
Article Number: e1845
Appears in Collections:National Heart and Lung Institute
Airway Disease
Faculty of Medicine



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