Chest physiotherapy in chronic obstructive pulmonary disease: Forced expiratory technique combined with either postural drainage or positive expiratory pressure breathing

Positive Expiratory Pressure in Patients with Chronic Obstructive Pulmonary Disease – A Systematic Review

“…Treatment with PEP mask, 10–20 cm H 2 O combined with forced expiratory technique, had less effect on mucociliary clearance than postural drainage combined with forced expiratory technique in the study by Olséni et al [19], although 9 of the 14 patients preferred the PEP treatment.…”

“…Seven of the studies had a cross-over design [17,18,19,20,21,22,23] and three studies compared separate groups [24,25,26]. In 4 studies, PEP was compared to a control group or placebo [20, 22, 25, 26], and in the remaining studies it was compared with other chest physiotherapy techniques.…”

“…The methodological quality score varied between 4 and 8 with a maximal score of 11. Based on the text in the articles, 2 reached the level of adequate (≥ 6) methodological quality [24, 27], but after the authors’ written replies, 3 more trials reached an adequate level of methodological quality [17, 19, 26]. …”

“…Four studies with a crossover design [17,18,19,20] were identified measuring single treatment or the direct effects of PEP (within 1 h after intervention). Numbers of patients included in the trials were 10–14.…”

“…Numbers of patients included in the trials were 10–14. Two of the studies were classified as having adequate methodological quality [17, 19]. …”