Design and Function of a New Conical Positive Expiratory Pressure Device to Be Used During Exercise

Phimphasak, Chatchai; Ubolsakka-Jones, Chulee; Jones, David A.

doi:10.4187/respcare.06049

Cited by 3 publications

(10 citation statements)

References 24 publications

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“…We identified 2 studies in which resistors were tested. 16,21 Both included various resistors with different designs, and the differences were reported to affect the pressure generated. 16,21 In one of the studies, valves or conical resistors with inner diameters of 5-7 mm were tested with flows of 0.2-1.5 L/min.…”

Section: Resistorsmentioning

confidence: 99%

“…16,21 Both included various resistors with different designs, and the differences were reported to affect the pressure generated. 16,21 In one of the studies, valves or conical resistors with inner diameters of 5-7 mm were tested with flows of 0.2-1.5 L/min. 21 For a given flow, pressure decreased as the inner diameter of the orifice increased; the pressure also decreased as the length of the resistor decreased.…”

Section: Resistorsmentioning

confidence: 99%

“…16,21 In one of the studies, valves or conical resistors with inner diameters of 5-7 mm were tested with flows of 0.2-1.5 L/min. 21 For a given flow, pressure decreased as the inner diameter of the orifice increased; the pressure also decreased as the length of the resistor decreased. Among the valves tested, pressure quickly rose as flow velocity increased; the smaller diameter (5 mm in this case) generated the maximum resistance most quickly, while the resistance at both 6 mm and 7 mm was associated with a flatter rise in the resistance curve.…”

Section: Resistorsmentioning

confidence: 99%

“…The conical resistor created almost the same pressure, though at slightly higher flows. 21 In the other study, resistors from different manufacturers were tested at the constant flows of 10 and 18 L/min. 16 The study included resistors in the RMT/PEP set, PiPEP, Mini-PEP, and the 15-mm endo-adapter, and the tested resistors had diameters of 1.5-5.0 mm.…”

Section: Resistorsmentioning

confidence: 99%

“…We identified 4 studies that evaluated diameter and length of tubes for PEP solely or as part of a water-bottle PEP device. 9,19,21,24 In the study by Boden et al, 9 expiring through a tube with an internal diameter of 4 mm with various lengths (40-120 cm) was tested at flows of 4-11 L/min. A positive linear relationship between pressure and flow was noted across the different tube lengths up to 120 cm at flows of 4-11 L/min.…”

Section: Valvesmentioning

confidence: 99%

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Technical Aspects of Devices and Equipment for Positive Expiratory Pressure With and Without Oscillation

Olsén

Olofsson²,

Frejd³

et al. 2021

Respir Care

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BACKGROUND: Breathing exercises with positive expiratory pressure (PEP) and oscillating PEP are common treatments for patients with respiratory impairments. There are several trials evaluating the clinical effects of a variety of commercially available and self-made devices. There is a lack of evaluation concerning technical aspects and construction of the devices. The aims of this review were to describe and compare technical aspects of devices and equipment used for PEP and oscillating PEP as a basis for clinical decisions regarding prescriptions. METHODS: In this systematic review, we included trials evaluating different technical aspects of devices and equipment for PEP and oscillating PEP until June 2019. The literature search was performed in PubMed, CINAHL, Cochrane Library, Embase and PEDro. RESULTS: The literature search resulted in 812 studies, which, after being read by 2 independent reviewers, were reduced to 21 trials that matched the inclusion criteria. The achieved PEP is dependent on the given resistance or achieved expiratory flow through the devices and their separate parts. Oscillation frequency in oscillating PEP devices affects the pressure and oscillation amplitude and flow. For some devices, the device's position also has an impact on the outcome. There are similarities and differences among all of the devices, and the equipment components are not interchangeable without changing the achieved PEP levels. CONCLUSIONS: Many devices are available to provide PEP and oscillating PEP treatment. These devices differ substantially in design as well as in performance. When using PEP devices, it is important to understand how all parts of the devices affect outcomes. An increased understanding of how PEP is produced for the spontaneously breathing patient is important to achieve desired treatment effects.

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Section: Resistorsmentioning

confidence: 99%

Section: Resistorsmentioning

confidence: 99%

Section: Resistorsmentioning

confidence: 99%

Section: Resistorsmentioning

confidence: 99%

Section: Valvesmentioning

confidence: 99%

See 3 more Smart Citations

Technical Aspects of Devices and Equipment for Positive Expiratory Pressure With and Without Oscillation

Olsén

Olofsson²,

Frejd³

et al. 2021

Respir Care

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Breathing better: A tech‐monitored study of positive expiratory pressure and reading aloud for chronic obstructive pulmonary disease

Özden,

Parlar Kılıç

2023

Int J of Nursing Practice

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BackgroundBreathing exercises, such as diaphragmatic breathing and positive expiratory pressure (PEP), relieve breathlessness in people with chronic obstructive pulmonary disease (COPD).AimThis study aimed to investigate the effects of breathing exercises with PEP and reading aloud on vital signs, fatigue level, severity of dyspnoea and respiratory function parameters in patients with COPD.DesignThe study followed a randomized controlled trial of COPD patients from a single hospital in eastern Turkey.MethodsThe study included 103 patients who were randomly assigned to receive pre‐reading exercises, breathing exercises with a PEP device or no intervention for 8 weeks.ResultsThe use of a PEP device improved oxygen saturation, forced expiratory volume in 1 s (FEV1) and FEV1/forced vital capacity (FVC) values and reduced fatigue and dyspnoea severity. Reading aloud lowered the mean arterial pressure and reduced fatigue and dyspnoea severity.ConclusionThe study concludes that PEP devices and reading aloud can improve respiratory function in patients with COPD. Additionally, reading aloud is an accessible, easy‐to‐implement and economically feasible method for treating COPD symptoms.

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effect of phonated breathing on oxygen uptake during and after submaximal cycling

Potočnik¹,

Stanković²

2022

Ann. Kin.

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Purpose: Positive expiratory pressure (PEP) exhalation during exercise is reported to improve body adaptation to exercise and enhance the exercise tolerance in patients with chronic obstructive pulmonary disease. Wearing mouthguards results in lower oxygen consumption and increased performance by increasing PEP in athletes. Airway resistance during expiration can be manipulated by phonation. Thus, the aim of our study was to examine the effects of phonated breathing on cardiopulmonary adaptation to moderate exercise and subsequent recovery. Methods: 26 young healthy participants conducted the same moderate steady cycling protocol using three different breathing patterns: spontaneous breathing (BrP1), phonated breathing pronouncing the sound “h” (BrP2) and phonated breathing pronouncing the sound “sh” (BrP3). Heart rate, oxygen consumption, CO2 production, respiratory rate, tidal volume, respiratory exchange ratio and ventilatory equivalents were measured (Cosmed, Italy) before, during and 20 minutes after cycling. Data were analyzed using SPSS, with significance level p<0.05. Results: The analysis revealed no significant differences related to the breathing economy; respiratory rate was increased, and tidal volume decreased with spontaneous breathing compared to both phonated breathing patterns during exercise; no effect of BrPs on cardiopulmonary parameters was found in recovery. Conclusion: Our results do not confirm the assumption that PEP breathing improves exercise economy probably because of the low exercise intensity applied. Further studies should be conducted at higher exercise loads or in patients with pulmonary dysfunction.

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Design and Function of a New Conical Positive Expiratory Pressure Device to Be Used During Exercise

Cited by 3 publications

References 24 publications

Technical Aspects of Devices and Equipment for Positive Expiratory Pressure With and Without Oscillation

Technical Aspects of Devices and Equipment for Positive Expiratory Pressure With and Without Oscillation

Breathing better: A tech‐monitored study of positive expiratory pressure and reading aloud for chronic obstructive pulmonary disease

effect of phonated breathing on oxygen uptake during and after submaximal cycling

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