Inspiratory High Frequency Airway Oscillation Attenuates Resistive Loaded Dyspnea and Modulates Respiratory Function in Young Healthy Individuals

Abstract

Direct chest-wall percussion can reduce breathlessness in Chronic Obstructive Pulmonary Disease and respiratory function may be improved, in health and disease, by respiratory muscle training (RMT). We tested whether high-frequency airway oscillation (HFAO), a novel form of airflow oscillation generation can modulate induced dyspnoea and respiratory strength and/or patterns following 5 weeks of HFAO training (n = 20) compared to a SHAM-RMT (conventional flow-resistive RMT) device (n = 15) in healthy volunteers (13 males; aged 20–36 yrs). HFAO causes oscillations with peak-to-peak amplitude of 1 cm H2O, whereas the SHAM-RMT device was identical but created no pressure oscillation. Respiratory function, dyspnoea and ventilation during 3 minutes of spontaneous resting ventilation, 1 minute of maximal voluntary hyperventilation and 1 minute breathing against a moderate inspiratory resistance, were compared PRE and POST 5-weeks of training (2×30 breaths at 70% peak flow, 5 days a week). Training significantly reduced NRS dyspnoea scores during resistive loaded ventilation, both in the HFAO (p = 0.003) and SHAM-RMT (p = 0.005) groups. Maximum inspiratory static pressure (cm H2O) was significantly increased by HFAO training (vs. PRE; p<0.001). Maximum inspiratory dynamic pressure was increased by training in both the HFAO (vs. PRE; p<0.001) and SHAM-RMT (vs. PRE; p = 0.021) groups. Peak inspiratory flow rate (L.s−1) achieved during the maximum inspiratory dynamic pressure manoeuvre increased significantly POST (vs. PRE; p = 0.001) in the HFAO group only. HFAO reduced inspiratory resistive loading–induced dyspnoea and augments static and dynamic maximal respiratory manoeuvre performance in excess of flow-resistive IMT (SHAM-RMT) in healthy individuals without the respiratory discomfort associated with RMT.

The Comparison of Inspiratory Muscle Training Effectiveness in COPD Patients with Obesity and Normal Weight

“…This in turn contributes to the maximum increase in strength and endurance of the trained respiratory muscles. (21,22) Thus, the results of our study indicate a positive effect of IMT in patients with COPD, and a greater effect in patients with obesity than in those with normal body weight. Clinically, an improvement in the IMT parameters was expressed in a decrease in dyspnea and an improvement in spirometric indicators.…”

The Training to Improve Dyspnoea Study- Patient Experiences of Using a High Frequency Airway Oscillating Device

“…During the discussion there was a mix of patients that found the device helpful and those that did not. This is supported by the survey data, which was embedded in the trial 8 In the postal survey 23 out of 42 respondents (55%) were still using the device. 22 (58%) reported they found the device helpful and “helpful” was coded 11 times in the two focus groups, and “unhelpful” was coded 12 times ( Figure 2 ).…”

“…The HFAO device has demonstrated improvements in respiratory muscle strength and breathlessness in healthy volunteers through flow resistance. 8 The use of HFAO in patients with COPD (the TIDe study) did not demonstrate clinical benefits in breathlessness above a sham, however both groups did improve their breathlessness above established Minimal Clinical Important Differences. The HFAO device demonstrated improves inspiratory muscle strength above the sham group, however, this was not translated into significant benefits in breathlessness.…”

Тренировка Дыхательной Мускулатуры У Пациентов С Хронической Обструктивной Болезнью Легких

“…Протоколы ТДМ, предполагающие интервальный подход с включением периодов отдыха, во время которых происходит снижение выраженности симптомов, развившихся во время нагрузочного периода, являются более эффективными и позволяют оптимизировать достижение переносимости больших нагрузок. Это, в свою очередь, способствует максимальному увеличению силы и выносливости тренируемой дыхательной мускулатуры [17,23,31].…”