Mechanical Behaviors of Flutter VRP1, Shaker, and Acapella Devices

Santos, Alexandre Pereira dos; Guimarães, R.C.; Carvalho, Eliane Maria de; Gastaldi, Ada Clarice

doi:10.4187/respcare.01685

Cited by 36 publications

(27 citation statements)

References 17 publications

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“…Every session lasted 30 minutes and every patient had a treatment twice per day (morning and late afternoon). Chest Physiotherapy (CPT) consisted of a group of respiratory physiotherapy techniques like, slow expiratory with glottis opened in lateral position (ELTGOL) [24], positive expiratory pressure (PEP) mask [25] or PEP bottle [26] and vibratory positive expiratory pressure therapy system [27] (Acapella choice, Smiths Medical, England). Every session lasted 45 minutes and every patient had a treatment twice per day (morning and late afternoon).…”

Section: Methodsmentioning

confidence: 99%

Effectiveness of treatment with high-frequency chest wall oscillation in patients with bronchiectasis

Nicolini¹,

Cardini²,

Landucci³

et al. 2013

BMC Pulm Med

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BackgroundHigh-frequency airway clearance (HFCWC) assist devices generate either positive or negative trans-respiratory pressure excursions to produce high-frequency, small-volume oscillations in the airways.HFCWC can lead to changes in volume of 15–57 ml and in flow up to 1.6 L/s, which generate minimal coughing to mobilize secretions. The typical treatment lasts 20–30 minutes, and consists of short periods of compression at different frequencies, separated by coughing.The aim of this study was to find the more efficacious treatment in patients with bronchiectasis: traditional techniques of chest physiotherapy (CPT) versus high frequency oscillation of the chest wall in patients with bronchiectasis.Methods37 patients were enrolled. Seven of them were excluded. Computer randomization divided the patients into three groups:– 10 patients treated with HFCWO by using the Vest® Airway Clearance System;– 10 patients treated with traditional techniques of air way clearance (PEP bottle, PEP mask, ELTGOL, vibratory positive expiratory pressure);– 10 patients received medical therapy only (control group).To be eligible for enrollment, participants had to be between 18 and 85 years old and have a diagnosis of bronchiectasis, confirmed on high resolution computed tomography. Exclusion criteria: lack of informed consent, signs of exacerbation, cystic fibrosis. Before the treatment, each patient had blood tests, sputum volume and cell count, pulmonary function tests and on the quality of life inventories (MMRC, CAT, BCSS). The results were processed through the covariance analysis, performed with the R-Project statistical program. It has been considered a positive result p <005.ResultsBoth treatments (traditional CPT and HFCWO) showed a significant improvement in some biochemical and functional respiratory tests as well as in the quality of life compared to the control group. The use of HFCWO compared to CPT also produced a significant improvement in blood inflammation parameter C-RP (p ≤0.019), parameters of lung functionality associated with bronchial obstruction (FVC, FEV1) (p ≤0.006 and p ≤0.001), and in the dyspnea. Improvement in quality of life scales was noted. (BCSS, CAT) (both p ≤0.001). No significant changes of total cell counts in sputum samples were observed in the two groups. In the HFCWO group a significant reduction of neutrophils percentage (p≤0.002) and a significant increase of macrophages percentage (p ≤0.012).ConclusionsThe HFCWO technique provides an improvement both in pulmonary function and quality of life related parameters in patients with chronic hypersecretive disease. Since those patients need daily airway clearance, this treatment should be included among the principal options in chest physiotherapy. The study was registered as ChiCTR-TRC-12002134 at http://www.chictr.org.

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Section: Methodsmentioning

confidence: 99%

Effectiveness of treatment with high-frequency chest wall oscillation in patients with bronchiectasis

Nicolini¹,

Cardini²,

Landucci³

et al. 2013

BMC Pulm Med

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“…72, 73 The Lung Flute is a small self-powered handheld audio device that produces a low frequency acoustic wave with moderately vigorous exhalation, rather than oscillatory back pressure, to increase mucus clearance. 74 The majority of patients can manage their chest clearance without requiring devices, but these may be helpful as adjuncts under the supervision of specialist chest physiotherapists.…”

Section: Overall Goals Of Treatmentmentioning

confidence: 99%

Raising awareness of bronchiectasis in primary care: overview of diagnosis and management strategies in adults

Chalmers

Sethi

2017

npj Prim Care Resp Med

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Bronchiectasis is a chronic lung disease characterised by recurrent infection, inflammation, persistent cough and sputum production. The disease is increasing in prevalence, requiring a greater awareness of the disease across primary and secondary care. Mild and moderate cases of bronchiectasis in adults can often be managed by primary care clinicians. Initial assessments and long-term treatment plans that include both pharmacological and non-pharmacological treatments, however, should be undertaken in collaboration with a secondary care team that includes physiotherapists and specialists in respiratory medicine. Bronchiectasis is often identified in patients with other lung diseases, such as chronic obstructive pulmonary disease, asthma, and in a lesser but not insignificant number of patients with other inflammatory diseases, such as rheumatoid arthritis and inflammatory bowel disease. Overall goals of therapy are to prevent exacerbations, improve symptoms, improve quality of life and preserve lung function. Prompt treatment of exacerbations with antibiotic therapy is important to limit the impact of exacerbations on quality of life and lung function decline. Patient education and cooperation with health-care providers to implement treatment plans are key to successful disease management. It is important for the primary care provider to work with secondary care providers to develop an individualised treatment plan to optimise care with the goal to delay disease progression. Here, we review the diagnosis and treatment of bronchiectasis with a focus on practical considerations that will be useful to primary care.

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“…The authors concluded that the Flutter, VRP1 and Shaker devices had a similar performance to that of Acapella in many aspects, except for PEP [9]. It was found that there were significant difference in FVC, FEV1, also (PaO2) and carbon dioxide pressure (PaCO2) in group-A who received positive expiratory pressure breathing (PEPB) plus traditional physical therapy program (TPTP) than group-B who received TPTP only after 4 weeks [10].…”

Section: Discussionmentioning

confidence: 99%

Response of Forced Expiratory Volume/Forced Vital Capacity Ratio to Acapella Device and Breathing Exercises After Upper Abdominal Surgeries

Allam¹,

Khalaf²,

Thabet³

et al. 2016

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Abstract:Background: A major decline in pulmonary function is observed on the first day after upper abdominal surgery.This decline can reduce vital and inspiratory capacity and can culminate in restrictive lung diseases that cause atelectasis, reduced diaphragm movement, and respiratory insufficiency. The aim was to compare the effect of Acapella device and breathing exercises with traditional chest physiotherapy program on forced expiratory volume/ forced vital capacity ratio after upper abdominal surgeries. Subjects and methods: Thirty patients underwent upper abdominal surgery were assigned randomly into two equal groups; their ages ranged from 20-50 years. The study group received breathing exercises, Acapella device and traditional chest physical therapy program (postural drainage. percussion, vibration, cough training and early ambulation). Control group received traditional chest physical therapy program (postural drainage. percussion, vibration, cough training and early ambulation). All groups received three sessions per week for four successful weeks. The data were collected before and after the same period of treatment for both groups. Evaluation procedures were carried out to measure forced expiratory volume/ forced vital capacity ratio (FEV1/FVC ratio) using electronic spirometer. Results: Post treatment results showed that there was a significant difference in FEV1/FVC ratio in both groups in favor of the study group. Percentage of improvement of FEV1/ FVC ratio in the study group was 10.17%, while it was 2.96% in the control group. Conclusion: Acapella device and breathing exercises were more effective in improvement of FEV1/FVC % than traditional chest physical therapy after upper abdominal surgeries.

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Mechanical Behaviors of Flutter VRP1, Shaker, and Acapella Devices

Abstract: The Flutter VRP1 and Shaker devices had a similar performance to that of Acapella in many aspects, except for PEP.

Cited by 36 publications

References 17 publications

Effectiveness of treatment with high-frequency chest wall oscillation in patients with bronchiectasis

Effectiveness of treatment with high-frequency chest wall oscillation in patients with bronchiectasis

Raising awareness of bronchiectasis in primary care: overview of diagnosis and management strategies in adults

Response of Forced Expiratory Volume/Forced Vital Capacity Ratio to Acapella Device and Breathing Exercises After Upper Abdominal Surgeries

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