Regional lung clearance during cough and forced expiration technique (FET): effects of flow and viscoelasticity.

Hasani, A.; Pavia, D; Agnew, J. E.; Clarke, S W

doi:10.1136/thx.49.6.557

Cited by 78 publications

(44 citation statements)

References 19 publications

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“…Mean flow rate is lower than PFR. PCF is even higher than PFR 2) . The increase in expiratory muscle strength appeared to contribute only to FEV 1.0 , during which the flow rate is relatively low.…”

Section: Discussionmentioning

confidence: 93%

“…D i f f i c u l t y i n e x p e c t o r a t i o n c a u s e d b y n e u r o m u s c u l a r a n d p u l m o n a r y d i s e a s e s , particularly chronic obstructive pulmonary disease (COPD), increases the risk of pulmonary infection due to the accumulation of airway secretions [1][2][3][4][5] . In patients with respiratory or neuromuscular disease, it is important to maintain exhalation capacity.…”

Section: Introductionmentioning

confidence: 99%

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The Effects of Strength Training of Pelvis Elevator Muscles on Exhalation Capacity in Healthy Men

2007

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Abstract. The effects on expiratory muscle strength and exhalation capacity of increased pelvis elevator muscles strength caused by strength training are not known. Twenty-six male students were randomized to either a training group or a control group. The training group had pelvis elevator muscles strength training twice daily for 4 weeks. At the beginning and end of the study, pelvis elevator muscle strength, maximum expiratory muscle strength (PE max ), and peak cough flow (PCF) were measured, and pulmonary function testing (forced vital capacity (FVC), forced expiratory volume in 1 s (FEV 1.0 ), peak expiratory flow rate (PFR)) was performed. In the training group, significant increases were seen in pelvis elevator muscles strength, PE max , and FEV 1.0 ; no changes were seen in FVC, PFR, or PCF. No significant correlation was seen between change in pelvis elevator muscles strength and changes in exhalation capacity parameters in the training group. Strength training of the pelvis elevator muscles increases respiratory muscle strength, which would suggest that such training could increase exhalation capacity. However, the increase in pelvis elevator muscles strength that occurred as a result of training could not fully account for the changes in expiratory muscle strength or other parameters of exhalation capacity noted after training.

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Section: Discussionmentioning

confidence: 93%

Section: Introductionmentioning

confidence: 99%

The Effects of Strength Training of Pelvis Elevator Muscles on Exhalation Capacity in Healthy Men

2007

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“…Based on the mechanism for normal cough, since expiratory muscles need to contract markedly during the compressive phase, muscles contract in a relatively static manner (more isometric) until the glottis opens. Conversely, a huffing maneuver consists of 1-2 forced expirations without glottal closure 38,43) , and contraction is relatively dynamic (more isotonic). From the perspective of velocity-specific muscle strength trainin 47) , NFR appears useful for improving PCF, while FFR may improve PFR or FEV 1.0 without glottal closure, as in huffing.…”

Section: Discussionmentioning

confidence: 99%

“…Impaired airway clearance increases the risk of pulmonary infection due to the accumulation of airway secretions [37][38][39][40][41] . Coughing 39,40) or forced expiration techniques (called huffing) 43) represent a key m e c h a n i s m f o r a i r w a y p r o t e c t i o n .…”

Section: Introductionmentioning

confidence: 99%

The Effect of Expiratory Muscle Training on Pulmonary Function in Normal Subjects

Sasaki

2007

J Phys Ther Sci

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Abstract. The objective of the present study was to investigate the effects of expiratory muscle training (EMT) on pulmonary function, including peak cough flow (PCF), by administering EMT at a natural or fast flow rate to healthy volunteers. Subjects comprised 33 healthy volunteers randomly divided into 3 groups: EMT at a natural expiratory flow rate (NFR group); EMT at a fast expiratory flow rate (FFR group); and no EMT (Control group). For the NFR and FFR groups, subjects trained using a device for expiratory muscle training at 30% maximal expiratory muscle pressure (PE max ) for 15 min twice daily, 7 days a week for 4 weeks. Before and after training, PE max and pulmonary function were measured. For the NFR and FFR groups, PE max significantly increased but pulmonary function, including PCF, was unchanged. Moreover, no significant correlation was seen between changes in PE max and changes in pulmonary function parameters in the NFR and FFR groups. In conclusion, natural or fast flow rate EMT increases PE max , but neither technique improves pulmonary function, including PCF. Thus, velocity-specific muscle strengthening by EMT does not contribute to changes in pulmonary function related to expiratory flow.

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“…(3) These two respiratory therapy techniques are routinely recommended for the bronchial hygiene of patients with hypersecretion and are typically successful. (3,4) However, there is no evidence that respiratory therapy techniques can be adjunct tools in sputum collection for the analysis of the inflammatory process. Therefore, the objective of this study was to evaluate whether these respiratory therapy techniques influence the quantity of and number of cells within induced sputum in patients with asthma or COPD, with or without hypersecretion.…”

Section: Introductionmentioning

confidence: 99%

Influência da técnica de pressão expiratória positiva oscilante e da técnica de expiração forçada na contagem de células e quantidade do escarro induzido em portadores de asma ou doença pulmonar obstrutiva crônica

et al. 2008

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Objective: To evaluate whether respiratory therapy techniques influence the number of cells within and quantity of induced sputum in patients with asthma or chronic obstructive pulmonary disease (COPD). Methods: Randomized clinical trial, in which patients with asthma or COPD under intervention (n = 16 and 10, respectively) were compared with control groups (n = 16 and 10). Patients in the asthma/intervention (A/I) and COPD/intervention (C/I) groups were submitted to oscillating positive expiratory pressure maneuvers for 5 min, followed by 10 forced expiratory technique sequences. These patients were also submitted to an induced sputum protocol with inhaled hypertonic saline (3%, 4% or 5%; A/I group) or inhaled isotonic saline (C/I group). The asthma/control (A/C) and COPD/control (C/C) groups were submitted only to the standard induced sputum protocol. Results: The final mean weight of the sputum samples was significantly greater in the A/I group than in the A/C group (2,767.25 ± 998.08 mg vs. 1,689.17 ± 1,189.96 mg; p = 0.03). The mean/median total cell counts (×10 6 /mL) were higher in the A/I and C/I groups than in the A/C and C/C groups (4.06/0.95 and 0.63/0.39, p = 0.05, vs. 5.08/1.77 and 0.64/0.40, p = 0.02). There were no statistically significant differences among the groups in terms of cell viability. Conclusions: The use of respiratory therapy techniques can increase sputum sample weight in asthma patients, as well as increasing total cell counts in patients with asthma or COPD.Keywords: Asthma; Pulmonary disease, obstructive chronic; Sputum; Physical therapy modalities. ResumoObjetivo: Avaliar se técnicas fisioterápicas interferem no número de células e na quantidade do escarro obtido por coleta induzida, em pacientes com asma e doença pulmonar obstrutiva crônica (DPOC). Métodos: Ensaio clínico prospectivo e randomizado, no qual os pacientes com asma ou DPOC sob intervenção (n = 16 e 10, respectivamente) foram comparados com grupos controle (n = 16 e 10). Pacientes dos grupos asma/intervenção (A/I) e DPOC/intervenção (D/I) foram submetidos a manobras de pressão expiratória positiva oscilante por 5 min, seguidas de 10 repetições da técnica de expiração forçada. Além disso, esses pacientes foram submetidos a um protocolo de indução de escarro com a inalação de solução salina hipertônica (3%, 4% e 5%), no caso dos A/I, e de solução salina isotônica, no caso dos D/I. Os grupos asma / controle(A/C) e DPOC/controle (D/C) foram somente submetidos ao protocolo padrão de indução de escarro. Resultados: Houve aumento significante do peso média final de escarro no grupo A/I vs. grupo A/C (2.767,25 ± 998,08 mg e 1.689,17 ± 1.189,96 mg, respectivamente; p = 0,03). O número absoluto de células (×10 6 /mL) foi maior nos grupos A/I e D/I do que nos grupos A/C e D/C ( média / mediana, 4,06/0,95 e 0,63/0,39, respectivamente; p = 0,05; e 5,08/1,77 e 0,64/0,40; p = 0,02). A viabilidade celular não apresentou diferença estatisticamente significante entre os grupos. Conclusões: O uso de técnicas respiratórias pode...

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Regional lung clearance during cough and forced expiration technique (FET): effects of flow and viscoelasticity.

Cited by 78 publications

References 19 publications

The Effects of Strength Training of Pelvis Elevator Muscles on Exhalation Capacity in Healthy Men

The Effects of Strength Training of Pelvis Elevator Muscles on Exhalation Capacity in Healthy Men

The Effect of Expiratory Muscle Training on Pulmonary Function in Normal Subjects

Influência da técnica de pressão expiratória positiva oscilante e da técnica de expiração forçada na contagem de células e quantidade do escarro induzido em portadores de asma ou doença pulmonar obstrutiva crônica

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