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Short-term effects of three slow expiratory airway clearance techniques in patients with bronchiectasis: a randomised crossover trial.

Abstract：

OBJECTIVE:To compare the efficacy of three slow expiratory airway clearance techniques (ACTs). DESIGN:Randomised crossover trial. SETTING:Tertiary hospital. PARTICIPANTS:Thirty-one outpatients with bronchiectasis and chronic sputum expectoration. INTERVENTIONS:Autogenic drainage (AD), slow expiration with glottis opened in lateral posture (ELTGOL), and temporary positive expiratory pressure (TPEP). MAIN OUTCOMES:Sputum expectoration during each session (primary endpoint) and in the 24-hour period after each session. Leicester Cough Questionnaire (LCQ) score and spirometry results were recorded at the beginning and after each week of treatment. Data were summarised as median difference [95% confidence interval (CI)]. RESULTS:Median (interquartile range) daily expectoration at baseline was 21.1 (15.3 to 35.6)g. During physiotherapy sessions, AD and ELTGOL expectorated more sputum than TPEP [AD vs TPEP 3.1g (95% CI 1.5 to 4.8); ELTGOL vs TPEP 3.6g (95% CI 2.8 to 7.1)], while overall expectoration in the 24-hour period after each session was similar for all techniques (P=0.8). Sputum clearance at 24hours post-intervention was lower than baseline assessment for all techniques [AD vs baseline -10.0g (95% CI -15.0 to -6.8); ELTGOL vs baseline -9.2g (95% CI -14.2 to -7.9); TPEP vs baseline -6.0g (95% CI -12.0 to -6.1)]. The LCQ score increased with all techniques (AD 0.5, 95% CI 0.1 to 0.5; ELTGOL 0.9, 95% CI 0.5 to 2.1; TPEP 0.4, 95% CI 0.1 to 1.2), being similar for all ACTs (P=0.6). No changes in lung function were observed. CONCLUSIONS:Slow expiratory ACTs enhance mucus clearance during treatment sessions, and reduce expectoration for the rest of the day in patients with bronchiectasis. CLINICAL TRIAL REGISTRATION NUMBER:NCT01854788.

journal_name

Physiotherapy

journal_title

Physiotherapy

authors

Herrero-Cortina B,Vilaró J,Martí D,Torres A,San Miguel-Pagola M,Alcaraz V,Polverino E

doi

10.1016/j.physio.2015.07.005

subject

Has Abstract

pub_date

2016-12-01 00:00:00

pages

357-364

issue

eissn

0031-9406

issn

1873-1465

pii

S0031-9406(15)03852-3

journal_volume

102

pub_type

杂志文章,随机对照试验

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Short-term effects of three slow expiratory airway clearance techniques in patients with bronchiectasis: a randomised crossover trial.