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Acute effects on flutter VRP1 on COPD patients

Grant number: 11/21875-0
Support Opportunities:Scholarships abroad - Research
Effective date (Start): August 23, 2012
Effective date (End): July 25, 2013
Field of knowledge:Health Sciences - Physiotherapy and Occupational Therapy
Principal Investigator:Ada Clarice Gastaldi
Grantee:Ada Clarice Gastaldi
Host Investigator: Peter Barnes
Host Institution: Faculdade de Medicina de Ribeirão Preto (FMRP). Universidade de São Paulo (USP). Ribeirão Preto , SP, Brazil
Research place: Imperial College London, England  


Chronic Obstructive Pulmonary Disease (COPD) is characterized by airflow limitation that is not fully reversible, usually progressive, commonly associated with cigarette smoke, chronic inflammation and increased secretory cells associated with mucus hypersecretion. It may occur episodes of exacerbation, characterized by a change in the patient's baseline dyspnea, cough and/or sputum beyond normal daily variations. Several techniques and devices for physical therapy may be indicated to aid removal of secretions, including Flutter VRP1, which is a device capable of combining positive expiratory pressure (PEP) and high frequency oscillations. Studies with stable COPD Flutter VRP1 showed improvement in lung function, while a study of the forced oscillation technique (FOT) showed no differences in pulmonary mechanics. A single study evaluated patients with acute exacerbation and the results showed no changes in lung function, but a greater volume of sputum expectorated. Patients with COPD may benefit from flutter exercises by PEP and oscillations produced, but it is necessary to consider that the PEP produced by the flutter is dependent on flow and may promote airway collapse and opening and may have a negative effect in patients with COPD. For this assessment, measurement of the resistance of central and peripheral airways, measured by the forced oscillation technique (FOT), may be a more sensitive and reliable parameter. The objective is to verify the acute effect of exercise with Flutter on pulmonary mechanics, oxygen saturation and sputum volume in COPD patients, stable and during exacerbations, with or without expectoration, and relate the airway resistance with volume of sputum expectorated. Will be recruited patients with COPD exacerbation and stable, with or without sputum, in a randomized, crossover study, underwent two exercise sessions with the Flutter ® VRP1 or "flutter-sham" for 30 minutes on two consecutive days in random order, assessed before and after therapy by pulse oximetry, measurement of the volume expectorated, and pulmonary function tests by the FOT technique. (AU)

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Scientific publications
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
GASTALDI, ADA CLARICE; PAREDI, PAOLO; TALWAR, ANJANA; MEAH, SALLY; BARNES, PETER J.; USMANI, OMAR S.. Oscillating Positive Expiratory Pressure on Respiratory Resistance in Chronic Obstructive Pulmonary Disease With a Small Amount of Secretion A Randomized Clinical Trial. MEDICINE, v. 94, n. 42, . (11/21875-0)

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