Oscillating Positive Expiratory Pressure on Respiratory Resistance in Chronic Obstructive Pulmonary Disease With a Small Amount of Secretion A Randomized Clinical Trial

Author(s)

Gastaldi, Ada Clarice ^[1] ; Paredi, Paolo ^{[2, 3]} ; Talwar, Anjana ^[4] ; Meah, Sally ^{[2, 3]} ; Barnes, Peter J. ^{[2, 3]} ; Usmani, Omar S. ^{[2, 3]}

Affiliation

^[1] Univ Sao Paulo, Sch Med Ribeirao Preto, Physiotherapy Course, BR-3900 Sao Paulo - Brazil

^[2] Univ London Imperial Coll Sci Technol & Med, Airway Dis Sect, Natl Heart & Lung Inst, London SW7 2AZ - England

^[3] Royal Brompton Hosp, London - England

^[4] All India Inst Med Sci, Dept Physiol, New Delhi 110029 - India

• Document type: Journal article
• Source: MEDICINE; v. 94, n. 42 OCT 2015.
• Web of Science Citations: 4

Abstract

This study aims to evaluate the acute effects of an oscillating positive expiratory pressure device (flutter) on airways resistance in patients with chronic obstructive pulmonary disease (COPD). Randomized crossover study: 15 COPD outpatients from Asthma Lab-Royal Brompton Hospital underwent spirometry, impulse oscillometry (IOS) for respiratory resistance (R) and reactance (X), and fraction exhaled nitric oxide (FeNO) measures. Thirty minutes of flutter exercises: a ``flutter-sham{''} procedure was used as a control, and airway responses after a short-acting bronchodilator were also assessed. Respiratory system resistance (R): in COPD patients an increase in X5insp (0.21 to 0.33 kPa/L/s) and Fres (24.95 to 26.16 Hz) occurred immediately after flutter exercises without bronchodilator. Following 20 min of rest, a decrease in the R5, Delta R5, R20, X5, and Ax was observed, with R5, R20, and X5 values lower than baseline, with a moderate effect size; there were no changes in FeNO levels or spirometry. The use of flutter can decrease the respiratory system resistance and reactance and expiratory flow limitation in stable COPD patients with small amounts of secretions. (AU)

• FAPESP's process: 11/21875-0 - Acute effects on flutter VRP1 on COPD patients
• Grantee: Ada Clarice Gastaldi
• Support Opportunities: Scholarships abroad - Research