The Science Journal of the American Association for Respiratory Care

1996 OPEN FORUM Abstracts

COMPARISON OF CHEST PHYSICAL THERAPY, FLUTTER VALVE^{TM}, THERA PEP^{TM} AND AUTOGENIC DRAINAGE.

Tetsuo Miyagawa, RRT, RPT, RCET, Fumihito Kasai, MD, Masazumi Mizuma, MD, Yoshiaki Mori, MD, Dept of Rehab. Medicine, Showa Univ. School of Medicine, Tokyo, Japan, Shinji Fukasawa, RCET, Dept of Inhlation Therapy, Juntendo Univ. School of Medicine, Tokyo, Japan.

Introduction: In recent years, a variety of airway clearance modalities have been developed. They include the flutter valve^{TM}, positive expiratory pressure (Thera PEP^{TM}), and autogenic drainage. Conventional chest physical therapy (CPT) for enhanced mucus clearance involves the use of postural drainage and percussion. Since CPT has been associated with some complications, we administered a modified drainage position and squeezing technique. This study was designed to compare the acute efficacy of airway clearance techniques Methods: A randamized crossover trial consisting of four treatement regimens (CPT, flutter valve^{TM}. Thera PEP^{TM}, and autogenic drainage) was administered to seven patients. Three had chronic bronchitis and four with bronchiectasis. On the first day, each patient was received to 30 minutes of one of the four treatement regimen. A different treatement regimen would be randamized and administered on subsequent day. Pulmonary function testing (PFT), respiratory muscle function. and arterial blood gas (ABG) analysis were measured before and after each treatement. The quantity of sputums expectrated was determined by volume and weight. Results. Thre was a large variance in sputum production between the four treatement regimen. CPT 24.5±3.8g, flutter valve^{TM} 16.7±2.5g, Thera PEP^{TM} 13.0±1.5g, autogenic drainage 11.0±2.0g (ANOVA p0.01). The results of PFT, respiratory muscle strength and ABG analysis were not significantly different between the four treatement regimen. There were significant improvement in FVC, %VC, FEV_{10}, P_{1}max and P_{E}max after each of the four treatements was administered (p^{0.05}). We could not identify any significant change in ABGs after administration of the treatement. Conclusion: We concluded CPT (modified drainage position and squeezing technique) resulted in a significantly greater volume of sputum expectoration than flutter valve^{TM}. Thera PEP^{TM}, and autogenic drainage. No other significant difference in PFT, respiratory muscle strength and ABGs, between the four airway clearance modalities, were identified. All four modalities were found to be equally safe and effective in clearance of bronchial secretions.

Reference: OF-96-198

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