Acute Effects of a Flutter Device and Chest Wall Compression on Respiratory System Impedance in Bronchiectasis Patients

University of Sao Paulo

Status: Completed

Conditions: Bronchiectasis

Treatments: Other: Chest Compression; Other: Difficulty sputum; Other: Dyspnea scale; Device: Flutter; Other: Impulse Oscillometric; Other: Acceptability and tolerance; Other: Control; Device: Pulse oximetry

Study type: Interventional

Funder types: Other

Identifiers

NCT02509637

USP 2015-3

Details and patient eligibility

About

Bronchiectasis is characterized pathologically by the abnormal and permanent dilation of bronchi caused mainly by the perpetuation of inflammation and impaired clearance of secretions. Physical therapy is essential in the treatment of these patients, using its various techniques and devices. The aim of this study is to evaluate the impedance of the respiratory system, by impulse oscillometry, after breathing exercises with chest compression or flutter in patients with bronchiectasis, considering that there are no results in the literature on the effect of these techniques in the small airways of these patients.

Full description

Bronchiectasis patients and healthy subjects will be evaluated before and after a 30 minutes session of control, breathing exercises with flutter valve, that is a device that produces oscillation and positive pressure during the expiratory phase, or chest compression, that is a manual manoeuvre in the right and left sides of the lower chest, all of them in a sitting position. The main outcome will be obtained by impulse oscillometry, that is a method to access large and small airways, to evaluate the resistance (R), reactance (X), reactance area (AX) and resonant frequency (Fres) of respiratory system for the whole breath and for inspiratory and expiratory phase. Additionally, will be analysed the dyspnea using the Medical Research Council scale; acceptability and tolerability scale; pulse oxymetry; difficulty of expectoration score; and volume, adhesivity and purulence of sputum.

Enrollment: 40 patients

Sex: All

Ages: 30 to 80 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• aged between 30 and 80 years
• diagnosed with bronchiectasis not resulting from cystic fibrosis, defined by history and full clinical examination and confirmed by computed tomography.

Exclusion criteria

• Chest pain
• acute hemoptysis
• recent history rib fracture and pneumothorax
• respiratory infection in the last 4 weeks prior to study
• cystic fibrosis
• asthma
• fistula.
• chronic obstructive pulmonary disease

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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40 participants in 3 patient groups

Flutter Intervention

Active Comparator group

Description:

After initial evaluation, the subjects will perform breathing exercises with quiet inspiration and prolonged expiration on the device for thirty minutes, with breaks of one minute every four minutes. Immediately after the exercise will be performed new assessment against Impulse Oscillometry. Then patients will be kept for 30 minutes at rest and at the end will be applied the acceptability and tolerance scale and a third evaluation with Impulse Oscillometry. The secretions expectorated during the protocol will be evaluated for weight, adhesiveness and purulence.

Treatment:

Other: Difficulty sputum

Other: Impulse Oscillometric

Device: Pulse oximetry

Other: Dyspnea scale

Device: Flutter

Other: Acceptability and tolerance

Chest Compression Intervention

Active Comparator group

Description:

After initial evaluation, the subjects will be instructed to perform deep breaths between three quiet inspiration brought, and expiration will be accompanied by bilateral compression with the therapist's hands on the lower ribs during thirty minutes with one minute intervals of rest every four minutes. Immediately after the exercise will be performed new assessment against Impulse Oscillometry. Then patients will be kept for 30 minutes at rest and at the end will be applied the acceptability and tolerance scale and a third evaluation with Impulse Oscillometry. The secretions expectorated during the protocol will be evaluated for weight, adhesiveness and purulence.

Treatment:

Other: Difficulty sputum

Other: Impulse Oscillometric

Device: Pulse oximetry

Other: Dyspnea scale

Other: Acceptability and tolerance

Other: Chest Compression

Crontrol Intervention

Active Comparator group

Description:

After initial evaluation, patients will be remain seated quiet breathing without any guidance for thirty minutes. Immediately after this time will be held reassessment with Impulse Oscillometry. Then patients will be kept for 30 minutes at rest and at the end will be applied to acceptance and tolerance scale and a third evaluation with Impulse Oscillometry. The secretions expectorated during the protocol will be evaluated for wight, adhesiveness and purulence.

Treatment:

Other: Difficulty sputum

Other: Control

Other: Impulse Oscillometric

Device: Pulse oximetry

Other: Dyspnea scale

Other: Acceptability and tolerance