A Jones1, B H Rowe. 1. Department of Respiratory Care, University of Texas at San Antonio, Texas, USA.
Abstract
OBJECTIVES: This study had two objectives: (1) to examine the effects of bronchopulmonary hygiene physical therapy on patients with chronic obstructive pulmonary disease and bronchiectasis; (2) to determine any differences between manual and mechanical techniques for bronchopulmonary hygiene physical therapy. DESIGN: The study design was a systematic review of the literature that used an exhaustive search for trials and review methods prescribed by the Cochrane Collaboration. INCLUSION CRITERIA: Randomized controlled trials examined patient groups, interventions, and dependent variables. PATIENTS: Patients included those with chronic obstructive pulmonary diseases (emphysema or chronic bronchitis) or bronchiectasis. INTERVENTIONS: Any of the following interventions or combinations thereof were included: manual interventions, such as postural drainage, chest percussion, vibration, chest shaking, directed coughing, or forced exhalation technique. CONTROLS: Controls of the study were as follows: no intervention; placebo; coughing; and mechanical interventions, such as mechanical vibration. RESULTS: The search identified 99 potential trials; inclusion or exclusion analysis left 7, which examined a total of 126 patients. Mean score on trial quality was 1.4 (5 = greatest). Three separate trials (N = 51) found statistically significant effects for bronchopulmonary hygiene physical therapy on sputum production and radioaerosol clearance. No trials (N = 126) found statistically significant effects on pulmonary function variables or differences between manual and mechanical techniques. CONCLUSIONS: Considering the small sizes, low quality, and mixed results from the trials, the research on bronchopulmonary hygiene physical therapy is inconclusive. There is a need for adequately sized, high-quality, randomized controlled trials with uniform patient populations to examine the effects of bronchopulmonary hygiene physical therapy.
OBJECTIVES: This study had two objectives: (1) to examine the effects of bronchopulmonary hygiene physical therapy on patients with chronic obstructive pulmonary disease and bronchiectasis; (2) to determine any differences between manual and mechanical techniques for bronchopulmonary hygiene physical therapy. DESIGN: The study design was a systematic review of the literature that used an exhaustive search for trials and review methods prescribed by the Cochrane Collaboration. INCLUSION CRITERIA: Randomized controlled trials examined patient groups, interventions, and dependent variables. PATIENTS: Patients included those with chronic obstructive pulmonary diseases (emphysema or chronic bronchitis) or bronchiectasis. INTERVENTIONS: Any of the following interventions or combinations thereof were included: manual interventions, such as postural drainage, chest percussion, vibration, chest shaking, directed coughing, or forced exhalation technique. CONTROLS: Controls of the study were as follows: no intervention; placebo; coughing; and mechanical interventions, such as mechanical vibration. RESULTS: The search identified 99 potential trials; inclusion or exclusion analysis left 7, which examined a total of 126 patients. Mean score on trial quality was 1.4 (5 = greatest). Three separate trials (N = 51) found statistically significant effects for bronchopulmonary hygiene physical therapy on sputum production and radioaerosol clearance. No trials (N = 126) found statistically significant effects on pulmonary function variables or differences between manual and mechanical techniques. CONCLUSIONS: Considering the small sizes, low quality, and mixed results from the trials, the research on bronchopulmonary hygiene physical therapy is inconclusive. There is a need for adequately sized, high-quality, randomized controlled trials with uniform patient populations to examine the effects of bronchopulmonary hygiene physical therapy.
Authors: Luiz Carlos de Abreu; Vitor E Valenti; Adriana G de Oliveira; Claudio Leone; Arnaldo Af Siqueira; Dafne Herreiro; Rubens Wajnsztejn; Katia V Manhabusque; Hugo Macedo Júnior; Carlos B de Mello Monteiro; Laís L Fernandes; Paulo Hn Saldiva Journal: Int Arch Med Date: 2011-10-26
Authors: Mohammed Khalid; Sarfraz Saleemi; Mohammed Zeitouni; Saleh Al Dammas; Muhammad Rehan Khaliq Journal: Ann Saudi Med Date: 2004 Jul-Aug Impact factor: 1.526