Article

Objective: To evaluate whether temporary positive expiratory pressure provides
benefit in patients with lung diseases and chronic hypersecretion. Design: Single
blind multicentre randomized trial. Setting: Five Italian rehabilitation centres.
Participants: Ninety-eight patients with chronic obstructive pulmonary disease
and/or chronic bronchitis (n=78), or bronchiectasis (n=20), with a peak cough
expiratory flow >150 l/min and sputum production >30 ml/day, randomly included
into two treatment groups. Interventions: For 10 consecutive days, the active
group performed twice a day 20-minute cycles of manually assisted breathing
techniques in sequence with the addition of 15 minutes of temporary positive
expiratory pressure, while the control group was treated by manually assisted
breathing techniques alone. Measures: Within and between group changes of
arterial oxygenation index, lung volumes and respiratory muscles strength were
recorded at enrolment and after 3 and 10 treatment sessions. Pre-to-post
treatment change of sputum volume and bronchial encumbrance (Delta-visual analog
scale), sputum density and purulence were compared daily within the study period.
Results: No significant changes were recorded for the oxygenation index, while
dynamic lung volumes and respiratory muscle strength significantly (P <0.05)
improved in the active group. The group comparison analysis of the pre-to-post
change showed that inspiratory capacity was significantly higher in the active
than in the control group (+19.5% and +2.2%, P=0.044) at day 10. A greater
improvement in Delta-visual analog scale was recorded in the active group at day
3 and 8. Conclusions: These preliminary data suggest that temporary positive
expiratory pressure improves lung volumes and speeds up the improvement of
bronchial encumbrance in patients with lung diseases and hypersecretion.

Langue : ANGLAIS