In addition, there has also been reported improvement in compliance and shorter hospital stays 27. Reduction in pulmonary infections/antibiotic courses and improved bronchodilation is also reported 24 – 26. Small clinical studies have reported improved tracheobronchial clearance and patient comfort with PEP devices compared to standard CPT 23, 24. PEP device may give independence to patients with chronic respiratory diseases, as it can be carried out without an assistant and is easy and convenient in use 20 – 22. Treatment is usually performed for about 15–20 minutes twice a day in patient with stable clinical condition 12. Therapy duration and frequency are adjusted according to individual's needs 19. Periods for relaxation and breathing control for about 1–2 minutes are necessary 17, 18. Then a "huff" or a forced exhalation should follow to clean secretions that have been mobilized. This slow deep breathing manoeuvre is repeated anywhere from 10 to 20 times. Then slowly exhales through the mouthpiece with the fixed orifice resister that is usually set to create an expiratory pressure resistance between 10–20 cm H 2O. The patient slowly inspires to vital capacity and then holds his breath for about 3 seconds. This device is considered to allow more air to enter peripheral airways via collateral channels, to allow pressure air to go behind secretions, moving them towards larger airways where they can easily be expelled and to prevent the alveoli from collapsing 8, 13, 14 – 16.Īpplication: Patient must be able to perform certain manoeuvres in an upright or sitting position. The current devices of respiratory physiotherapy are: Positive Expiratory Pressure, High Frequency Chest Wall Oscillation, Oral High Frequency Oscillation, Intrapulmonary Percussive Ventilation, Incentive Spirometry and the Flutter device. Aerosol treatments may be given while the patient is using these devices, if needed. Patients with chronic respiratory diseases prefer to use devices of respiratory physiotherapy because of their benefits, such as the independent application and the reduced cost of therapy. These devices are safe and offer acceptable airway clearance to conventional CPT. According to recent literature, devices of respiratory physiotherapy are introduced as alternative therapy methods 5 – 8 in order to facilitate and improve mobilization of mucus from airways, through which better lung ventilation and improved pulmonary function can be achieved. In recent years, devices of respiratory physiotherapy have emerged which offer alternatives to standard CPT which are less time–consuming and offer greater independence to the patient with chronic lung disease. For this reason many patients refuse to do daily physiotherapy and interrupt it with all bad consequences. However, standard CPT is very labor–intensive and time–consuming both for hospitalized and non-hospitalized patients with impaired airway clearance. CPT has been shown to be effective in maintaining pulmonary function and prevention or reduction of respiratory complications in patients with chronic respiratory diseases 1 – 4. More controlled studies are needed due to the fact that the number of published studies is limited.Ĭhest physiotherapy (CPT) with bronchial drainage is the standard treatment for mobilization and removal of airway secretions in many types of respiratory dysfunction especially in chronic lung disease, such as cystic fibrosis, brochiectasis, bronchitis, bronchial asthma, primary ciliary dyskinesia syndrome. The choice of the suitable device for each patient is a challenge for the physiotherapist in order to achieve better compliance in daily treatment. Current devices seem to be effective in terms of mucus expectoration and pulmonary function improvement, as it is shown by published studies. These devices are the Positive Expiratory Pressure, the High Frequency Chest Wall Oscillation, the Oral High Frequency Oscillation, the Intrapulmonary Percussive Ventilation, the Incentive Spirometry the Flutter and the Acapella and the Cornet. These devices seem to increase patients' compliance to daily treatment, because they present many benefits, as independent application, full control of therapy and easy use. The current devices of physiotherapy for patients with respiratory diseases, are presented as an alternative therapy method or a supplemental therapy and they can motivate patients to apply therapy by themselves. The aim of the present study is to determine the effectiveness of the current devices of respiratory physiotherapy, as it comes from the review of literature. In recent years patients with respiratory diseases use various devices, which help the removal of mucus from the airways and the improvement of pulmonary function.
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