High-Frequency Airway Oscillating Device for Respiratory Muscle Training in Subjects With COPD.

BACKGROUND: COPD is characterized by expiratory flow limitation, which results in symptomatic dyspnea and reduced exercise capacity. Changes in breathing mechanics mean the respiratory muscles are unable to respond to the ventilatory demands, increasing the sensation of dyspnea. A high-frequency osc...

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Publicado en:Respiratory Care Vol. 63; no. 5; pp. 584 - 591
Autores principales: Daynes, Enya, Greening, Neil J., Harvey-Dunstan, Theresa C., Singh, Sally J.
Formato: research tables/charts Journal Article
Publicado: Mary Ann Liebert, Inc. May2018
Acceso en línea:Ver este registro en EBSCOhost
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      dt: May2018
      vid: 63
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      pub: Mary Ann Liebert, Inc.
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        atl: High-Frequency Airway Oscillating Device for Respiratory Muscle Training in Subjects With COPD.
      aug:
        au:
          Daynes, Enya
          Greening, Neil J.
          Harvey-Dunstan, Theresa C.
          Singh, Sally J.
        affil: Centre for Exercise & Rehabilitation Science, Leicester Respiratory Biomedical Research Unit, Glenfield Hospital, and the University of Leicester, Leicester, United Kingdom
      sug:
        subj:
          Ventilation, High Frequency
          Technology, Medical
          Oscillator
          Pulmonary Disease, Chronic Obstructive Therapy
          Human
          Equipment and Supplies
          Muscle Strengthening Methods
          Pulmonary Disease, Chronic Obstructive Complications
          Respiration
          Respiratory Muscles
          Dyspnea Diagnosis
          Respiratory Function Tests
          Forced Expiratory Volume
          Vital Capacity
          Rehabilitation
          Descriptive Statistics
          Lung Diseases Diagnosis
          Positive Pressure Ventilation
          Wilcoxon Rank Sum Test
      ab: BACKGROUND: COPD is characterized by expiratory flow limitation, which results in symptomatic dyspnea and reduced exercise capacity. Changes in breathing mechanics mean the respiratory muscles are unable to respond to the ventilatory demands, increasing the sensation of dyspnea. A high-frequency oscillating device has been developed to improve dyspnea in patients with COPD. We conducted a feasibility trial to gain insight into the potential for recruitment, retention, and study design for a future randomized controlled trial. METHODS: Symptomatic subjects with COPD were included on the basis of a Medical Research Council (MRC) score ≥ 3 and FEV1/FVC < 0.70). Patients were excluded if they received pulmonary rehabilitation within the last 6 months. The intervention employed the device for 8 weeks, 3 times daily. Clinical outcomes included the MRC score, maximal expiratory and inspiratory pressures (PEmax/PImax), the incremental shuttle walk test (ISWT), and the endurance shuttle walk test (ESWT). RESULTS: We successfully recruited 23 subjects with established COPD (65.2% male, mean age 65 ± 5.03 y, mean % predicted FEV1 43.9 ± 16, mean FEV1/FVC ratio 0.46 ± 0.13, and median [interquartile range] MRC 4 [3-5]). There was a significant change in MRC from 4 to 3 pre to post intervention (P = .003). There was a statistically significant difference in PEmax P < .008 and PImax P = .044. There were no significant differences observed in the ISWT or ESWT. CONCLUSIONS: This study design appeared feasible to proceed to a clinical effectiveness trial. The use of the device for 8 weeks showed a significant improvement in PEmax, PImax, and reduced symptomatic dyspnea on the MRC dyspnea score. The results of this study should encourage a randomized controlled trial.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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