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Gastaldi A.C.1, Souza L.H.1, Santos D.O.1, Nascimento L.P.1, Paula M.H.1, Martinez J.A.B.2, Souza H.C.D.1
1USP, BMRAL, Ribeirão Preto, Brazil, 2USP, CM, Ribeirão Preto, Brazil
Background: Bronchiectasis is characterized pathologically by abnormal and permanent dilatation of the bronchi caused by the perpetuation of inflammatory processes and impaired removal of secretions. Physical therapy is an essential part of the treatment of these patients, using its various techniques and devices.
Purpose: The objective of this study was to evaluate the effect of techniques flutter and chest compression on removing secretion and changes in the total resistance of the respiratory system in patients with bronchiectasis.
Methods: In a crossover, randomized and blind study, patients with bronchiectasis and healthy volunteers were evaluated before and after 30-minute sessions of control, breathing exercises with flutter, or manual operation of chest compression, all in the sitting position, with a washout period of seven days. The main assessment method used was the impulse oscillometry (IOS), which analyzed 5Hz resistance (R5), 5Hz reactance (X5), and resonance frequency (Fres) of the respiratory system. Additionally, it was evaluated a dyspnea scale of the Medical Research Council (MRC); scale of acceptability and tolerance; pulse oximetry; difficulty to expectorate; and volume, adhesiveness, and purulence of expectorated secretions.
Results: Were recruited 18 subjects to bronchiectasis and 17 for the healthy groups. No significant changes were found in the R5 values, X5 and Fres before and after the interventions flutter, chest compression and control in healthy subjects and bronchiectasis. Thirteen patients with bronchiectasis had cough with secretion with flutter interventions or chest compression, while only three expectorate during the intervention control. The total dry weight of expectorated secretions were higher in both interventions when compared to control intervention (total volume: 7.02 ± 9.24 g, 4.98 ± 4.79 g, 0.88 ± 1.71; dry weight: 1.59 g ± 4.60, 2.05 ± 4.72 g 0.03 ± 0.07 g, respectively) (p 0.05). There was no difference in the ranges of adhesiveness and purulence, in pulse oximetry values, the acceptability ranges, tolerance and dyspnea by the MRC.
Conclusion(s): The results suggest that flutter and chest compression techniques are effective in removing secretion, safe and well tolerated by patients without acute effects on the total resistance of the respiratory system in patients with bronchiectasis.
Implications: A mechanical and manual chest physical therapy technique, flutter and chest compression, can be used to help bronchiectasis patients to remove secretions.
Funding acknowledgements: FAPESP - São Paulo Research Foundation
Topic: Cardiorespiratory
Ethics approval: CEP HC-FMRP
All authors, affiliations and abstracts have been published as submitted.
