View More View Less
  • 1 Non-profit National Health Care Provider Svábhegy Allergology Immunology and Pulmonology Budapest Hungary
  • 2 Kaposi Mór Teaching Hospital Mosdós Hungary
  • 3 University of Pécs Pécs Hungary
  • 4 Tábornok u. 20/B H-1143 Budapest Hungary
Restricted access

Purchase article

USD  $25.00

1 year subscription (Individual Only)

USD  $752.00

The objective of the study was to investigate the effect of positive expiratory pressure (PEP) and Flutter on expectoration in cystic fibrosis (CF) patients. Data was gathered through 260 treatments with 10 patients (5 female; 19.2 years; BMI: 18.0). Two methods were used alternately, first the patients started with Flutter and proceeded with PEP, and the next occasion they exercised in the reverse order, starting with PEP then continuing with Flutter. During each phase, 5 sets of 10 exhalations were performed. Sputum weight was measured after the use of the first device, and at the end of the treatment. During sessions starting with Flutter 4.0 ± 4.0 g sputum was expectorated, continuing with PEP, an additional 5.2 ± 5.0 g was produced, altogether 9.2 ± 8.2 g. At sessions starting with PEP 7.4 ± 3.7 g was expectorated, continuing with Flutter an additional 0.8 ± 1.4 g, that is 8.2 ± 4.1 g. Comparing the two devices by themselves, PEP proved to be significantly more efficient then Flutter. Comparing the two treatment types it is statistically not proven, which one is preferable using both devices. Conclusively, PEP is significantly more efficient than the Flutter in sputum expectoration among CF patients. The Flutter is a useful supplementary device.

  • Bell SC, Robinson PJ: Exacerbations in cystic fibrosis. Prevention Thorax 62, 723–732 (2007)

    Robinson P.J. , 'Exacerbations in cystic fibrosis ' (2007 ) 62 Prevention Thorax : 723 -732.

  • Bradley JM, Moran FM, Elborn JS: Evidence for physical therapies (airway clearance and physical training) in cystic fibrosis: An overview of five Cochrane systematic reviews. Respiratory Medicine 100, 191–201 (2006)

    Elborn J.S. , 'Evidence for physical therapies^(airway clearance and physical training) in cystic fibrosis: An overview of five Cochrane systematic reviews ' (2006 ) 100 Respiratory Medicine : 191 -201.

    • Search Google Scholar
  • Celli BR, MacNee W: Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. Eur. Respir. J. 23, 932–946 (2004)

    MacNee W. , 'Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper ' (2004 ) 23 Eur. Respir. J : 932 -946.

    • Search Google Scholar
  • Clunes MT, Boucher RC: Cystic fibrosis: the mechanisms of pathogenesis of an inherited lung disorder. Drug Discov. Today Dis. Mech. 4(2), 63–72 (2007)

    Boucher R.C. , 'Cystic fibrosis: the mechanisms of pathogenesis of an inherited lung disorder ' (2007 ) 4 Drug Discov. Today Dis. Mech : 63 -72.

    • Search Google Scholar
  • Dalcin PTR, Silva F Cystic fibrosis in adults: diagnostic and therapeutic aspects. J Bras. Pneumol. 34(2), 107–117 (2008)

    Silva F.A.A. , 'Cystic fibrosis in adults: diagnostic and therapeutic aspects ' (2008 ) 34 J Bras. Pneumol : 107 -117.

    • Search Google Scholar
  • Elborn JS: How can we prevent multisystem complications of cystic fibrosis? Semin. Respir. Crit. Care. Med. 28(3), 303–311 (2007)

    Elborn J.S. , 'How can we prevent multisystem complications of cystic fibrosis? ' (2007 ) 28 Semin. Respir. Crit. Care. Med : 303 -311.

    • Search Google Scholar
  • Elkins MR, Jones A, van der Schans C: Positive expiratory pressure physiotherapy for airway clearance in people with cystic fibrosis. Cochrane Database Syst. Rev. 19(2), CD003147 (2006)

    Schans C. , 'Positive expiratory pressure physiotherapy for airway clearance in people with cystic fibrosis ' (2006 ) 19 Cochrane Database Syst. Rev : CD003147 -.

    • Search Google Scholar
  • Garrod R, Lasserson T: Role of physiotherapy in management of chronic lung disease: An overview of systematic reviews. Respiratory Medicine 101, 2429–2439 (2007)

    Lasserson T. , 'Role of physiotherapy in management of chronic lung disease: An overview of systematic reviews ' (2007 ) 101 Respiratory Medicine : 2429 -2439.

    • Search Google Scholar
  • Goss CH, Rosenfeld M: Update on cystic fibrosis epidemiology. Curr. Opin. Pulm. Med. 10(6), 510–514 (2005)

    Rosenfeld M. , 'Update on cystic fibrosis epidemiology ' (2005 ) 10 Curr. Opin. Pulm. Med : 510 -514.

    • Search Google Scholar
  • Hristara-Papadopoulou J, Tsanakas G, Papadopoulou DO: Current devices of respiratory physiotherapy. Hippokratia 12(4), 211–220 (2008)

    Papadopoulou D.O. , 'Current devices of respiratory physiotherapy ' (2008 ) 12 Hippokratia : 211 -220.

    • Search Google Scholar
  • Lagerkvist ALB, Sten GM, Redfors SB, Lindblad AG, Hjalmarson O: Immediate changes in blood-gas tensions during chest physiotherapy with positive expiratory pressure and oscillating positive expiratory pressure in patients with cystic fibrosis. Respir. Care 51(10), 1154–1161 (2006)

    Hjalmarson O. , 'Immediate changes in blood-gas tensions during chest physiotherapy with positive expiratory pressure and oscillating positive expiratory pressure in patients with cystic fibrosis ' (2006 ) 51 Respir. Care : 1154 -1161.

    • Search Google Scholar
  • Lindsay KLB, McNamara SB: Airway clearance: The good. The bad. The Research. Cardiopulmonary Physical Therapy Journal Jun (2004)

  • Massery M: Musculoskeletal and neuromuscular interventions: a physical approach to cystic fibrosis. J. R. Soc. Med. 98(Suppl. 45), 55–66 (2005)

    Massery M. , 'Musculoskeletal and neuromuscular interventions: a physical approach to cystic fibrosis ' (2005 ) 98 J. R. Soc. Med. : 55 -66.

    • Search Google Scholar
  • McCarren B, Alison JA: Physiological effects of vibration in subjects with CF. Eur. Respir. J. 27, 1204–1209 (2006)

    Alison J.A. , 'Physiological effects of vibration in subjects with CF ' (2006 ) 27 Eur. Respir. J : 1204 -1209.

    • Search Google Scholar
  • McIlwaine PM, Wong LT, Peacock DA, Davidson GF: Long-term comparative trial of conventional postural drainage and percussion versus positive expiratory pressure physiotherapy in the treatmant of cystic fibrosis. J. Pediatr. 131, 570–574 (1997)

    Davidson G.F. , 'Long-term comparative trial of conventional postural drainage and percussion versus positive expiratory pressure physiotherapy in the treatmant of cystic fibrosis ' (1997 ) 131 J. Pediatr : 570 -574.

    • Search Google Scholar
  • McIlwaine PM, Wong LT, Peacock DA, Davidson GF: Long-term comparative trial of positive expiratory pressure versus oscillating positive expiratory pressure (flutter) physiotherapy in the treatment of cystic fibrosis. J. Pediatr. 138(6), 845–850 (2001)

    Davidson G.F. , 'Long-term comparative trial of positive expiratory pressure versus oscillating positive expiratory pressure^(flutter) physiotherapy in the treatment of cystic fibrosis ' (2001 ) 138 J. Pediatr : 845 -850.

    • Search Google Scholar
  • Mills R: Airways clearance techniques. Cystic fibrosis worldwide. 12, 44–48 (2009)

    Mills R. , 'Airways clearance techniques ' (2009 ) 12 Cystic fibrosis worldwide : 44 -48.

  • Orenstein DM, Hovell MF, Mulvihill M, Keating KK, Hofstetter CR, Kelsey S, Morris K, Nixon PA: Strength vs aerobic training in children with cystic fibrosis. Chest 126, 1204–1214 (2004)

    Nixon P.A. , 'Strength vs aerobic training in children with cystic fibrosis ' (2004 ) 126 Chest : 1204 -1214.

    • Search Google Scholar
  • Orlik T, Sands D: Long-term evaluation of effectiveness for selected chest physiotherapy methods used in the treatment of cystic fibrosis. Med. Wieku Rozwoj. 5(3), 245–257 (2001)

    Sands D. , 'Long-term evaluation of effectiveness for selected chest physiotherapy methods used in the treatment of cystic fibrosis ' (2001 ) 5 Med. Wieku Rozwoj : 245 -257.

    • Search Google Scholar
  • Schechter MS: Airway clearance applications in infants and children. Respiratory Care 52, 10 (2007)

    Schechter M.S. , 'Airway clearance applications in infants and children ' (2007 ) 52 Respiratory Care : 10 -.

    • Search Google Scholar
  • van der Schans C, Prasad A, Main E: Chest physiotherapy compared to no chest physiotherapy for cystic fibrosis. Cochrane Database Syst. Rev. 2, CD001401 (2000)

    Main E. , 'Chest physiotherapy compared to no chest physiotherapy for cystic fibrosis ' (2000 ) 2 Cochrane Database Syst. Rev : CD001401 -.

    • Search Google Scholar
  • Winden van CMQ, Visser A, Hop W, Sterk PJ, Beckers S, de Jongste JC: Effects of flutter and PEP mask physiotherapy on symptoms and lung function in children with cystic fibrosis. Eur. Respir. J. 12, 143–147 (1998)

    Jongste J.C. , 'Effects of flutter and PEP mask physiotherapy on symptoms and lung function in children with cystic fibrosis ' (1998 ) 12 Eur. Respir. J : 143 -147.

    • Search Google Scholar