Positive expiratory pressure physiotherapy for airway clearance in people with cystic fibrosis.

@article{McIlwaine2015PositiveEP,
  title={Positive expiratory pressure physiotherapy for airway clearance in people with cystic fibrosis.},
  author={Maggie Patricia McIlwaine and Brenda M. Button and Kerry Dwan},
  journal={The Cochrane database of systematic reviews},
  year={2015},
  volume={6},
  pages={
          CD003147
        }
}
BACKGROUND Chest physiotherapy is widely prescribed to assist the clearance of airway secretions in people with cystic fibrosis. Positive expiratory pressure (PEP) devices provide back pressure to the airways during expiration. This may improve clearance by building up gas behind mucus via collateral ventilation and by temporarily increasing functional residual capacity. Given the widespread use of PEP devices, there is a need to determine the evidence for their effect. This is an update of a… 

Tables from this paper

Positive expiratory pressure physiotherapy for airway clearance in people with cystic fibrosis.
TLDR
The effectiveness and acceptability of PEP devices compared to other forms of physiotherapy as a means of improving mucus clearance and other outcomes in people with CF is determined.
Oscillating devices for airway clearance in people with cystic fibrosis.
TLDR
Whether oscillatory devices, oral or chest wall, are effective for mucociliary clearance and whether they are equivalent or superior to other forms of airway clearance in the successful management of secretions in people with cystic fibrosis is investigated.
Chest physiotherapy compared to no chest physiotherapy for cystic fibrosis.
TLDR
The results of this review show that airway clearance techniques have short-term effects in the terms of increasing mucus transport, and no evidence was found on which to draw conclusions concerning the long- term effects.
Chest physiotherapy compared to no chest physiotherapy for cystic fibrosis.
TLDR
The results of this review show that airway clearance techniques have short-term effects in the terms of increasing mucus transport and no evidence was found on which to draw conclusions concerning the long- term effects.
Active cycle of breathing technique for cystic fibrosis.
TLDR
There is insufficient evidence to support or reject the use of the active cycle of breathing technique over any other airway clearance therapy, and longer-term studies are needed to more adequately assess the effects of the Active Cycle of Breathing technique on outcomes important for people with cystic fibrosis.
Airway clearance techniques for cystic fibrosis: an overview of Cochrane systematic reviews.
TLDR
There is little evidence to support the use of one airway clearance technique over another, and more long-term, high-quality randomised controlled trials comparingAirway clearance techniques among people with cystic fibrosis are needed.
Autogenic drainage for airway clearance in cystic fibrosis.
TLDR
The review found that larger studies are required to better evaluate autogenic drainage in comparison to other airway clearance techniques in view of the relatively small number of participants in this review and the complex study designs.
Physiotherapy and cystic fibrosis: what is the evidence base?
TLDR
The role of physiotherapy in CF is complex and includes airway clearance, exercise, and management of the long-term sequelae of musculoskeletal issues which can affect activities of daily living and respiratory health.
Positive expiratory pressure therapy versus other airway clearance techniques for bronchiectasis.
TLDR
Oscillatory PEP therapy twice daily for four weeks had similar effects on disease-specific HRQOL and dynamic and static measures of lung volumes and gas exchange as autogenic drainage and L'expiration Lente Totale Glotte Ouverte en Decubitus Lateral (ELTGOL).
The role of positive expiratory pressure (PEP) in physiotherapy of patients with cystic fibrosis. Comparison with oscillating positive expiratory pressure (OPEP)
TLDR
The aim of this study is to review the literature and analyse the effectiveness of both PEP and OPEP, to summarise the existing evidence and to point to gaps in the knowledge about this issue.
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This review demonstrated no advantage of CCPT over other airway clearance techniques in terms of respiratory function, and there was a trend for participants to prefer self-administered airways clearance techniques.
Chest physiotherapy compared to no chest physiotherapy for cystic fibrosis.
TLDR
The results of this review show that airway clearance techniques have short-term effects in the terms of increasing mucus transport, and no evidence was found on which to draw conclusions concerning the long- term effects.
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TLDR
Sputum clearance was less effective when positive expiratory pressure was included in the treatment regimen and most adolescent and adult patients are able to carry out their treatment independently using gravity assisted positions, breathing exercises emphasising inspiration, and the forced expiration technique.
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It was concluded that PEP mask therapy is an acceptable and effective alternative to postural drainage in interval therapy of patients with cystic fibrosis, although the patients have tended to revert to posturally drainage during acute exacerbations.
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TLDR
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TLDR
Low PEP and high PEP improve gas mixing in individuals with CF, and these improvements were associated with increased lung function, sputum expectoration, and SpO(2).
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TLDR
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