| T1: Muñoz et al., 2018(14) Randomized controlled trial |
Evaluate the effectiveness of the ELTGOL technique in respiratory function and elimination of secretions(14).
n = 44. Experimental group (EG): n = 22; age: 63.1±13.5 years. Control (CG)/placebo group: n = 22; age: 66.8±8.4 years(14). |
EG: ELTGOL technique with thoracoabdominal compressions(14). CG / placebo: stretching exercises for the upper limbs(14). |
- Greater clearance of secretions within 24 hours after the first assessment and fewer exacerbations in the EG;
- Significant improvement in quality of life (QL) and impact of coughing on the EG(14). |
| T2: Ozalp et al., 2018(15) Randomized controlled trial |
Evaluate the impact of high intensity inspiratory muscle training (H-IMT)(15).
n = 45. EG: n = 23; age: 42.22±14.3 years. CG: n=22; age: 45.95±11.26 years old(15). |
Experimental group: H-IMT with gradual increase in intensity throughout training(15). Control group: low intensity inspiratory muscle training, maintaining the same intensity(15). |
- Lower values on the dyspnea scale; higher values in the social aspects of the QoL scale and higher number of hospitalizations in the EG;
- Decrease in fatigue in both groups(15). |
| T3: Liao et al., 2015(16) Randomized controlled trial |
Evaluate the effects of FRR regarding dyspnea, cough, exercise tolerance, and sputum production(16).
n = 61. EG: n = 30; age: 68 years (44%-89%). CG: n=31; age: 70 years (52%-91%)(16). |
Experimental group (components of FRR): health education, postural drainage associated with percussion, breathing with semi-closed lips, mobilization of the upper limbs and walking training / mobilization of the lower limbs with breathing control(16). Control group: usual health care and health education sessions(16). |
- Dyspnea and coughing spells decreased, and exercise tolerance and the ability to expectorate increased in the EG(16). |
| T4: Dwyer et al., 2017(17) Randomized controlled crossover trial |
Evaluate the effects of exercises performed on a treadmill and with the Flutter®for airway clearance(17).
n = 25. Age: 30±8 years (19%-48%)(17). |
Treadmill intervention: 20 minutes of constant exercise(17). Flutter®intervention: breathing 15 times through the device, followed by deep breathing, coughing and huffing. Cycle repeated 6 times(17). Control intervention: sitting quietly for 20 minutes(17). Participants were randomly assigned to the three interventions, performing them(17). |
- The treadmill and Flutter®intervention revealed identical and significant improvements in the expiratory flow peak and in the reduction of the mechanism preventing expectoration;
- The Flutter®created a expiratory air flow trend;
- The treadmill intervention promoted sputum hydration(17). |
| T5: Nicolini et al., 2018(18) Randomized controlled trial |
Evaluate whether pharmacological therapy in combination with two percussion techniques produce additional benefits in terms of respiratory function and performance of activities of daily living (ADL)(18).
n = 63. IPV group: n = 20; age 72.8±6.1 years. HFCWO group: n=21; age: 73.8±5.9 years. GC: n=22; age: 74.9±2.7 years(18). |
IPV group (intrapulmonary percussive ventilation): pharmacological treatment along with the IPV device(18). HFCWO (high-frequency chest wall oscillation) group: pharmacological treatment along with the HFCWO device(18). Control group: pharmacological treatment(18). |
- Significant improvement in the IPV and HFCWO groups in relation to dyspnea and performance of ADL and pulmonary function (arterial blood gas values);
- Significant improvement in maximal inspiratory and expiratory pressure in the IPV group, as well as greater efficiency in airway clearance and pulmonary muscle strengthening;
- Similar results in cytological alterations of sputum with a decrease in inflammatory cells(18). |
| T6: Marques et al., 2020(19) Randomized controlled trial |
To verify the effects of FRR, compared to traditional pharmacological care of the symptoms and functionality of people with lower respiratory tract infection (LRTI)(19).
n = 115. EG: n = 55; age: 56.02±18.5 years. CG: n=60; age: 54.1±17.3 years old(19). |
Experimental group: conventional pharmacological treatment combined with FRR, which includes: breath control (breathing with semi-closed lips, rest and relaxation positions, and diaphragmatic breathing); CIFE and ELTGOL; ACBT technique, exercise training (mobilization of the trunk and upper and lower limbs, muscle strengthening, and stretching exercises) and health education sessions(19). Control group: conventional pharmacological treatment(19). |
- Both groups improved in all studied variables except for the values obtained in the modified Borg scale;
- Improvement in terms of pulmonary crackle, oxygen saturation values, mMRC scale, and 6-minute walk test in the EG(19). |
| T7: Nicolini et al., 2017(20) Randomized controlled trial |
To compare the effectiveness of two devices that use PEP in reducing exacerbations and improving respiratory function(20).
n = 120. T-PEP group: n = 40; age: 72.15±1.2 years. O-PEP group: n=40; age: 70.67±2.1 years. CG: n=40; age: 71.13±1.9(20). |
O-PEP group: pharmacological therapy along with an oscillatory positive expiratory pressure (O-PEP) generator device(20). T-PEP group: pharmacological therapy along with a device that generates temporary positive expiratory pressure (T-PEP)(20). Control group: pharmacological therapy(20). |
- Only the T-PEP group statistically reduced exacerbations;
- The use of the two devices resulted in improvements in the dyspnea scale, in pulmonary function, and in the COPD assessment test;
- Both interventions were well tolerated(20). |
| T8: Dwyer et al., 2019(21) Randomized controlled crossover trial |
To compare the effect of exercise on a treadmill with the use of PEP in cleaning the airways at rest(21).
n = 15. Age: 27 years (18%-48%)(21). |
Treadmill intervention: 20 minutes of constant exercise(21). Intervention with PEP: breathing 15 times through the device, followed by deep breathing, coughing, and huffing. Cycle repeated 6 times for 20 minutes(21). Control intervention: breath control sitting calmly for 20 minutes(21). Participants were randomly assigned to the three interventions for participation(21). |
- Exercise on a treadmill increased the clearance of secretions but was significantly less effective than intervention with PEP;
- After the treadmill intervention, less sputum was eliminated from the central region of the lung compared to the PEP intervention;
- PEP enabled more coughing spells than intervention on the treadmill(21). |
| T9: Simoni et al., 2019(22) Randomized controlled crossover trial |
Evaluate the short-term effect of O-PEP and chest compressions on airway clearance(22).
n = 40. EG: n = 20; age: 57±14 years old. CG: n=20; age: 56±10 years old(22). |
Two groups were created: people with bronchiectasis (bronchiectasis group / EG) and healthy people (control group). Each group performed three sessions randomly, that is, three types of intervention: O-PEP (Flutter®) intervention; lower back reeducation intervention; control intervention (sitting quietly)(22). |
- The lower back reeducation intervention increased the amount of sputum eliminated, but O-PEP was more effective in the EG;
- In the EG, there was a decrease in resistance to air passage through the airways;
- There were no significant differences in acceptance, tolerance, dyspnea, and oxygen saturation(22). |
Functional respiratory re-education interventions in people with respiratory disease: a systematic literature review
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