Effectiveness of oscillatory instrumental bronchial clearance techniques in the treatment of Chronic Obstructive Pulmonary Disease, a systematic review

Abstract

Introduction: Bronchial clearance techniques using oscillatory instrumental devices used in the approach to the COPD patient can improve the cough pattern and favor expiratory flow, thus facilitating the expulsion of secretions, avoiding atelectasis, favoring ventilatory mechanics, oxygenation and maintenance of a patent airway. Methods: A systematic review was carried out following the inclusion criteria based on a search of electronic databases such as: PubMed, Science Direct, Scopus, Springer, Google Scholar, between the period 01/05/2023 to 01/02/2024 in English, Spanish and Portuguese, including studies such as Randomized Clinical Trials and cohort studies. Results: A total of 14 articles were included, 100% in English. The number of participants was 3105, aged between 35 and 85 years, 50.2% of the participants were women. High Frequency Chest Wall Oscillation (HCFWO®) was the most commonly used device 35.7% n=5, followed by Flutter® 28.6% n=4. Intervention time ranged from 1 to 12 weeks, 3 to 7 times per week, 1 to 4 sessions per day, lasting 10 to 30 minutes, between 10 to 20 Hz. Conclusions: The use of HFCWO can have a positive impact on pulmonary rehabilitation, specifically on pulmonary function and oxygenation variables, when implemented as a complementary therapy to early mobilization, therapeutic exercise, and bronchial clearance breathing techniques. Keywords: COPD, mucociliary clearance, chest wall oscillations, respiratory therapy, breathing exercises.

Keywords

• COPD, mucociliary clearance, chest wall oscillations, respiratory therapy.