• Minerva medica · Feb 2024

    Randomized Controlled Trial

    Effectiveness of a new "focused pulse" high-frequency chest wall oscillation in patients with moderate to severe COPD.

    • Maria T Pestelli, Bruna Grecchi, Erica Vottero, Alice Galli, Antonello Nicolini, Elena Compalati, Paolo Banfi, Teresa Diaz DE Teran, Monica Gonzales, Francesco D'Abrosca, Lorenzo Lippi, Gianluca Ferraioli, Shauna Sheridan, Marian Dimabuyu-Francisco, and Paolo Solidoro.
    • Physical Medicine and Rehabilitation, General Hospital, Sestri Levante, Genoa, Italy.
    • Minerva Med. 2024 Feb 1; 115 (1): 4134-13.

    BackgroundChest physiotherapy plays a crucial role in the treatment of COPD, although the optimal techniques for airway clearance have not been definitively established. Among the different techniques, high-frequency chest wall oscillation (HFCWO) has gained attention for its potential to create a widespread lung percussion, facilitating the removal of secretions and potentially clearing the peripheral bronchial tree. This study aims to assess the effectiveness of a novel "focused pulse" HFCWO in patients with moderate to severe COPD.MethodsSixty patients were randomized to three groups: a group treated with the PEP technique, a group with "focused pulse "HFCWO" and a group with pharmacological therapy alone (control group). The primary outcomes were changes in respiratory function parameters, changes in dyspnea and quality of life scores as well as daily life activity and health status assessment. The secondary outcomes were the number of exacerbations and the number of practitioner or emergency department (ED) visits after 1, 3, and 6 months.ResultsSixty patients concluded the study with 20 patients allocated to each group. The two devices improved respiratory function tests, quality of life and health scores and dyspnea compared to the control group. Maximal expiratory pressure and diffusing lung carbon oxide were significantly improved in the focused pulse HFCWO group compared to the PEP group. Only pulse-focused HFCWO showed a statistically significant lower number of exacerbations and visits to ED or practitioner compared to the control group.ConclusionsThe focused pulse HFCWO technique improves daily life activities and lung function in patients with stable COPD. The device demonstrated significantly greater effectiveness in lowering COPD exacerbations as well as visits to ED or practitioner.

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