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. 2017 Mar 17:5:2050312117697505.
doi: 10.1177/2050312117697505. eCollection 2017.

Evaluation of a novel technique in airway clearance therapy - Specific Cough Technique (SCT) in cystic fibrosis: A pilot study of a series of N-of-1 randomised controlled trials

Sandra Gursli  1 , Leiv Sandvik  2 , Egil Bakkeheim  1 , Bjørn Skrede  3 , Britt Stuge  4
Affiliations

Evaluation of a novel technique in airway clearance therapy - Specific Cough Technique (SCT) in cystic fibrosis: A pilot study of a series of N-of-1 randomised controlled trials

Sandra Gursli et al. SAGE Open Med. .

Abstract

Objectives: The aim of this pilot study was to evaluate the efficacy, safety and participants' perception of a novel technique in airway clearance therapy - specific cough technique in cystic fibrosis.

Methods: We conducted randomised controlled individual trials (N-of-1 randomised controlled trials) in six adults. Each trial included 8 weeks of treatment with two interventions each week, one with specific cough technique and one with forced expiration technique. The efficacy was investigated by a blinded assessor measuring wet weight of sputum (g) after each session. Perceived usefulness and preference was self-reported at the end of study. Additional measurements included oxygen saturation and heart rate before and after each session and lung function (week 2).

Results: Three of six participants produced significantly higher mean sputum weight when using specific cough technique, differences being 21%, 38% and 23%, respectively. In three of the six participants, mean sputum weight was lower after forced expiration technique than after specific cough technique in each of the eight treatment pairs. Participant-reported outcomes were completed in all participants. Specific cough technique was reported to be easier to use in daily treatments and more normalising in everyday life.

Conclusion: Specific cough technique was well tolerated and accepted by the participants with cystic fibrosis. Specific cough technique was non-inferior to forced expiration technique in terms of sputum production, thus specific cough technique appears to represent a promising alternative for clearing sputum in airway clearance therapy.

Keywords: Airway clearance physiotherapy; N-of-1 randomised controlled trials; forced expiration technique; participants’ perception; specific cough technique; sputum production.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Figures

Figure 1.
Figure 1.
Schematic presentation of the treatment schedule for one of the participants: 16 treatments during eight treatment periods and two interventions each week: one with SCT and one with FET and randomised sequence of the interventions. A: forced expiration technique; B: specific cough technique.
Figure 2.
Figure 2.
Participant flow.
See this image and copyright information in PMC

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