Chest physiotherapy in chronic obstructive pulmonary disease: forced expiratory technique combined with either postural drainage or positive expiratory pressure breathing

Abstract

The aim of this study was to measure the short-term effects on mucus clearance after forced expiratory technique (FET) combined with either postural drainage (PD) or positive expiratory pressure breathing (PEP) on two different days. We also wanted to assess the patient's preference to the two methods. We measured mucociliary clearance at rest and during physiotherapy in 14 patients with chronic obstructive pulmonary disease. The subjects inhaled an aerosol containing 99mTc-labelled albumin colloid. Five sets of scintigraphic images were obtained with 22-min intervals. Lung retention of radioactivity was quantified using a gamma camera and the clearance of particles from the lungs calculated for each 22-min period. The first image was obtained directly after inhalation, the second after a period of 22 min rest, the third after physiotherapy and the fourth and fifth images after further periods of rest. Clearance from the whole lung and from central and peripheral regions were much greater after physiotherapy than at rest. Clearance during PD+FET was significantly higher than during PEP+FET in the total lung field (P < 0.05) and in the peripheral region (P < 0.004). The patients found the two methods equally efficient but most of the patients preferred PEP as a treatment.