ORIGINAL ARTICLE   

Minerva Medica 2024 February;115(1):4-13

DOI: 10.23736/S0026-4806.23.08874-2

Copyright © 2023 EDIZIONI MINERVA MEDICA

language: English

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

Maria T. PESTELLI ¹, Bruna GRECCHI ¹, Erica VOTTERO ¹, Alice GALLI ¹, Antonello NICOLINI ² ✉, Elena COMPALATI ², Paolo BANFI ², Teresa DIAZ DE TERAN ³, Monica GONZALES ³, Francesco D’ABROSCA ^{4, 5}, Lorenzo LIPPI ^{4, 5}, Gianluca FERRAIOLI ⁶, Shauna SHERIDAN ⁷, Marian DIMABUYU-FRANCISCO ⁸, Paolo SOLIDORO ⁹

¹ Physical Medicine and Rehabilitation, General Hospital, Sestri Levante, Genoa, Italy; ² Cardio-Pulmonary Rehabilitation Unit, IRCCS Don Gnocchi Foundation, Milan, Italy; ³ Sleep and Ventilation Unit, Department of Pneumology, Marqués de Valdecilla University Hospital, Cantabria University, Santander, Spain; ⁴ Department of Physical and Rehabilitative Medicine, University of Eastern Piedmont, Novara, Italy; ⁵ Infrastruttura Ricerca Formazione Innovazione (IRFI), SS Antonio e Biagio e Cesare Arrigo Hospital, Alessandria, Italy; ⁶ Respiratory Diseases Unit, Hospital of Sestri Levante, Sestri Levante, Genoa, Italy; ⁷ Lane Fox Unit, St Thomas’ Hospital, London, UK; ⁸ Cardinal Santos Medical Center, Manila, Philippines; ⁹ Unit of Pneumology, Cardiovascular and Thoracic Department, Molinette Hospital, Città della Salute e della Scienza and University of Turin, Turin, Italy

BACKGROUND: Chest 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.
METHODS: Sixty 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.
RESULTS: Sixty 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.
CONCLUSIONS: The 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.

KEY WORDS: Chronic obstructive pulmonary disease; Chest wall oscillation; Respiratory function tests; Quality of life