Acute Effects of a Flutter Device and Chest Wall Compression on Respiratory System Impedance in Bronchiectasis Patients
Condition: Bronchiectasis
MeSH terms: Bronchiectasis
Study type: Interventional

Summary: 
      Bronchiectasis is characterized pathologically by the abnormal and permanent dilation of
      bronchi caused mainly by the perpetuation of inflammation and impaired clearance of
      secretions. Physical therapy is essential in the treatment of these patients, using its
      various techniques and devices. The aim of this study is to evaluate the impedance of the
      respiratory system, by impulse oscillometry, after breathing exercises with chest compression
      or flutter in patients with bronchiectasis, considering that there are no results in the
      literature on the effect of these techniques in the small airways of these patients.
    

Detailed description: 
      Bronchiectasis patients and healthy subjects will be evaluated before and after a 30 minutes
      session of control, breathing exercises with flutter valve, that is a device that produces
      oscillation and positive pressure during the expiratory phase, or chest compression, that is
      a manual manoeuvre in the right and left sides of the lower chest, all of them in a sitting
      position. The main outcome will be obtained by impulse oscillometry, that is a method to
      access large and small airways, to evaluate the resistance (R), reactance (X), reactance area
      (AX) and resonant frequency (Fres) of respiratory system for the whole breath and for
      inspiratory and expiratory phase. Additionally, will be analysed the dyspnea using the
      Medical Research Council scale; acceptability and tolerability scale; pulse oxymetry;
      difficulty of expectoration score; and volume, adhesivity and purulence of sputum.
    

Intervention name(s): Flutter; Chest Compression; Control; Impulse Oscillometric; Dyspnea scale; Acceptability and tolerance; Pulse oximetry; Difficulty sputum
Intervention type(s): Device; Other; Other; Other; Other; Other; Device; Other
Intervention description(s): Flutter is a small device, simple, like a plastic pipe with a mouthpiece at one end and a perforated cover on the other, containing a steel ball resting in a plastic cone inside. When the patient exhales through the flutter expiratory flow causes movement of the ball, creating an oscillatory positive pressure.; Manual chest compression is based on the application of forces resulting from the action of respiratory muscles or physiotherapist manual action in order to increase the alveolar pressure creating a pressure gradient to promote change in pulmonary flow and volume.It consists of vigorous compression of the chest at the beginning of expiration or during expiration.; For this measure will be used IOS Jaeger (Jaeger, Wurzburg, Germany). to minimize the effect of the bad positioning of the tongue will use a mouth "free-flow", which contains a depressant for keeping the tongue in the mouth soil, stabilizing it and reducing oral resistance. Volunteers will support hands firmly on the cheeks to reduce the effect of oscillation thereof. The measures will be carried out with the volunteer sitting, using nasal, relaxed and your head in neutral clip, breathing normally through the mouthpiece to his lips tightly sealed to prevent air leaks.; Dyspnea will be evaluated across the range Medical Research Council (MRC) for use in patients with chronic obstructive pulmonary disease in Brazil.; patients will complete scales 1-7, 1: extremely and 7: none) on usefulness, ease to understand the instructions, easy to perform the exercises, degree of fatigue and discomfort; During therapy the patient will remain monitored with digital oximeter and the information will be recorded before and after the procedures; Patients inform the ease or difficulty sputum according to a scale of 1 to 5, where 1 = no difficulty and 5 = extremely difficult.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Single (Investigator)
Primary purpose: Treatment
Keywords: Respiratory System; Physical Therapy Modalities