The validity and reliability of modified cough transport outcome using slower airflow for assessing mucus viscoelasticity
Authors:   School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen Province, Thailand. ,Innovation to Improve Cardiopulmonary and Physical Performance (IICP) Research Group, Khon Kaen University, Khon Kaen Province, Thailand., Nwe Aung Aung , Kosura Nimit ,   Department of Physical Therapy, Faculty of Medicine, Prince of Songkla University, Songkla Province, Thailand, Innovation to Improve Cardiopulmonary and Physical Performance (IICP) Research Group, Khon Kaen University, Khon Kaen Province, Thailand., Phimphasak Chatchai ,   School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Barnludech Pornthip ,   Unit of Physical Therapy, Department of Rehabilitation, Chulaborn Hospital, Bangkok, Thailand, Innovation to Improve Cardiopulmonary and Physical Performance (IICP) Research Group, Khon Kaen University, Khon Kaen Province, Thailand, Aung Sithu ,   Department of Tropical Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen Province, Thailand., Chumpangern Worawat ,   Innovation to Improve Cardiopulmonary and Physical Performance (IICP) Research Group, Khon Kaen University, Khon Kaen Province, Thailand, Pulmonary and Critical Care Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen Province, Thailand., Hongrattana Guntaragorn ,   Department of Physical Therapy, Khon Kaen Hospital, Khon Kaen Province, Thailand., Kluayhomthong Sujittra ,   Department of Physical Therapy, School of Integrative Medicine, Mae Fah Luang University,Chiang Rai Province, Thailand, Domthong Pornanan ,   Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Khon Kaen Hospital, Khon Kaen Province, Thailand., Reechaipichitkul Wipa ,   Pulmonary and Critical Care Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen Province, Thailand., Jaimanee Chatchaya ,   School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen Province, Thailand., Innovation to Improve Cardiopulmonary and Physical Performance (IICP) Research Group, Khon Kaen University, Khon Kaen Province, Thailand., Chatchawan Uraiwon ,   School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen Province, Thailand., Siritaratiwat Wantana ,   School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen Province, Thailand., Ubolsakka-Jones Chulee ,   School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen Province, Thailand., Innovation to Improve Cardiopulmonary and Physical Performance (IICP) Research Group, Khon Kaen University, Khon Kaen Province, Thailand.
Published: September 2024

Background: The cough transportability technique reflects changes in mucus rheology. However, the necessity of high airflow rates, such as 8 L/s, to carry out this technique limits its utility, as specialized setups or equipment are required. Objective: This study aims to identify practical alternatives to higher airflow rates and utilize easily accessible equipment, such as mechanical air pumps (2 L/s). Materials and methods: Mucus simulant gel (MSG) of 4 viscoelasticity and sputum from patients with bronchiectasis were collected and prepared. All samples underwent standard airflow cough transport (sCT) and modified cough transport (mCT). Additionally, three rounds of each MSG and two rounds of sputum underwent mCT. Results: A Pearson correlation analysis between mCT and sCT revealed very high (r=0.986, p=0.014) and high (r=0.771, p<0.001) in the MSG and the sputum of bronchiectasis patients, respectively. The test-retest reliability of mCT revealed ICCs of 0.997 and 0.926 in the MSG and sputum of patients with bronchiectasis, respectively.> Conclusion: mCT could be an alternative to sCT, offering a more accessible option for conducting cough transportability