DOI QR코드

DOI QR Code

A Comparison of Acute Effect of Air Stacking Using Resuscitator Bag versus Balloon on Pulmonary Functions

도수 소생기와 풍선을 이용한 공기 누적이 폐 기능에 미치는 즉각적인 효과 비교

  • Ryu, Ji-Yun (Graduate School of Physical Therapy, Sunmoon University) ;
  • Lee, Dong-Yeop (Dept. of Physical Therapy, Sunmoon University) ;
  • Hong, Ji-Heon (Dept. of Physical Therapy, Sunmoon University) ;
  • Kim, Jin-Seop (Dept. of Physical Therapy, Sunmoon University) ;
  • Kim, Seong-Gil (Dept. of Physical Therapy, Sunmoon University)
  • 류지윤 (선문대학교 물리치료학과) ;
  • 이동엽 (선문대학교 물리치료학과) ;
  • 홍지헌 (선문대학교 물리치료학과) ;
  • 김진섭 (선문대학교 물리치료학과) ;
  • 김성길 (선문대학교 물리치료학과)
  • Received : 2020.12.03
  • Accepted : 2020.12.31
  • Published : 2021.02.28

Abstract

Purpose : To compare the immediate effects of air stacking maneuver using resuscitator bags and balloons. Methods : Twenty healthy young adults participated in this study. Forced vital capacity (FVC) and peak cough flow (PCF) tests were performed at pre-intervention, and then, the maximum insufflation capacity (MIC), forced expiratory volume in 1 s (FEV1), FEV1/FVC, peak expiratory flow (PEF), and peak cough flow (PCF) were measured using the air stacking maneuver via resuscitator bags and balloons. Interventions were randomly performed, and a 40-min break was provided between interventions. The evaluation process in this study was conducted in accordance with the guidelines of the American Thoracic Society (ATS) 2019. To compare the three outcomes measured at pre-and post-interventions, repeated measures analysis of variance was performed. Results : A significant difference was found in the MIC, FEV1, PEF, and PCF after the air stacking maneuver using resuscitator bags and balloons, whereas no significant difference was observed between resuscitator bags and balloons. Conclusion : No significant difference was found in the immediate effect of the air stacking maneuver using resuscitator bags and balloons in this study. Air stacking maneuver using balloons can increase the success rate of the techniques by providing visual feedback on the amount of air insufflation when performed with balloon blowing exercise. Balloons are cheaper and easier to buy compared to manual resuscitator bags; therefore, education on the air stacking maneuver using balloons will have a positive effect on pulmonary rehabilitation.

References

  1. An SK, Shin WS(2018). Effect of air stacking training on pulmonary function, respiratory strength and peak cough flow in persons with cervical spinal cord injury. Phys Ther Rehabil Sci, 7(4), 147-153. https://doi.org/10.14474/ptrs.2018.7.4.147. https://doi.org/10.14474/ptrs.2018.7.4.147
  2. Barcelar JM, Aliverti A, Rattes C, et al(2014). The expansion of the pulmonary rib cage during breath stacking is influenced by age in obese women. PLoS One, 9 (11), Printed Online. https://doi.org/10.1371/journal.pone.0110959. https://doi.org/10.1371/journal.pone.0110959
  3. Cha HG, Choe YW, Kim MK(2016). The effects of air stacking exercise on pulmonary function in elderly adults. J Korean Soc Phys Med, 11(4), 55-64. https://doi.org/10.13066/kspm.2016.11.4.55. https://doi.org/10.13066/kspm.2016.11.4.55
  4. Cleary S, Misiaszek JE, Kalra S, et al(2013). The effects of lung volume recruitment on coughing and pulmonary function in patients with ALS. Amyotroph Lateral Scler Frontotemporal Degener, 14(2), 111-115. https://doi.org/10.3109/17482968.2012.720262. https://doi.org/10.3109/17482968.2012.720262
  5. Giggins OM, Persson UMC, Caulfield B(2013). Biofeedback in rehabilitation. J Neuroeng Rehabil, 10(1), Printed Online. https://doi.org/10.1186/1743-0003-10-60. https://doi.org/10.1186/1743-0003-10-60
  6. Graham BL, Steenbruggen I, Miller MR, et al(2019). Standardization of spirometry 2019 update. An official American thoracic society and European respiratory society technical statement. Am J Respir Crit Care Med, 200(8), e70-e88. https://doi.org/10.1164/rccm.201908-1590ST. https://doi.org/10.1164/rccm.201908-1590ST
  7. Hachmann JT, Grahn PJ, Calvert JS, et al(2017). Electrical neuromodulation of the respiratory system after spinal cord injury. Mayo Clin Proc, 92(9), 1401-1414. https://doi.org/10.1016/j.mayocp.2017.04.011. https://doi.org/10.1016/j.mayocp.2017.04.011
  8. Iskandar K, Nugrahanto AP, Ilma N, et al(2019). Use of air stacking to improve pulmonary function in Indonesian Duchenne muscular dystrophy patients: bridging the standard of care gap in low middle income country setting. BMC Proc, 13(11), Printed Online. https://doi.org/10.1186/s12919-019-0179-4. https://doi.org/10.1186/s12919-019-0179-4
  9. Jeong JH, Yoo WG(2015) Effects of air stacking on pulmonary function and peak cough flow in patients with cervical spinal cord injury, J Phys Ther Sci, 27(6), 1951-1952. https://doi.org/10.1589/jpts.27.1951. https://doi.org/10.1589/jpts.27.1951
  10. Katz SL, Barrowman N, Monsour A, et al(2016). Long-term effects of lung volume recruitment on maximal inspiratory capacity and vital capacity in Duchenne muscular dystrophy. Ann Am Thorac Soc, 13, 217-222. https://doi.org/10.1513/AnnalsATS.201507-475BC. https://doi.org/10.1513/AnnalsATS.201507-475BC
  11. Lee JM, Kim EJ, Kang MJ, et al(2016). The influence of aging on pulmonary function tests in elderly Korean population. Tuberc Respir Dis, 49(6), 752-759. https://doi.org/10.4046/trd.2000.49.6.752. https://doi.org/10.4046/trd.2000.49.6.752
  12. Matsuda C, Shimizu T, Nakayama Y, et al(2019). Cough peak flow decline rate predicts survival in patients with amyotrophic lateral sclerosis. Muscle Nerve, 59, 168-173. https://doi.org/10.1002/mus.26320. https://doi.org/10.1002/mus.26320
  13. Marbate RB, Diwate AD, Das AK(2019). An experimental study to check immediate effect of stacked breathing exercise on peak expiratory flow rate in cardiac surgery patient-pilot study. Clin Pract, 16(5), 1259-1265.
  14. Morrow B, Argent A, Zampoli M, et al(2018). Cough augmentation techniques for people with chronic neuromuscular disorders. Cochrane Database Syst Rev, Printed Online. https://doi.org/10.1002/14651858.CD013170. https://doi.org/10.1002/14651858.CD013170
  15. Rafiq MK, Bradburn M, Proctor A, et al(2015). A preliminary randomized trial of the mechanical insufflator exsufflator versus breath stacking technique in patients with amyotrophic lateral sclerosis. Amyotroph Lateral Scler Frontotemporal Degener, 16(7-8), 448-455. https://doi.org/10.3109/21678421.2015.1051992. https://doi.org/10.3109/21678421.2015.1051992
  16. Sarmento A, de Andrade AF, Lima IN, et al(2017) Air stacking: a detailed look into physiological acute effects on cough peak flow and chest wall volumes of healthy subjects. Respir Care, 62(4), 432-443. https://doi.org/10.4187/respcare.05189432. https://doi.org/10.4187/respcare.05189432
  17. Scarlata S, Pedone C, Fimognari FL, et al(2008). Restrictive pulmonary dysfunction at spirometry and mortality in the elderly. Respir Med, 102(9), 1349-1354. https://doi.org/10.1016/j.rmed.2008.02.021. https://doi.org/10.1016/j.rmed.2008.02.021
  18. Spinou A(2020). A review on cough augmentation techniques: assisted inspiration, assisted expiration and their combination. Physiol Res, 69, S93-S103. https://doi.org/10.33549/physiolres.934407. https://doi.org/10.33549/physiolres.934407
  19. Toussaint M, Boitano LJ, Gathot V, et al(2009). Limits of effective cough augmentation techniques in patients with neuromuscular disease. Respir Car, 54(3), 359-366.
  20. Toussaint M, Pernet K, Steens M, et al(2016). Cough augmentation in subjects with Duchenne muscular dystrophy: comparison of air stacking via a resuscitator bag versus mechanical ventilation. Respir Car, 61(1), 61-67. https://doi.org/10.4187/respcare.04033. https://doi.org/10.4187/respcare.04033
  21. Torres-Castro R, Vilaro J, Vera-Uribe R, et al(2014). Use of air stacking and abdominal compression for cough assistance in people with complete tetraplegia. Spinal Cord, 52(5), 354-357. https://doi.org/10.1038/sc.2014.19. https://doi.org/10.1038/sc.2014.19
  22. Torres-Castro R, Vilaro J, Vera-Uribe R, et al(2016). Acute effects of air stacking versus glossopharyngeal breathing in patients with neuromuscular disease. J Med Med Res, 14(3), 1-8. https://doi.org/10.9734/BJMMR/2016/23192. https://doi.org/10.9734/BJMMR/2016/23192