Comparing the performance characteristics of different positive expiratory pressure devices

Journal article


Franks, Lisa J., Walsh, James R., Hall, Kathleen, Jacuinde, Guillermo, Yerkovich, Stephanie and Morris, Norman R.. (2019). Comparing the performance characteristics of different positive expiratory pressure devices. Respiratory Care. 64(4), pp. 434-444. https://doi.org/10.4187/respcare.06410
AuthorsFranks, Lisa J., Walsh, James R., Hall, Kathleen, Jacuinde, Guillermo, Yerkovich, Stephanie and Morris, Norman R.
Abstract

BACKGROUND: Positive expiratory pressure (PEP) devices are widely used in clinical settings, yet the performance characteristics of these devices remain relatively unknown. This study compared the performance characteristics of 6 airway clearance devices by varying resistance and flow.

METHODS: Mean PEP, peak PEP, oscillation frequency, and amplitude PEP of the Flutter, Pari PEP S, Acapella Choice, Acapella DM, Acapella DH, and Aerobika devices were obtained across flows of 5, 10, 15, 20, 25 and 30 L/min and at low, medium, and high resistance using an experimental apparatus custom-built for this bench study.

RESULTS: Performance characteristics of the devices differed across flows and resistance settings (device × flow/resistance interaction; P < .001). At a fixed resistance, increasing flows increased mean PEP produced by the Acapella Choice, Acapella DH, Aerobika, and Pari PEP S. Increasing flow resulted in minimal change in mean PEP produced by the Flutter and Acapella DM. Increasing flow increased peak PEP and amplitude PEP produced by all devices except the Acapella DH and Acapella Choice. Increasing flow maintained or increased oscillation frequency for all devices except the Flutter. At a fixed flow, increasing resistance increased mean PEP produced by all devices except the Acapella Choice. Increasing resistance increased peak PEP produced by the Acapella DM, Aerobika, and Pari PEP S but resulted in minimal change in peak PEP for the Flutter and Acapella Choice. Increasing resistance either maintained or increased oscillation frequency for all devices. Amplitude PEP was either maintained or increased during oscillations when increasing resistance for all devices except the Flutter.

CONCLUSIONS: PEP devices produced small but statistically significant variations in performance characteristics across a range of flows and resistance settings. There appear to be flow-dependent and non–flow-dependent devices. Varying flow or resistance typically maintained or increased the production of mean, peak, and amplitude PEP and oscillation frequency.

Keywordsairway clearance; airway clearance techniques; positive expiratory pressure device; PEP; physiotherapy
Year2019
JournalRespiratory Care
Journal citation64 (4), pp. 434-444
PublisherNLM (Medline)
ISSN1943-3654
0020-1324
Digital Object Identifier (DOI)https://doi.org/10.4187/respcare.06410
Scopus EID2-s2.0-85064239171
Research or scholarlyResearch
Page range434-444
Publisher's version
License
All rights reserved
File Access Level
Controlled
Output statusPublished
Publication dates
Online02 Apr 2019
Publication process dates
Deposited21 May 2021
Permalink -

https://acuresearchbank.acu.edu.au/item/8w1q9/comparing-the-performance-characteristics-of-different-positive-expiratory-pressure-devices

Restricted files

Publisher's version

  • 75
    total views
  • 0
    total downloads
  • 1
    views this month
  • 0
    downloads this month
These values are for the period from 19th October 2020, when this repository was created.

Export as

Related outputs

Physiotherapist perspectives of airway clearance techniques in bronchiectasis
Franks, Lisa J., Walsh, James R., Hall, Kathleen, Adsett, Julie A. and Morris, Norman R.. (2023). Physiotherapist perspectives of airway clearance techniques in bronchiectasis. Physiotherapy Theory and Practice. 39(4), pp. 785-793. https://doi.org/10.1080/09593985.2022.2028326
Evaluation of the inclusion of an allied health assistant within an adult cystic fibrosis centre : Their role, scope of practice, and impact on physiotherapy services
Hall, Kathleen. (2022). Evaluation of the inclusion of an allied health assistant within an adult cystic fibrosis centre : Their role, scope of practice, and impact on physiotherapy services [PhD Thesis]. Australian Catholic University https://doi.org/10.26199/acu.90096
Patient perspectives of airway clearance techniques in bronchiectasis
Franks, Lisa J., Walsh, James R., Hall, Kathleen, Adsett, Julie A. and Morris, Norman R.. (2022). Patient perspectives of airway clearance techniques in bronchiectasis. Physiotherapy Theory and Practice. pp. 1-11. https://doi.org/10.1080/09593985.2022.2126741
Benchmarking service provision, scope of practice, and skill mix for physiotherapists in adult cystic fibrosis care delivery
Hall, Kathleen, Maxwell, Lyndal, Cobb, Robyn, Chambers, Rebecca, Roll, Mark, Bell, Scott C. and Kuys, Suzanne. (2022). Benchmarking service provision, scope of practice, and skill mix for physiotherapists in adult cystic fibrosis care delivery. Physiotherapy Theory and Practice. 38(4), pp. 572-578. https://doi.org/10.1080/09593985.2020.1777606
Physiotherapy service provision in a specialist adult cystic fibrosis service : A pre-post design study with the inclusion of an allied health assistant
Hall, Kathleen, Maxwell, Lyndal, Cobb, Robyn, Steele, Michael, Chambers, Rebecca, Roll, Mark, Bell, Scott Cameron and Kuys, Suzanne. (2021). Physiotherapy service provision in a specialist adult cystic fibrosis service : A pre-post design study with the inclusion of an allied health assistant. Chronic Respiratory Disease. 18, pp. 1-10. https://doi.org/10.1177/14799731211017895
Measuring airway clearance outcomes in bronchiectasis : A review
Franks, Lisa J., Walsh, James R., Hall, Kathleen and Morris, Norman R.. (2020). Measuring airway clearance outcomes in bronchiectasis : A review. European Respiratory Review. 29(156), p. 190161. https://doi.org/10.1183/16000617.0161-2019
Exercise is commonly used as a substitute for traditional airway clearance techniques by adults with cystic fibrosis in Australia : A survey
Ward, Nathan, Stiller, Kathy, Holland, Anne E., Australian Cystic Fibrosis Exercise Survey group and Hall, Kathleen. (2019). Exercise is commonly used as a substitute for traditional airway clearance techniques by adults with cystic fibrosis in Australia : A survey. Journal of Physiotherapy. 65(1), pp. 43-50. https://doi.org/10.1016/j.jphys.2018.11.006
Relating exercise-induced desaturation and gas-exchange in pulmonary artery hypertension
Balmain, Bryce N., Seale, Helen, Harris, Julie, Hall, Kathleen, Lin, Aaron C. W., Sabapathy, Surendran and Morris, Norman R.. (2019). Relating exercise-induced desaturation and gas-exchange in pulmonary artery hypertension. Respiratory Physiology & Neurobiology. 259, pp. 58-62. https://doi.org/10.1016/j.resp.2018.07.008
Gas exchange responses during 6-min walk test in patients with pulmonary arterial hypertension
Morris, Norman R., Seale, Helen, Harris, Julie, Hall, Kathleen, Lin, Aaron C. W. and Kermeen, Fiona. (2017). Gas exchange responses during 6-min walk test in patients with pulmonary arterial hypertension. Respirology. 22(1), pp. 165 - 171. https://doi.org/10.1111/resp.12868
Physiotherapy for cystic fibrosis in Australia and New Zealand: A clinical practice guideline
Button, Brenda M., Wilson, Christine, Dentice, Ruth, Cox, Narelle S., Middleton, Anna, Tannenbaum, Esta, Bishop, Jennifer, Cobb, Robyn, Burton, Kate, Wood, Michelle, Moran, Fiona, Black, Ryan, Bowen, Summar, Day, Rosemary, Depiazzi, Julie, Doiron, Katherine, Doumit, Michael, Dwyer, Tiffany, Elliot, Alison, ... Holland, Anne E.. (2016). Physiotherapy for cystic fibrosis in Australia and New Zealand: A clinical practice guideline. Respirology. 21(4), pp. 656 - 667. https://doi.org/10.1111/resp.12764
The challenge of establishing, growing and sustaining a large biobank. A personal perspective
McQueen, M. J., Keys, J. L., Bamford, K. and Hall, Kathleen. (2014). The challenge of establishing, growing and sustaining a large biobank. A personal perspective. Clinical Biochemistry. 47(4 - 5), pp. 239 - 244. https://doi.org/10.1016/j.clinbiochem.2013.11.017
Gaming console exercise and cycle or treadmill exercise provide similar cardiovascular demand in adults with cystic fibrosis : A randomised cross-over trial
Kuys, Suzanne, Hall, Kathleen, Peasey, Maureen, Wood, Michelle, Cobb, Robyn and Bell, Scott. (2011). Gaming console exercise and cycle or treadmill exercise provide similar cardiovascular demand in adults with cystic fibrosis : A randomised cross-over trial. Journal of Physiotherapy. 57(1), pp. 35 - 40. https://doi.org/10.1016/S1836-9553(11)70005-4