Annals of Rehabilitation Medicine

Korean Academy of Rehabilitation Medicine (대한재활의학회)
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Improvement of Peak Cough Flow After the Application of a Mechanical In-exsufflator in Patients With Neuromuscular Disease and Pneumonia: A Pilot Study

  • Jung, Ji Ho (Department of Rehabilitation Medicine and Rehabilitation Institute of Neuromuscular Disease, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Oh, Hyeon Jun (Department of Rehabilitation Medicine and Rehabilitation Institute of Neuromuscular Disease, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Lee, Jang Woo (Department of Physical Medicine and Rehabilitation, National Health Insurance Service Ilsan Hospital) ;
  • Suh, Mi Ri (Department of Rehabilitation Medicine and Rehabilitation Institute of Neuromuscular Disease, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Park, Jihyun (Department of Rehabilitation Medicine and Rehabilitation Institute of Neuromuscular Disease, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Choi, Won Ah (Department of Rehabilitation Medicine and Rehabilitation Institute of Neuromuscular Disease, Gangnam Severance Hospital, Yonsei University College of Medicine) ;
  • Kang, Seong-Woong (Department of Rehabilitation Medicine and Rehabilitation Institute of Neuromuscular Disease, Gangnam Severance Hospital, Yonsei University College of Medicine)
  • Received : 2018.05.21
  • Accepted : 2018.06.26
  • Published : 2018.12.31
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Abstract

Objective To investigate and demonstrate persistent increase of peak cough flow after mechanical in-exsufflator application, in patients with neuromuscular diseases and pneumonia. Methods A mechanical in-exsufflator was applied with patients in an upright or semi-upright sitting position (pressure setting, +40 and $-40cmH_2O$; in-exsufflation times, 2-3 and 1-2 seconds, respectively). Patients underwent five cycles, with 20-30 second intervals to prevent hyperventilation. Peak cough flow without and with assistive maneuvers, was evaluated before, and 15 and 45 minutes after mechanical in-exsufflator application. Results Peak cough flow was 92.6 L/min at baseline, and 100.4 and 100.7 L/min at 15 and 45 minutes after mechanical in-exsufflator application, respectively. Assisted peak cough flow at baseline, 15 minutes, and 45 minutes after mechanical in-exsufflator application was 170.7, 179.3, and 184.1 L/min, respectively. While peak cough flow and assisted peak cough flow increased significantly at 15 minutes after mechanical in-exsufflator application compared with baseline (p=0.030 and p=0.016), no statistical difference was observed between 15 and 45 minutes. Conclusion Increased peak cough flow after mechanical in-exsufflator application persists for at least 45 minutes.

Keywords

References

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