Effect of the chest high-frequency oscillations on lung function in pulmonary diseases

Summary. Mucociliary clearance (MCC) and thoracic muscles are defensive mechanisms which provide effective functioning of respiratory system. Usually, respiratory failure is associated with disorders of MCC and respiratory muscles, primarily due to hyperinflation of the lungs. Medication therapy can not successfully improve these changes. Chest high-frequency oscillation could enhance the airway clearance and decrease lung hyperinflation. The aim of this study was to investigate effects of the chest high-frequency oscillation methods on functional status of patients with pulmonary diseases. This open comparative study involved 3 groups of patients: 10 patient with bronchiectasis (the 1st group; mean age, 55.5 ± 39.0 years), 11 patients with COPD (the 2nd group, 66.2 ± 7.0 years), and 12 patients with COPD as controls (the 3rd group, 60.4 ± 8.6 years). Apart from the standard medication therapy, the 1st and the 2nd groups were treated with chest high-frequency compression device VEST, the 3rd group was administered standard drug treatment only. Lung function using spirometry and body plethysmography, dyspnea, cough and sputum production using the modified MRC scale were measured during the first and the final visits. The treatment with VEST device led to significant improvement in lung function (FEV1 increased by 9.9 % and 5.7 % in the 1st and the 2nd groups, respectively, FVC increased by 7.7 % and 5 %, respectively, RV decreased by 4.6 % and 10 %, respectively). In the 3rd group patients, significant improvement was noted only for FVC by 3 %. Also, dyspnea, cough and sputum production improved more markedly in groups treated with VEST device. Therefore, vibration and compression applied on the chest could improve MCC and lung hyperinflation.

1. Reid L.M. The pathology of obstructive and inflammatory airway diseases. Eur. J. Respir. Dis. 1986; 69 (Suppl. 147): 26–37.

2. Warwick W.J. Mechanisms of mucous transport. Eur. J. Respir. Dis. 1983; 64 (Suppl. 127): 162–167.

3. Mannino D.M., Buist A.S. Global burden of COPD: risk factors, prevalence, and fyture trends. Lancet 2007; 370: 765–773.

4. Bourdin A., Burgel P., Chanez P. et al. Recent advances in COPD: pathophysiology, respiratory physiology and clinical aspects, including comorbidities. Eur. Respir. Rev. 2009; 18: 198–212.

5. Гриппи М.А. Патофизиология легких. М.: БИНОМ; 2008. 27–33, 102–103.

6. Aliverti A., Stevenson N., Dellaca R.L. et al. Regional chest wall volumes during exercise in chronic obstructive pulmonary disease. Thorax 2004; 59: 210–216.

7. Diaz O., Villafranca C., Ghezzo H. et al. Role of inspiratory capacity on exercise tolerance in COPD patients with and without tidal expiratory flow limitation at rest. Eur. Respir. J. 2000; 16: 269–275.

8. Kirilloff L.H., Owens G.R., Rogers R.M., Mazzocco M.C. Does chest physiotherapy work? Chest 1985; 83 (3): 436–444.

9. Diette G.B., Rand C.S., Wise R.A. et al. Feasibility of using a sham control device in clinical trials of High freguency Chest wall Oscillation (HFCWO) in COPD. Am. J. Respir. Crit. Care Med. 2004; 167: 613.

10. Kempainen R.R., Milla C., Dunitz J. et al. Comparison of settings used for high-freguency chest-wall compression in cyctic fibrosis. Respir. Care 2010; 55 (6): 782–783.

11. Allan J.S., Garrity G.M., Donahue D.M. High-freguency chest-wall compression during the 48 hours following thoracic surgery. Respir. Care 2009; 54 (3): 340–343.

12. Chatburn R.L. High-freguency assisted airway clearance. Respir. Care 2007; 52 (9): 1224–1237.

13. Wanger J., Clausen J.L., Coates A. et al. Standardisation of the measurement of lung volumes. Eur. Respir. J. 2005; 26: 511–522.