Abstrakt

Modern therapy should be evidence-bas- ed, that means that the effectiveness of a the r- apy has been proven by clinical trials that satisfy fixed statistical demands. For the oscillating PEP-devices (Flutter, RC-Cornet, and Acapella) this “effectiveness” has been proven. These devices produce in different settings with the same mouthpressure different flows and oscillating frequencies. In addition these devices produce in the different settings different kinds of PEP, from combined PEP (part of the pressure is constant positive, as with the PEP-mask and the other part of the resulting pressure is oscillating on top of the constant pressure) to dynamic PEP, where the whole pressure increases from zero to a maximum and falls back to zero. There is also a difference in the form of those oscillations (“symmetric” that is about sinusoidal and “asymmetric” with a slow increase from zero to the maximum followed by an abrupt drop of the pressure). We examined the flow- and frequency pattern of the devices using a CPAP-machine as pressure source in different settings. In another study we tested what pressure in what setting was felt “comfortable” in normal persons. We compared these pressures with mouthpressures measured in 50 patients with obstructive lung disease in different settings of the RC-Cornet and found that the pressures produced by the patients were about a 30 – 50% lower than in the normals. But these pressures had been high enough to induce therapeutic effects. On the basis of the resulting flows, frequencies and pressures of the oscillating PEP-devices proposals for the setting of the systems for treating different pathologies are given. Looking through the literature proves physiotherapy by oscillating PEP-devices as evidence-based for cystic fibrosis, COPD, asthma and bronchiectasis.

Autoreninformation

Autoren

• U.H. Cegla

Abteilungen

• Medizinisches Fortbildungs- und Schulungszentrum, Montabaur

Adresse

Prof. Dr. med. U.H. Cegla
Horresser Berg 1
D–56410 Montabaur
Email: [email protected]

Citation