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Table 2 Randomized clinical trials

From: Benefits of interventions for respiratory secretion management in adult palliative care patients—a systematic review

Population\PEDro Scale Groups Intervention Outcomes
Pillastrini et al (2006) [17]
Upper Spinal Cord Injury
1
Control (n = 4) Chest Physiotherapy No improvement: FVC; FEV1; PCF; FEV1/FVC; PaO2; PaCO2; Ph; SaO2.
Experimental (n = 5) Chest Physiotherapy + MIE Improvement: FVCa (Before 0.37 ± 0.23 ml /After 0.46 ± 0.21;↑24 %); FEV1a (Before 0.21 ± 0.15 ml /After 0.28 ± 0.14; ↑33 %); PCFa (Before 0.24 ± 0.19 L/s /After 0.31 ± 0.19 L/s;↑29 %).
No improvement: FEV1/FVC; PaO2; PaCO2; Ph; SaO2.
Gosselink et al (2000) [18]
Multiple Sclerosis
5
Control (n = 9) Non-supervised breathing exercises No Improvement: PIMax; Pulmonary Index, FVC; PEMax.
Training (n = 9) Expiratory muscle training (Threshold) Improvement : PIMaxa (↑39 ± 41cmH2O); Pulmonary Indexb (↓ 2 ± 1pts).
No Improvement: FVC; PEMax.
Chaisson et al (2006) [19]
ALS
6
Control (n = 4) Manually assisted cough No improvement: Respiratory complications; Rate of decline in FVC; Survival days.
Experimental (n = 5) Manually assisted cough + Vibratory vest No improvement: Respiratory complications; Rate of decline in FVC; Survival days.
Christensen et al (1990) [20]
COPD
4
Control (n = 22) SHAM therapy with low PEP mask No improvement: FEV1; FVC; PaO2; PaCO2; dyspnoea during activities; cough; sputum; exacerbations; bedridden days; hospitalizations and days with antibiotics.
Experimental (n = 25) Therapy with PEP mask No Improvement: FEV1; FVC; PaO2; dyspnoea walking on ground level; sputum; exacerbations; bedridden days; hospitalizations and days with antibiotics.
Worsening: Coughb [↓11 (−69–75)mm]; PaCO2 [↑0.05(−69–75)kPa]b; dyspnoea walking on staircaseb [↓1 (−69–53)mm].
Smeltzer et al (1996) [21]
Multiple Sclerosis
4
Control (n = 5) SHAM therapy with Threshold No improvement: PIMax; PEMax.
Experimental (n = 10) Expiratory muscle training (Threshold) Improvement: PEMaxb (19,4 ± 9.9cmH2O; ↑19 %).
No improvement: PIMax.
Rafiq et all (2015) [22]
NMD
5
Breath Stacking (n = 21) Breath Stacking Therapy No improvement: Hospital Admissions, number of antibiotics days, pulmonary morbidities, Survival, quality of life.
MIE (n = 19) MIE No Improvement: Hospital Admissions, number of antibiotics days, Hospital Admissions, number of antibiotics days, pulmonary morbidities, Survival, quality of life.
  1. Values presented as mean ± standard deviation or median (interquartile range). apre-post intra-group comparison; bstatistical difference between groups; FVC forced vital capacity, FEV 1 forced expiratory volume in the first second, PCF peak cough flow, PaO 2 Arterial pressure of oxygen, PaCO 2 Arterial pressure of carbon dioxide, SaO 2 Arterial Oxygen Saturation, MIE Mechanical Insufflation-Exsufflation, PIMax Maximum inspiratory pressure, PEMax Maximum expiratory pressure, COPD Chronic obstructive pulmonary disease, PEP Positive expiratory pressure, ALS Amyotrophic lateral sclerosis, NMD Neuromuscular Disease