Airway clearance techniques for bronchiectasis

Cochrane Database of Systematic Reviews

Volumn 2015, Issue 11, 2015, Pages

  Lee, Annemarie L ^a,b   Burge, Angela T ^c,d   Holland, Anne E ^b,c,d  

^a WEST PARK HEALTHCARE CENTRE   (Canada)

^b AUSTIN HOSPITAL   (Australia)

^c ALFRED HEALTH   (Australia)

^d LA TROBE UNIVERSITY   (Australia)

Author keywords

[No Author keywords available]

Indexed keywords

ARTERIAL CARBON DIOXIDE TENSION; ARTERIAL OXYGEN TENSION; BREATHING EXERCISE; BRONCHIECTASIS; CHEST WALL OSCILLATION; DISEASE EXACERBATION; FORCED EXPIRATORY VOLUME; FORCED VITAL CAPACITY; FUNCTIONAL RESIDUAL CAPACITY; HOSPITALIZATION; HUMAN; HYPERINFLATION; LUNG CLEARANCE; OUTCOME ASSESSMENT; PRIORITY JOURNAL; QUALITY OF LIFE; REVIEW; ST. GEORGE RESPIRATORY QUESTIONNAIRE; SYSTEMATIC REVIEW; TOTAL LUNG CAPACITY; ADOLESCENT; ADULT; AGED; ARTIFICIAL VENTILATION; CHILD; COMPLICATION; COUGHING; DEVICES; DISEASE COURSE; HEALTH STATUS; META ANALYSIS; MIDDLE AGED; POSTURAL DRAINAGE; PROCEDURES; RANDOMIZED CONTROLLED TRIAL (TOPIC); SECRETION (PROCESS); SPUTUM; STATISTICS AND NUMERICAL DATA;

ADOLESCENT; ADULT; AGED; BRONCHIECTASIS; CHEST WALL OSCILLATION; CHILD; COUGH; DISEASE PROGRESSION; DRAINAGE, POSTURAL; HEALTH STATUS; HOSPITALIZATION; HUMANS; MIDDLE AGED; QUALITY OF LIFE; RANDOMIZED CONTROLLED TRIALS AS TOPIC; RESPIRATORY THERAPY; SPUTUM;

EID: 84964695278     PISSN: None     EISSN: 1469493X     Source Type: Journal    
DOI: 10.1002/14651858.CD008351.pub3     Document Type: Review

References (149)

1. Figueiredo PHS, Zin WA, Guimaraes FS. Flutter valve improves respiratory mechanics and sputum production in patients with bronchiectasis. Physiotherapy Research International 2010;17:12-20.
2. Guimaraes FS, Moco VJR, Menezes SLS, Dias CM, Salles REB, Lopes AJ. Effects of ELTGOL and Flutter VRP1 on the dynamic and static pulmonary volumes and on the secretion clearance of patients with bronchiectasis [Efeitos da ELTGOL e do Flutter nos volumes pulmonares dinamicos e estaticos e na remocao de secrecao de pacientes com bronquiectasia]. Revista Brasileira de Fisioterapia 2012;16(2):108-13.
3. Kurz M, Ahrens P, Zielen S, Hofmann D. Physiotherapy with the VRP-1 device. Objective and subjective results of a comparative study in children with chronic lung diseases [Physiotherapie mit dem VRP1-Gerat: Objektive und subjektive Ergebnisse einer vergleichenden Studie bei Kindern mit chronischen Lungenerkrankungen]. Pravention und Rehabilitation 1997;9(3):105-9.
4. Murray MP, Pentland JL, Hill AT. A randomised crossover trial of chest physiotherapy in non-cystic fibrosis bronchiectasis. European Respiratory Journal 2009;34(5):1086-92.
5. Nicolini A, Cardini F, Landucci N, Lanata S, Ferrari-Bravo M, Barlascini C. Effectiveness of treatment with high-frequency chest wall oscillation in patients with bronchiectasis. BMC Pulmonary Medicine 2013;13(21):1-8.
6. Sutton PP, Gemmell HG, Innes N, Davidson J, Smith FW, Legge JS. Use of nebulised saline and nebulised terbutaline as an adjunct to chest physiotherapy. Thorax 1988;43:57-60.
7. Svenningsen S, Paulin G, Wheatley A, Pike D, Suggett J, McCormack D, et al. Oscillating positive expiratory pressure therapy in chronic obstructive pulmonary disease and bronchiectasis. Chest 2013;144(741A):741.
8. Altiay G, Uzmezoglu B, Sut N, Tuna H, Hatipoglu ON. Evaluating flutter device and the active cycle of breathing technique in non-cystic bronchiectasis: the prospective randomised study. European Respiratory Journal 2012;40(56s):449s.
9. Ambrosino N, Callegari G, Galloni C, Brega S, Pinna G. Clinical evaluation of oscillating positive expiratory pressure for enhancing expectoration in diseases other than cystic fibrosis. Monaldi Archives for Chest Disease 1995;50(4):269-75.
10. Antunes LC, de Carvalho SMF, Borges FD, de Assis VL, de Godoy I. A study of the conventional chest physiotherapy versus Flutter VRP1 in the treatment of patients carrying bronchiectasis. Salusvita 2001;20(1):23-30.
11. Bernabeu Lledo M, Atin Arratibel MA, Martinez Tardido M, Gonzalez Cifuentes M, Fuertes Conejo R. Efficacy of respiratory physiotherapy combined with ventilation percussive intrapulmonary (VPI) in stable adult. Annals of Physical and Rehabilitation Medicine 2014;57:e326.
12. Bilton D, Daviskas E, Anderson SD, Kolbe J, King G, Stirling RG, et al. Phase 3 randomized study of the efficacy and safety of inhaled dry powder mannitol for the symptomatic treatment of non-cystic fibrosis bronchiectasis. Chest 2013;44(1):215-25.
13. Bradley J, Moran F. Pulmonary rehabilitation improves exercise tolerance in patients with bronchiectasis. Australian Journal of Physiotherapy 2006;52(1):65.
14. Briffa PJ, Anderson SD, Burton DL, Young IH. Sodium cromoglycate and eformoterol attenuate sensitivity and reactivity to inhaled mannitol in subjects with bronchiectasis. Respirology 2011;16(5):161-6.
15. Camargo AA, Lanza FC, Tupinamba T, Corso SD. Reproducibility of step tests in patients with bronchiectasis. Brazilian Journal of Physical Therapy 2013;17(3):255-62.
16. Cecins N, Jenkins SC, Pengelley J, Ryan G. The active cycle of breathing techniques - to tip or not to tip?. Respiratory Medicine 1999;93(9):660-5.
17. Cegla UH, Retzow A. Physiotherapy in chronic obstructive lung diseases - experiences with the VRP1 Desitin in a multicentre comparative study [Physiotherapie mit dem VRP1 bei chronisch obstruktiven Atemwegserkrankungen - Ergebnisse einer multizentrischen vergleichsstudie]. Pneumologie 1993;47:636-9.
18. Clinkscale D, Spihlman K, Watts P, Rosenbluth D, Kollef MH. A randomised trial of conventional chest physical therapy versus high frequency chest wall compressions in intubated and non-intubated adults. Respiratory Care 2012;57(8):221-8.
19. Conway JH, Fleming JS, Perring S, Holgate ST. Humidification as an adjunct to chest physiotherapy in aiding tracheo-bronchial clearance in patients with bronchiectasis. Respiratory Medicine 1992;86(2):109-14.
20. Crisafulli E, Coletti O, Costi S, Zanasi E, lorenzi C, Lucic S, et al. Effectiveness of erdosteine in elderly patients with bronchiectasis and hypersecretion: a 15 days prospective, parallel, open-label, pilot study. Clinical Therapeutics 2007;29(9):2001-9.
21. Currie DC, Greenstone M, Pavia D, Agnew JE, Pellow P, Clarke SW, et al. Efficacy of 'mucoregulatory' agents in Young's syndrome. Thorax 1988;43(6):480-1.
22. Daviskas E, Anderson SD, Eberl S, Young IH. Effect of increasing doses of mannitol on mucus clearance in patients with bronchiectasis. European Respiratory Journal 2008;31(4):765-72.
23. De Diego A, Milara J, Martinez-Moragon E, Palop M, Leon M, Cortijo J. Effects of long-term azithromycin therapy on airway oxidative stress markers innon-cystic fibrosis bronchiectasis. Respirology 2013;18:1056-62.
24. Eaton T, Young P, Zeng I, Kolbe J. A randomised evaluation of the acute efficacy, acceptability and tolerability of Flutter and active cycle of breathing with and without postural drainage in non-cystic fibrosis bronchiectasis. Chronic Respiratory Disease 2007;4(1):23-30.
25. Gallon A. Evaluation of chest percussion in the treatment of patients with copious sputum production. Respiratory Medicine 1991;85(1):45-51.
26. Gastaldi A, Tambascio J, Lisboa R, Passarelli R, Tatiana L. Effect of the components of Flutter VRP1 on the transport of respiratory secretions in patients with bronchiectasis. World Physical Therapy Conference proceedings 2011;97:eS395-eS396.
27. Gokdemir Y, Karadag-Saygi E, Erdem E, Bayindir O, Ersu R, Karadag B, et al. Comparison of conventional pulmonary rehabilitation and high-frequency chest wall oscillation in primary ciliary dyskinesia. Pediatric Pulmonology 2014;49(6):611-6.
28. Gurses HN, Ayhan B, Demir R, Ozyilmaz S. The effects of inspiratory muscle training on respiratory muscle strength and pulmonary functions in children with bronchiectasis. European Respiratory Journal 2013;47(Suppl 57):5064.
29. Hartsell MB. Chest physiotherapy and mechanical vibration. Journal of Paediatric Nursing 1987;2(2):135-7.
30. Hasani A, Pavia D, Agnew JE, Clarke SW. Regional lung clearance during cough and forced expiration technique (FET): effects of flow and viscoelasticity. Thorax 1994;49(6):557-61.
31. Hasani A, Toms N, Agnew JE, Pavia D, Clarke SW. Regional mucus clearance following cough and forced expiration technique in patients with asthma, chronic bronchitis and bronchiectasis. European Respiratory Journal Supplement 1995;8:19297.
32. Herrero B, Polverino E, Romeu DM, Vilaro J. Efficacy of airway clearance therapy with different autonomy degrees in nonCF-bronchiectasis: randomised cross-over trial. European Respiratory Society 21st Annual Congress; 2011 Sep 24-28; Amsterdam. 2011; Vol. 38, issue 3:540s (2977).
33. Herrero B, Polverino E, SanMiguel M, Alcaraz V, Marti D, Vilaro J, Torres A. Wet sputum as an objective outcome in a randomized crossover trial in NCF-BE: Reliability and responsiveness. European Respiratory Journal 2014;44:P4274.
34. Huang H, Yang P, Xue J, Tang J, Ding L, Ma Y, Wang J, Guyatt GH, Vannivasingam T, Zhang Y. Evaluating the individualized treatment of traditional Chinese medicine: A pilot study of N-of-1 trials. Evidence-based Complementary and Alternative Medicine 2014;2014:148730.
35. Indinnimeo L, Tancredi G, Barreto M, De Castro G, Zicari AM, Monaco F, et al. Effects of a program of hospital-supervised chest physical therapy on lung function tests in children with chronic respiratory disease: 1-year follow-up. International Journal of Immunopathology and Pharmacology 2007;20(4):841-5.
36. Joshi JM, Sundaram P. Role of inhaled steroids in stable bronchiectasis. Indian Practitioner 2004;57(4):243-5.
37. Kaminska TM, Pearson SB. A comparison of postural drainage and positive expiratory pressure in the domiciliary management of patients with chronic bronchial sepsis. Physiotherapy 1988;74(5):251-4.
38. Kellett F, Redfern J, Niven RM. Evaluation of nebulised hypertonic saline (7%) as an adjunct to physiotherapy in patients with stable bronchiectasis. Respiratory Medicine 2005;99(1):27-31.
39. Kellett F, Robert NM. Nebulised 7% hypertonic saline improves lung function and quality of life in bronchiectasis. Respiratory Medicine 2011;105(4):1831-5.
40. Larroquet M, Balquet P, Gruner M. Video-assisted thorascopic surgery for bronchiectasis. Pediatric Pulmonology 1997;24 Suppl 16:180.
41. Lee AL, Hill CJ, Cecins N, Jenkins S, McDonald CF, Burge AT, et al. The short and long term effects of exercise training in non-cystic fibrosis bronchiectasis - a randomised controlled trial. Respiratory Research 2014;15(1):1-10.
42. Long C. The Effects of Manual Chest Percussion in Patients with Chronic Obstructive Pulmonary Disease and Bronchiectasis. East Sussex Hospitals NHS Trust 2001.
43. Maa SH, Tsou TS, Wang KY, Wang CH, Lin HC, Huang YH. Self-administered acupressure reduces the symptoms that limit daily activities in bronchiectasis patients: pilot study findings. Journal of Clinical Nursing 2007;16(4):794-804.
44. Mandal P, Sidhu MK, Kope L, Pollock W, Stevenson LM, Pentland JL, et al. A pilot study of pulmonary rehabilitation and chest physiotherapy versus chest physiotherapy alone in bronchiectasis. Respiratory Medicine 2012;106(12):1647-54.
45. Masekela R, Anderson R, Gongxeka H, Steel HC, Becker PJ, Green RJ. Lack of efficacy of an immunomodulatory macrolide in childhood HIV related bronchiectasis: a randomised, placebo-controlled trial. Journal of Antivirals and Antiretrovirals 2013;5(2):44-9.
46. Mazzocco MC, Owens GR, Kirilloff LH, Rogers RM. Chest physiotherapy and postural drainage in patients with bronchiectasis. Chest 1985;88(3):360-3.
47. Moran FM, Elborn SE, Bradbury I, Piper A, Hewitt O, Bradley JM. Airway clearance in bronchiectasis: is non-invasive ventilation a useful adjunct in moderate to severe disease?. Thorax 2007;62 Suppl III:A87.
48. Morgan LC, Maxwell L, de Longhi R, Peters MJ, Rutland J. Comparison of Flutter device (FD) with postural drainage (PD) in adult patients with non-CF bronchiectasis. Proceedings of the Thoracic Society of Australia and New Zealand 1999;52:P93.
49. Mutalithas K, Watkin G, Willig B, Wardlaw A, Pavord ID, Birring SS. Improvement in health status following bronchopulmonary hygiene physical therapy in patients with bronchiectasis. Respiratory Medicine 2008;102(8):1140-4.
50. Nakamura S, Hashimoto Y, Mikami M, Yamanaka E, Soma T, Hino M, et al. Effect of the proteolytic enzyme serrapeptase in patients with chronic airway disease. Respirology 2003;8(3):316-20.
51. Naraparaju S, Vaishali K, Venkatesan P, Acharya V. A comparison of the Acapella and a threshold inspiratory muscle trainer for sputum clearance in bronchiectasis - a pilot study. Physiotherapy Theory and Practice 2010;26(6):353-7.
52. Narayanan A, Meng O, Hyder Ali I A, Izmi M, Ahmad I, Rehab M, et al. A pilot randomized control cross over study evaluating the effectiveness and safety of mechanical percussor compared with conventional chest physiotherapy in adults with productive cough. Medical Journal of Malaysia 2014;69(1):16-20.
53. Newall C, Stockley RA, Hill SL. Exercise training and inspiratory muscle training in patients with bronchiectasis. Thorax 2005;60(11):943-8.
54. Newton DA. Chest physiotherapy under scrutiny. Lancet 1979;1(8106):49-50.
55. Noone PG, Bennett WD, Regnis JA, Zeman KL, Carson JL, King M, et al. Effect of aerosolized uridine-5'-triphosphate on airway clearance with cough in patients with primary ciliary dyskinesia. American Journal of Respiratory and Critical Care Medicine 1999;160(1):144-9.
56. Osadnik C, Stuart-Andrews C, Ellis SE, Thompson B, McDonald CF, Holland AE. Positive expiratory pressure via mask does not improve ventilation inhomogeneity more than huffing and coughing in individuals with stable chronic obstructive pulmonary disease and chronic sputum expectoration. Respiration 2014;87(1):38-44.
57. Paneroni M, Clini E, SImonelli C, Bianchi L, Degli Antoni F, Vitacca M. Safety and efficacy of short-term intrapulmonary percussive ventilation in patients with bronchiectasis. Respiratory Care 2011;56(7):984-8.
58. Patterson JE, Bradley JM, Elborn JS. Airway clearance in bronchiectasis: a randomized crossover trial of active cycle of breathing techniques (incorporating postural drainage and vibration) versus test of incremental respiratory endurance. Chronic Respiratory Disease 2004;1(3):127-30.
59. Patterson JE, Bradley J, Hewitt O, Bradbury I, Elborn JS. Airway clearance in bronchiectasis: a randomised cross-over trial of active cycle of breathing techniques versus acapella. Respiration 2005;72:239-42.
60. Patterson JE, Hewitt O, Kent L, Bradbury I, Elborn JS, Bradley JM. Acapella versus 'usual airway clearance' during acute exacerbation in bronchiectasis: a randomised crossover trial. Chronic Respiratory Disease 2007;4(2):67-74.
61. Polverino E, Herrero B, Vilaro J, Marti D. Efficacy of airway clearance therapy with different autonomy degrees in non-CF bronchiectasis: a randomised cross-over trial. American Journal of Respiratory and Critical Care Medicine 2012;185(1):A4876.
62. Santamaria F, Celentano L, Buonpensiero P, Sarnelli P, Caterino M, Raia V. Positive expiratory pressure treatment: efficacy in pulmonary diseases. Journal of Pediatrics 1998;133(5):717-8.
63. Savci S, Inal D, Arikan H. A comparison of the active cycle of breathing technique with and without manual techniques in patients with bronchiectasis. European Respiratory Journal 1998;1 Suppl 12:28212S.
64. Su CL, Chang CC, Lin YK, Lee KT, Lee CN, Chiang LL. Randomised crossover study of lung expansion therapy using negative pressure and positive pressure in bronchiectasis. Journal of Experimental and Clinical Medicine 2012;4(7):149-53.
65. Sutton PP, Parker RA, Webber BA, Newman SP, Garland N, Lopez Vidriero MT, et al. Assessment of the forced expiration technique, postural drainage and directed coughing in chest physiotherapy. European Journal of Respiratory Diseases 1983;64(1):62-8.
66. Syed N, Maiya AG, Siva Kumar T. Active cycles of breathing technique (ACBT) versus conventional chest physical therapy on airway clearance in bronchiectasis - crossover trial. Advances in Physiotherapy 2009;11(4):193-8.
67. Tabernero A, Gil P, Alkiza R, Garros J, Hernandez A, Artola JL. Inhaled colistin in elderly patients with non-cystic fibrosis bronchiectasis and chronic Pseudomonas aeruginosa (PA) bronchial infection. Chest 2014;145(Suppl 3):431A.
68. Tabernero Huguet E, Gil Alana P, Alkiza Basanez R, Hernandez Gil A, Garros Garay J, Artola Igarza JL. Inhaled colistin in elderly patients with non-cystic fibrosis bronchiectasis and chronic Pseudomonas aeruginosa bronchial infection [Tratamiento inhalado con colistina a largo plazo en pacientes ancianos con infeccion cronica por Pseudomonas aeruginosa y bronquiectasias]. Revista Espanola de Geriatria y Gerontologia 2015;50:111-5.
69. Tambascio J, de Souza LT, Lisboa RMh, Passarelli RDCV, de Souza HCD, Gastaldi AC. The influence of Flutter VRP1 components of mucus transport of patients with bronchiectasis. Respiratory Medicine 2011;105(9):1316-21.
70. Tambascio J, Baddini-Martinez JA, Passarelli CV, Goncalves EC, Miranda APB, Martinez R, Gastaldi AC. Effects of Flutter ® VRP1 on inflammatory profile, microbiology and transport indexes of respiratory secretions of patients with bronchiectasis. American Journal of Respiratory and Critical Care Medicine 2014;189:A6260.
71. Thompson CS, Harrison S, Ashley J, Day K, Smith DL. Randomised crossover study of the Flutter device and the active cycle of breathing technique in non-cystic fibrosis bronchiectasis. Thorax 2002;57(5):446-8.
72. Tsang KWT, Roberts P, Read RC, Kees R, Wilson R, Cole PJ. The concentrations of clarithromycin and its 14-hydroxy metabolite in sputum of patients with bronchiectasis following single dose administration. Journal of Antimicrobial Chemotherapy 1994;33(2):289-97.
73. Tsang SMH, Jones AYM. Postural drainage or flutter device in conjunction with breathing and coughing compared to breathing and coughing alone in improving secretion removal and lung function in patients with acute exacerbation of bronchiectasis. A pilot study. Hong Kong Physiotherapy Journal 2003;21:29-36.
74. Valente AM, Gastaldi AC, Cravo SL, Afonso JL, Sologuren MJJ, Guimaraes RC. The effect of two techniques on the characteristics and transport of sputum in patients with bronchiectasis. A pilot study. Physiotherapy 2004;90(3):158-64.
75. Venturelli E, Crisafulli E, deBiase A, Righi D, Berrighi D, Cavicchioli PP, et al. Efficacy of temporary positive expiratory pressure (TPEP) in patients with lung diseases and chronic mucus hypersecretion. The UNIKO(R) project: a multicentre randomized controlled trial. Clinical Rehabilitation 2013;27(4):336-46.
76. Volker C. Objectivation of treatment effects in children with respiratory tract diseases using spirometric examinations in the people's saline bath resort, Kosen. Zeitschrift Fur Physiotherapie 1972;24(5):383-90.
77. Wilson GE, Baldwin AL, Walshaw MJ. A comparison of traditional chest physiotherapy with the active cycle of breathing in patients with chronic suppurative lung disease. European Respiratory Journal 1995;8 Suppl 19:171S.
78. Silva Y, Greer T, Farah C, Li F, Morgan L. Lung flute is comparable to flutter device for sputum clearance in adults with non-cystic fibrosis bronchiectasis. Respirology 2015;20:114(TP 143).
79. NCT00700388 Efficacy of temporary positive expiratory pressure (TPEP) in chronic hypersecretion (UNIKO). https://clinicaltrials.gov/ct2/show/ (accessed 10 April 2015).
80. NCT01112410 Hypertonic saline (6%) versus isotonic saline (0.9%) in bronchiectasis. https://clinicaltrials.gov/ct2/show/NCT01112410 (accessed 10 April 2015).
81. NCT01209546 Study of the effect of FLUTTER® VRP1 (PEP and Oscillating High Frequency). (FLUTTER®VRP1). https://clinicaltrials.gov/ct2/show/NCT01209546 (accessed 10 April 2015).
82. ACTRN12610000078055 Acute effect of slow expiration with the glottis open in lateral posture ("expiration lente totale glotte ouverte en infralatéral", ELTGOL) and huff on physical properties of sputum from patients with bronchiectasis: a pilot study. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=335040 (accessed 2 July 2015).
83. ACTRN12614001072606 Evaluating the ease of secretion clearance with flutter device compared to lung Flute in patients with bronchiectasis. WHO Clinical Trials 2013.
84. ACTRN12614001233617 Does the bubble-positive expiratory pressure (PEP) device improve secretion clearance compared to the active cycle of breathing technique (ACBT) or no intervention (control) in people with non-cystic fibrosis bronchiectasis?. https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12614001233617 (accessed 3 July 2015).
85. NCT00452114 In-exsufflator cough assist device in patients with symptomatic bronchiectasis. https://clinicaltrials.gov/ct2/show/NCT00452114 (accessed 10 April 2015).
86. NCT01480882 Efficacy and safety study of a percussion device to mobilise sputum from respiratory passage (LEGA). https://clinicaltrials.gov/ct2/show/NCT01480882 (accessed 10 April 2015).
87. NCT01578681 ELTGOL and bronchiectasis. Respiratory therapy (ELTGOLBQ). https://clinicaltrials.gov/ct2/show/NCT01578681 (accessed 10 April 2015).
88. NCT01854788 3 airway clearance techniques in non cystic fibrosis bronchiectasis. https://clinicaltrials.gov/ct2/show/NCT01854788 (accessed 10 April 2015).
89. NCT01929356 Chest physiotherapy and lung function in primary ciliary dyskinesia. https://clinicaltrials.gov/ct2/show/NCT01929356 (accessed 10 April 2015).
90. NCT02324855 Long-term airway clearance therapy in non-cystic fibrosis bronchiectasis. https://clinicaltrials.gov/ct2/show/NCT02324855 (accessed 10 April 2015).
91. Australian Institute of Health and Welfare. Chronic Respiratory Diseases in Australia: Their Prevalence, Consequences and Prevention. http://www.aihw.gov.au/WorkArea/DownloadAsset.aspx?id=6442459693 (accessed 3 July 2015).
92. Arens RA, Gozal D, Omlin KJ, Vega J, Boyd KP, Keens TG, et al. Comparison of high frequency chest compression and conventional chest physiotherapy in hospitalised patients with cystic fibrosis. American Journal of Respiratory and Critical Care Medicine 1994;114:171-7.
93. Barker A. Medical progress: bronchiectasis. New England Journal of Medicine 2002;346(18):1383-93.
94. Bateman J, Newman S, Daunt K, Sheahan N, Pavia D, Clarke S. Is cough as effective as chest physiotherapy in the removal of excessive tracheobronchial secretions?. Thorax 1981;36:683-7.
95. Bott J, Blumenthal S, Buxton M, Ellum S, Falconer C, Garrod R, et al. Guidelines for the physiotherapy management of the adult medical, spontaneously breathing patient. Thorax 2009;64 Suppl 1:i1-i51.
96. Boucher RC. Bronchiectasis: a continuum of ion transport dysfunction or multiple hits?. American Journal of Respiratory and Critical Care Medicine 2010;181:1017-9.
97. Braveman J, Nozzarella M. High-frequency chest compression advanced therapy for obstructive lung disease. Respiratory Therapy 2007;2(48):51.
98. Chang A, Bilton D. Exacerbations of cystic fibrosis: 4 Non-cystic fibrosis bronchiectasis. Thorax 2008;63:269-76.
99. Chang AB, Bell SC, Torzillo PJ, King PT, Maguire GP, Byrnes CA, et al. Chronic suppurative lung disease and bronchiectasis in children and adults in Australia and New Zealand Thoracic Society of Australia and New Zealand guidelines. Medical Journal of Australia 2015;202(1):21-3.
100. Cochrane GM, Webber BA, Clarke SW. Effect of sputum on pulmonary function. British Medical Journal 1977;2:1181-3.
101. Cole PJ. Inflammation: a two-edged sword - the model of bronchiectasis. European Journal of Respiratory Disease - Supplement 1986;147:6-15.
102. Elborne JS, Bell S. Pulmonary exacerbations in cystic fibrosis and bronchiectasis. Thorax 2007;62(4):288-90.
103. Flude LJ, Agent P, Bilton D. Chest physiotherapy techniques in bronchiectasis. Clinics in Chest Medicine 2012;33(2):351-61.
104. Flume PA, Robinson KA, O'Sullivan BP, Finder JD, Vender RL, Willey-Courand DB. Cystic fibrosis pulmonary guidelines: airway clearance therapies. Respiratory Care 2009;54:522-37.
105. Gaga M, Bentley AM, Humbert M, Barkans J, O'Brien F, Wathens CG, et al. Increases in CD4+ T lymphocytes, macrophages, neutrophils and interleukin 8 positive cells in the airways of patients with bronchiectasis. Thorax 1998;53(8):685-91.
106. Garrard CS, Shah M. The effects of expiratory positive airway pressure on functional residual capacity in normal subjects. Critical Care Medicine 1978;6:320-2.
107. Goeminne PC, Scheers H, Decraene A, Seys S, Dupont LJ. Risk factors for morbidity and death in non-cystic fibrosis bronchiectasis: a retrospective cross-sectional analysis of CT diagnosed bronchiectatic patients. Respiratory Research 2012;13:21.
108. Hansen LG, Warwick WJ, Hansen KL. Mucus transport mechanisms in relation to the effect of high frequency chest compression (HFCC) on mucus clearance. Pediatric Pulmonology 1994;17:113-8.
109. Higgins J, Altman D (editors). Chapter 8: Assessing risk of bias in included studies. In: HigginsJPT, Green S (editors). Cochrane Handbook of Systematic Reviews of Interventions. Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. www.cochrane-handbook.org.
110. Hill AT, Pasteur M, Cornford C, Welham S, Bilton D. Primary care summary of the British Thoracic Society guideline on the management of non-cystic fibrosis bronchiectasis. Primary Care Respiratory Journal 2011;20(2):135-40.
111. Horsley A, Gustafsson P, Macleod K, Saunders C, Greening AP, Porteus DJ, et al. Lung clearance index is a sensitive, repeatable and practical measure of airway disease in adults with cystic fibrosis. Thorax 2008;63:135-40.
112. Isabey D, Harf A, Chang HK. Alveolar ventilation during high-frequency oscillation: core dead space concept. Journal of Applied Physiology 1984;56:700-7.
113. Jones PW. St George's Respiratory Questionnaire. Journal of Chronic Obstructive Pulmonary Disease 2005;2(11):75-9.
114. Kempainen RR, Milla C, Dunitz J, Savik K, Hazelwood A, Williams C, et al. Comparison of settings used for high-frequency chest wall compression in cystic fibrosis. Respiratory Care 2010;55:695-701.
115. Kim C, Rodriguez C, Eldridge M, Sackner M. Criteria for mucus transport in the airways by two-phase gas-liquid flow mechanism. Journal of Applied Physiology 1986;60(3):901-7.
116. Kim C, Iglesias A, Sackner M. Mucus clearance by two-phase gas-liquid flow mechanism: asymmetric periodic flow model. Journal of Applied Physiology 1987;62(3):957-71.
117. King P, Holdsworth SR, Freezer NJ, Villanueva E, Gallagher M, Holmes PW. Outcome in adult bronchiectasis. Journal of Chronic Obstructive Pulmonary Disease 2005;2:27-34.
118. King P, Holdsworth SR, Freezer NJ, Holmes PW. Bronchiectasis. Internal Medicine Journal 2006;36:729-37.
119. King P, Holdsworth SR, Freezer NJ, Villanueva E, Holmes PW. Characterisation of the onset and presenting clinical features of adult bronchiectasis. Respiratory Medicine 2006;100(12):2183-9.
120. King PT, Daviskas E. Management of bronchiectasis. Breathe 2010;6:353-60.
121. Koulouris NG, Retsou S, Kosmas E, Dimakou K, Malagari K, Mantzikopoulos G, et al. Tidal expiratory flow limitation, dyspnoea and exercise capacity in patients with bilateral bronchiectasis. European Respiratory Journal 2003;21:743-8.
122. Langendam M, Akl EA, Dahm P, Glasziou P, Guyatt G, Schunemann HJ. Assessing and presenting summaries of evidence in Cochrane reviews. Systematic Reviews 2013;2(81):1-9.
123. Loebinger M, Wells A, Hansell D, Chinyanganya N, Devaraj A, Meister M, et al. Mortality in bronchiectasis: a long-term study assessing the factors influencing survival. European Respiratory Journal 2009;34:843-9.
124. Martinez-Garcia MA, Perpina-Tordera M, Roman-Sanchez P, Soler-Cataluna JJ. Quality-of-life determinants in patients with clinically stable bronchiectasis. Chest 2005;128(2):739-45.
125. Martinez-Garcia MA, Soler-Cataluna JJ, Perpina-Tordera M, Roman-Sanchez P, Soriano J. Factors associated with lung function decline in adult patients with stable non-cystic fibrosis bronchiectasis. Chest 2007;132:1565-72.
126. Martinez-Garcia MA, Perpina-Tordera M, Soler-Cataluna JJ, Roman-Sanchez P, Lloris-Bayo A, Gonzalez-Molina A. Dissociation of lung function, dyspnoea ratings and pulmonary extension in bronchiectasis. Respiratory Medicine 2007;101:2248-53.
127. McCool FD, Rosen MJ. Nonpharmacologic airway clearance therapies: ACCP evidence-based clinical practice guidelines. Chest 2006;129 Suppl 1:250S-259S.
128. McShane PJ, Naureckas ET, Tino G, Strek ME. Non-cystic fibrosis bronchiectasis. American Journal of Respiratory and Critical Care Medicine 2013;188:647-56.
129. Neves PC, Guerra M, Ponce P, Miranda J, Vouga L. Non-cystic fibrosis bronchiectasis. Interactive Cardiovascular and Thoracic Surgery 2011;13:619-25.
130. O'Donnell AE, Barker AF, Ilowite JS, Fick RB and the rhDNAse Study Group. Treatment of idiopathic bronchiectasis with aerosolized recombinant human DNAse I. rhDNAse Study Group. Chest 1998;113:1329-34.
131. Oberwaldner B, Evans JC, Zach MS. Forced expirations against a variable resistance: a new physiotherapy method in cystic fibrosis. Pediatric Pulmonology 1986;2:358-67.
132. Onen ZP, Gulbay EB, Sen E, Yildiz OA, Saryal S, Acican T, Karabiyikoglu G. Analysis of the factors related to mortality in patients with bronchiectasis. Respiratory Medicine 2007;101:1390-7.
133. Pasteur MC, Bilton D, Hill AT, British Thoracic Society Bronchiectasis non-CF Group. British Thoracic Society guideline for Non-CF Bronchiectasis. Thorax 2010;65 Suppl 1:i1-58.
134. Prasad SA. Airway clearance techniques. Which one?. Chronic Respiratory Disease 2007;4:65-6.
135. Raj AA, Pavoord DI, Birring SS. Clinical cough IV: What is the minimal important difference for the Leicester Cough Questionnaire?. Handbook of Experimental Pharmacology 2009;187:311-20.
136. Regnis JA, Robinson M, Bailey DL, Cook P, Hooper P, Chan HK, et al. Mucociliary clearance in patients with cystic fibrosis and in normal subjects. American Journal of Respiratory and Critical Care Medicine 1994;150:66-71.
137. The Nordic Cochrane Centre, The Cochrane Collaboration. Review Manager (RevMan). 5.3. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2015.
138. Schunemann JH, Oxman AD, Vist GE, Higgins J, Deeks J, Glasziou P, et al. Chapter 12: Interpreting results and drawing conclusions. In: HigginsJPT, Green S (editors). Cochrane Handbook of Systematic Reviews of Interventions. Version 5.1.0 [updated March 2011]. The Cochrane Collaboration, 2011. www.cochrane-handbook.org.
139. Sutton P, Lopez-Vidriero M, Pavia D, Newman S, Clay M, Webber B, et al. Assessment of percussion, vibratory-shaking and breathing exercises in chest physiotherapy. European Journal of Respiratory Disease 1985;66(2):147-52.
140. Tsang K, Tipoe G. Bronchiectasis: not an orphan disease of the East. International Journal of Tuberculosis and Lung Disease 2004;8(6):691-702.
141. Tsang KW, Bilton D. Clinical challenges in managing bronchiectasis. Respirology 2009;14:637-50.
142. van der Schans CP, Prasad A, Main E. Chest physiotherapy compared to no chest physiotherapy for cystic fibrosis. Cochrane Database of Systematic Reviews 2000, Issue 2. [DOI: ]
143. van der Schans CP. Airway clearance: assessment of techniques. Paediatric Respiratory Reviews 2002;3:110-4.
144. van Henstrum M, Festen J, Beurskens C, Hankel M, Beekman F, Corstens F. Conventional physiotherapy and forced expiration manoeuvres have similar effects on tracheobronchial clearance. European Respiratory Journal 1988;1:758-61.
145. Weycker D, Edelsberg J, Oster G, Tino G. Prevalence and economic burden of bronchiectasis. Clinical Pulmonary Medicine 2005;12(4):205-9.
146. Williams MT. Chest physiotherapy and cystic fibrosis. Why is the most effective form of treatment still unclear?. Chest 1994;1006:1872-82.
147. Wilson C, Jones P, O'Leary CJ, Cole P, Wilson R. Validation of the St George's Respiratory Questionnaire in bronchiectasis. American Journal of Respiratory and Critical Care Medicine 1997;156:536-41.
148. Jones AP, Rowe BH. Bronchopulmonary hygiene physical therapy for chronic obstructive pulmonary disease and bronchiectasis. Cochrane Database of Systematic Reviews 1998, Issue 4. [DOI: ]
149. Lee AL, Burge AT, Holland AE. Airway clearance techniques for bronchiectasis. Cochrane Database of Systematic Reviews 2013, Issue 5. [DOI: ]