title: Bronchopulmonary hygiene physical therapy in bronchiectasis and chronic obstructive pulmonary disease: a systematic review.
abstract: OBJECTIVE
  This study had two objectives: (1) to examine the effects of bronchopulmonary hygiene physical therapy on patients with chronic obstructive pulmonary disease and bronchiectasis; (2) to determine any differences between manual and mechanical techniques for bronchopulmonary hygiene physical therapy.
  
  
  METHODS
  The study design was a systematic review of the literature that used an exhaustive search for trials and review methods prescribed by the Cochrane Collaboration.
  
  
  METHODS
  Randomized controlled trials examined patient groups, interventions, and dependent variables.
  
  
  METHODS
  Patients included those with chronic obstructive pulmonary diseases (emphysema or chronic bronchitis) or bronchiectasis.
  
  
  METHODS
  Any of the following interventions or combinations thereof were included: manual interventions, such as postural drainage, chest percussion, vibration, chest shaking, directed coughing, or forced exhalation technique.
  
  
  METHODS
  Controls of the study were as follows: no intervention; placebo; coughing; and mechanical interventions, such as mechanical vibration.
  
  
  RESULTS
  The search identified 99 potential trials; inclusion or exclusion analysis left 7, which examined a total of 126 patients. Mean score on trial quality was 1.4 (5 = greatest). Three separate trials (N = 51) found statistically significant effects for bronchopulmonary hygiene physical therapy on sputum production and radioaerosol clearance. No trials (N = 126) found statistically significant effects on pulmonary function variables or differences between manual and mechanical techniques.
  
  
  CONCLUSIONS
  Considering the small sizes, low quality, and mixed results from the trials, the research on bronchopulmonary hygiene physical therapy is inconclusive. There is a need for adequately sized, high-quality, randomized controlled trials with uniform patient populations to examine the effects of bronchopulmonary hygiene physical therapy.
authors.affiliation: Department of Respiratory Care, University of Texas at San Antonio, Texas, USA.
authors.forename: A
authors.initials: A
authors.lastname: Jones
authors.forename: B H
authors.initials: BH
authors.lastname: Rowe
mesh_terms: D001945:Breathing Exercises; D001987:Bronchiectasis / Q000503:physiopathology / Q000534:rehabilitation*; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000503:physiopathology / Q000534:rehabilitation*; D026741:Physical Therapy Modalities / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D015656:Respiratory Mechanics; D011795:Surveys and Questionnaires