title: Safety, tolerability, and efficacy of high-frequency chest wall oscillation in pediatric patients with cerebral palsy and neuromuscular diseases: an exploratory randomized controlled trial.
abstract: Airway secretions and infections are common in cerebral palsy and neuromuscular diseases. Chest physiotherapy is standard therapy but effort is substantial. High-frequency chest wall oscillation is used in cystic fibrosis but tolerability and safety data in cerebral palsy and neuromuscular disease are limited. A prospective, randomized, controlled trial of high-frequency chest wall oscillation and standard chest physiotherapy was performed in participants with neuromuscular disease or cerebral palsy. Outcome measures included respiratory-related hospitalizations, antibiotic therapy, chest radiographs, and polysomnography. Care-givers were questioned regarding therapy adherence. A total of 28 participants enrolled, 23 completed (12 chest physiotherapy, mean study period 5 months). No adverse outcomes were reported. Adherence to prescribed regimen was higher with high-frequency chest wall oscillation (P = .036). Our data suggest safety, tolerability, and better compliance with high-frequency chest wall oscillation. Improvement in airway clearance may help prevent hospitalizations. Larger controlled trials are required to confirm these results.
authors.affiliation: Department of Pediatrics, Division of Pulmonology, Stanford University, Palo Alto, California 94304, USA. nyuan@stanford.edu
authors.forename: Nanci
authors.initials: N
authors.lastname: Yuan
authors.forename: Peter
authors.initials: P
authors.lastname: Kane
authors.forename: Kristen
authors.initials: K
authors.lastname: Shelton
authors.forename: Julie
authors.initials: J
authors.lastname: Matel
authors.forename: Brian C
authors.initials: BC
authors.lastname: Becker
authors.forename: Richard B
authors.initials: RB
authors.lastname: Moss
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002547:Cerebral Palsy / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D035641:Chest Wall Oscillation / Q000379:methods*; D002648:Child; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D009468:Neuromuscular Diseases / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology / Q000628:therapy*; D010349:Patient Compliance; D017286:Polysomnography; D011446:Prospective Studies; D013902:Radiography, Thoracic; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents