title: High frequency chest wall oscillation for asthma and chronic obstructive pulmonary disease exacerbations: a randomized sham-controlled clinical trial.
abstract: BACKGROUND
  High frequency chest wall oscillation (HFCWO) is used for airway mucus clearance. The objective of this study was to evaluate the use of HFCWO early in the treatment of adults hospitalized for acute asthma or chronic obstructive pulmonary disease (COPD).
  
  
  METHODS
  Randomized, multi-center, double-masked phase II clinical trial of active or sham treatment initiated within 24 hours of hospital admission for acute asthma or COPD at four academic medical centers. Patients received active or sham treatment for 15 minutes three times a day for four treatments. Medical management was standardized across groups. The primary outcomes were patient adherence to therapy after four treatments (minutes used/60 minutes prescribed) and satisfaction. Secondary outcomes included change in Borg dyspnea score (≥ 1 unit indicates a clinically significant change), spontaneously expectorated sputum volume, and forced expired volume in 1 second.
  
  
  RESULTS
  Fifty-two participants were randomized to active (n = 25) or sham (n = 27) treatment. Patient adherence was similarly high in both groups (91% vs. 93%; p = 0.70). Patient satisfaction was also similarly high in both groups. After four treatments, a higher proportion of patients in the active treatment group had a clinically significant improvement in dyspnea (70.8% vs. 42.3%, p = 0.04). There were no significant differences in other secondary outcomes.
  
  
  CONCLUSIONS
  HFCWO is well tolerated in adults hospitalized for acute asthma or COPD and significantly improves dyspnea. The high levels of patient satisfaction in both treatment groups justify the need for sham controls when evaluating the use of HFCWO on patient-reported outcomes. Additional studies are needed to more fully evaluate the role of HFCWO in improving in-hospital and post-discharge outcomes in this population.
  
  
  BACKGROUND
  ClinicalTrials.gov: NCT00181285.
authors: Department of Medicine, Section of Pulmonary, Critical Care, Sleep, and Allergy, University of Illinois at Chicago, 840 S, Wood Street, Chicago, Illinois 60612, USA.
authors: Amit K
authors: AK
authors: Mahajan
authors: Gregory B
authors: GB
authors: Diette
authors: Umur
authors: U
authors: Hatipoğlu
authors: Andrew
authors: A
authors: Bilderback
authors: Alana
authors: A
authors: Ridge
authors: Vanessa Walker
authors: VW
authors: Harris
authors: Vijay
authors: V
authors: Dalapathi
authors: Sameer
authors: S
authors: Badlani
authors: Stephanie
authors: S
authors: Lewis
authors: Jeff T
authors: JT
authors: Charbeneau
authors: Edward T
authors: ET
authors: Naureckas
authors: Jerry A
authors: JA
authors: Krishnan
mesh_terms: D000208:Acute Disease; D000328:Adult; D001249:Asthma / Q000503:physiopathology / Q000628:therapy*; D035641:Chest Wall Oscillation / Q000379:methods*; D015331:Cohort Studies; D018450:Disease Progression; D006801:Humans; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology / Q000628:therapy*