title: Benefit of educational feedback for the use of positive expiratory pressure device.
abstract: BACKGROUND
  Positive expiratory pressure (PEP) is regularly used as a self-administered airway clearance technique.
  
  
  OBJECTIVE
  The aim of this study was to evaluate the need to teach the correct use of the PEP device and to measure the progress of the success rate of the maneuver after training.
  
  
  METHODS
  A PEP system (PariPEP-S Sytem) was used to generate PEP in 30 healthy volunteers. They were instructed by a qualified physical therapist to breathe correctly through the PEP device. Then they were evaluated during a set of ten expirations. Two other evaluations were performed at day 2 and day 8 (before and after feedback). The mean PEP and the success rate were calculated for each set of expirations. The number of maneuvers needed to obtain a correct use was calculated on the first session.
  
  
  RESULTS
  An optimal PEP was reached after 7.5 SD 2.7 attempts by all subjects. Success rates and mean pressures were similar between the different sets of expirations (p=0.720 and p=0.326, respectively). Pressure variability was around 10%. After one week, 30% of subjects generated more than two non-optimal pressures in the set of ten expirations. No difference in success rate was observed depending on the evaluations.
  
  
  CONCLUSIONS
  This study demonstrates that good initial training on the use of the PEP device and regular follow-up are required for the subject to reach optimal expiratory pressure.
authors.affiliation: Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain, Brussels, Belgium.
authors.forename: Gregory
authors.initials: G
authors.lastname: Reychler
authors.affiliation: Cliniques Universitaires Saint-Luc, Brussels, Belgium.
authors.forename: Manon
authors.initials: M
authors.lastname: Jacquemart
authors.affiliation: Cliniques Universitaires Saint-Luc, Brussels, Belgium.
authors.forename: William
authors.initials: W
authors.lastname: Poncin
authors.affiliation: Cliniques Universitaires Saint-Luc, Brussels, Belgium.
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: Aubriot
authors.affiliation: Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain, Brussels, Belgium.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Liistro
mesh_terms: D005541:Forced Expiratory Volume / Q000502:physiology*; D006801:Humans; D026741:Physical Therapy Modalities / Q000592:standards; D011175:Positive-Pressure Respiration / Q000295:instrumentation* / Q000379:methods; D011312:Pressure; D012119:Respiration