title: Effects of chest wall compression on expiratory flow rates in patients with chronic obstructive pulmonary disease.
abstract: BACKGROUND
  Manual chest wall compression (CWC) during expiration is a technique for removing airway secretions in patients with respiratory disorders. However, there have been no reports about the physiological effects of CWC in patients with chronic obstructive pulmonary disease (COPD).
  
  
  OBJECTIVE
  To compare the effects of CWC on expiratory flow rates in patients with COPD and asymptomatic controls.
  
  
  METHODS
  Fourteen subjects were recruited from among patients with COPD who were receiving pulmonary rehabilitation at the University Hospital (COPD group). Fourteen age-matched healthy subjects were also consecutively recruited from the local community (Healthy control group). Airflow and lung volume changes were measured continuously with the subjects lying in supine position during 1 minute of quiet breathing (QB) and during 1 minute of CWC by a physical therapist.
  
  
  RESULTS
  During CWC, both the COPD group and the healthy control group showed significantly higher peak expiratory flow rates (PEFRs) than during QB (mean difference for COPD group 0.14 L/sec, 95% confidence interval (CI) 0.04 to 0.24, p<0.01, mean difference for healthy control group 0.39 L/sec, 95% CI 0.25 to 0.57, p<0.01). In the between-group comparisons, PEFR was significantly higher in the healthy control group than in the COPD group (-0.25 L/sec, 95% CI -0.43 to -0.07, p<0.01). However, the expiratory flow rates at the lung volume at the PEFR during QB and at 50% and 25% of tidal volume during QB increased in the healthy control group (mean difference for healthy control group 0.31 L/sec, 95% CI 0.15 to 0.47, p<0.01: 0.31 L/sec, 95% CI 0.15 to 0.47, p<0.01: 0.27 L/sec, 95% CI 0.13 to 0.41, p<0.01, respectively) but not in the COPD group (0.05 L/sec, 95% CI -0.01 to 0.12: -0.01 L/sec, 95% CI -0.11 to 0.08: 0.02 L/sec, 95% CI -0.05 to 0.90) with the application of CWC.
  
  
  CONCLUSIONS
  The effects of chest wall compression on expiratory flow rates was different between COPD patients and asymptomatic controls.
authors.affiliation: Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women's University, Morikita-machi, Higashinada-ku, Kobe, Japan, Konan Women's University, Konan Women's University, Faculty of Nursing and Rehabilitation, Department of Physical Therapy, Higashinada-ku Kobe , Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Nozoe
authors.affiliation: Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women's University, Morikita-machi, Higashinada-ku, Kobe, Japan, Konan Women's University, Konan Women's University, Faculty of Nursing and Rehabilitation, Department of Physical Therapy, Higashinada-ku Kobe , Japan.
authors.forename: Kyoshi
authors.initials: K
authors.lastname: Mase
authors.affiliation: Department of Rehabilitation, Hyogo College of Medicine Sasayama Medical Center, Kurooka-cho, Sasayama-shi, Hyogo, Japan, Medicine Sasayama Medical Center, Hyogo College, Department of Rehabilitation, Sasayama-shi Hyogo , Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Ogino
authors.affiliation: Department of Rehabilitation, Hyogo College of Medicine Sasayama Medical Center, Kurooka-cho, Sasayama-shi, Hyogo, Japan, Medicine Sasayama Medical Center, Hyogo College, Department of Rehabilitation, Sasayama-shi Hyogo , Japan.
authors.forename: Shigefumi
authors.initials: S
authors.lastname: Murakami
authors.affiliation: Department of Physical Therapy, Faculty of Nursing and Rehabilitation, Konan Women's University, Morikita-machi, Higashinada-ku, Kobe, Japan, Konan Women's University, Konan Women's University, Faculty of Nursing and Rehabilitation, Department of Physical Therapy, Higashinada-ku Kobe , Japan.
authors.forename: Sachie
authors.initials: S
authors.lastname: Takashima
authors.affiliation: Department of Physical Medicine and Rehabilitation, Hyogo College of Medicine, Mukogawa-cho, Nishinomiya-shi, Hyogo, Japan, Hyogo College of Medicine, Hyogo College of Medicine, Department of Physical Medicine and Rehabilitation, Nishinomiya-shi Hyogo , Japan.
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Domen
mesh_terms: D006801:Humans; D008168:Lung / Q000503:physiopathology*; D010366:Peak Expiratory Flow Rate / Q000502:physiology*; D011312:Pressure; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology*; D035441:Thoracic Wall / Q000503:physiopathology*