A Systematised Literature Review investigating the effects of Oscillating Positive Expiratory Pressure (OPEP) therapy on clinical outcomes in patients with Chronic Obstructive Pulmonary Disease (COPD)

Becky Ransley, Kerry Gaskin, Helen Frank

Research output: Contribution to conferencePoster

Abstract

Background: Use of airway clearance techniques to remove excess secretions is widely used in the management of COPD. Intra-thoracic Oscillating Positive Expiratory Pressure (OPEP) produces high-frequency oscillations and increases expiratory airflow, to create shearing forces, which reduce secretion viscosity and aid secretion mobilisation.
Aims: To establish the effects of OPEP on clinical outcomes in stable and acute exacerbations of COPD.
Methods: A comprehensive search of MEDLINE, Academic Search Complete, CINAHL complete, psychINFO, SPORTdiscus, TRIP, ProQuest Central, and PubMed was conducted in order to identify randomised controlled trials or randomised crossover studies, which investigated the effects of intrathoracic OPEP in COPD. Methodological rigour, quality and validity of each record was assessed with the PEDro scale.
Results: 322 participants from 10 studies were included. The results of the review showed a significant improvement in FVC, 6MWT and exertional breathlessness and slowed deterioration in FEV1 and was equally as effective in improving Sp02, sputum volume, and PEFR, as other ACTs in stable COPD. In AECOPD, OPEP significantly improved ABGs, significantly reduced the requirement and duration of NIV treatment and reduced hospital length of stay.
Conclusions: This review suggests that in stable COPD, OPEP is associated with an improvement in exercise capacity, and in acute exacerbation of COPD, reduces the requirement and duration of NIV treatment and reduces hospital length of stay. More long-term trials are required, particularly investigating the effect of OPEP as an adjunct to pulmonary rehabilitation.

Original languageEnglish
Pages52
Number of pages1
Publication statusPublished - 2019
EventACPRC Conference 2019: Innovate, Influence and Inspire - Birmingham Conference and Exhibition Centre, Birmingham, United Kingdom
Duration: 26 Apr 201927 Apr 2019
https://www.acprc.org.uk/annual-conference/

Conference

ConferenceACPRC Conference 2019
CountryUnited Kingdom
CityBirmingham
Period26/04/1927/04/19
Internet address

Fingerprint

Chronic Obstructive Pulmonary Disease
Pressure
Length of Stay
Therapeutics
Peak Expiratory Flow Rate
Pulmonary Ventilation
Sputum
PubMed
Viscosity
MEDLINE
Dyspnea
Cross-Over Studies
Thorax
Rehabilitation
Randomized Controlled Trials
Exercise
Lung

Keywords

  • oscillatring positive expiratory pressure
  • Chronic obstructive pulmonary disease disease
  • airway clearance
  • Physiotherapy

Cite this

A Systematised Literature Review investigating the effects of Oscillating Positive Expiratory Pressure (OPEP) therapy on clinical outcomes in patients with Chronic Obstructive Pulmonary Disease (COPD). / Ransley, Becky; Gaskin, Kerry; Frank, Helen.

2019. 52 Poster session presented at ACPRC Conference 2019, Birmingham, United Kingdom.

Research output: Contribution to conferencePoster

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abstract = "Background: Use of airway clearance techniques to remove excess secretions is widely used in the management of COPD. Intra-thoracic Oscillating Positive Expiratory Pressure (OPEP) produces high-frequency oscillations and increases expiratory airflow, to create shearing forces, which reduce secretion viscosity and aid secretion mobilisation. Aims: To establish the effects of OPEP on clinical outcomes in stable and acute exacerbations of COPD.Methods: A comprehensive search of MEDLINE, Academic Search Complete, CINAHL complete, psychINFO, SPORTdiscus, TRIP, ProQuest Central, and PubMed was conducted in order to identify randomised controlled trials or randomised crossover studies, which investigated the effects of intrathoracic OPEP in COPD. Methodological rigour, quality and validity of each record was assessed with the PEDro scale. Results: 322 participants from 10 studies were included. The results of the review showed a significant improvement in FVC, 6MWT and exertional breathlessness and slowed deterioration in FEV1 and was equally as effective in improving Sp02, sputum volume, and PEFR, as other ACTs in stable COPD. In AECOPD, OPEP significantly improved ABGs, significantly reduced the requirement and duration of NIV treatment and reduced hospital length of stay.Conclusions: This review suggests that in stable COPD, OPEP is associated with an improvement in exercise capacity, and in acute exacerbation of COPD, reduces the requirement and duration of NIV treatment and reduces hospital length of stay. More long-term trials are required, particularly investigating the effect of OPEP as an adjunct to pulmonary rehabilitation.",
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N2 - Background: Use of airway clearance techniques to remove excess secretions is widely used in the management of COPD. Intra-thoracic Oscillating Positive Expiratory Pressure (OPEP) produces high-frequency oscillations and increases expiratory airflow, to create shearing forces, which reduce secretion viscosity and aid secretion mobilisation. Aims: To establish the effects of OPEP on clinical outcomes in stable and acute exacerbations of COPD.Methods: A comprehensive search of MEDLINE, Academic Search Complete, CINAHL complete, psychINFO, SPORTdiscus, TRIP, ProQuest Central, and PubMed was conducted in order to identify randomised controlled trials or randomised crossover studies, which investigated the effects of intrathoracic OPEP in COPD. Methodological rigour, quality and validity of each record was assessed with the PEDro scale. Results: 322 participants from 10 studies were included. The results of the review showed a significant improvement in FVC, 6MWT and exertional breathlessness and slowed deterioration in FEV1 and was equally as effective in improving Sp02, sputum volume, and PEFR, as other ACTs in stable COPD. In AECOPD, OPEP significantly improved ABGs, significantly reduced the requirement and duration of NIV treatment and reduced hospital length of stay.Conclusions: This review suggests that in stable COPD, OPEP is associated with an improvement in exercise capacity, and in acute exacerbation of COPD, reduces the requirement and duration of NIV treatment and reduces hospital length of stay. More long-term trials are required, particularly investigating the effect of OPEP as an adjunct to pulmonary rehabilitation.

AB - Background: Use of airway clearance techniques to remove excess secretions is widely used in the management of COPD. Intra-thoracic Oscillating Positive Expiratory Pressure (OPEP) produces high-frequency oscillations and increases expiratory airflow, to create shearing forces, which reduce secretion viscosity and aid secretion mobilisation. Aims: To establish the effects of OPEP on clinical outcomes in stable and acute exacerbations of COPD.Methods: A comprehensive search of MEDLINE, Academic Search Complete, CINAHL complete, psychINFO, SPORTdiscus, TRIP, ProQuest Central, and PubMed was conducted in order to identify randomised controlled trials or randomised crossover studies, which investigated the effects of intrathoracic OPEP in COPD. Methodological rigour, quality and validity of each record was assessed with the PEDro scale. Results: 322 participants from 10 studies were included. The results of the review showed a significant improvement in FVC, 6MWT and exertional breathlessness and slowed deterioration in FEV1 and was equally as effective in improving Sp02, sputum volume, and PEFR, as other ACTs in stable COPD. In AECOPD, OPEP significantly improved ABGs, significantly reduced the requirement and duration of NIV treatment and reduced hospital length of stay.Conclusions: This review suggests that in stable COPD, OPEP is associated with an improvement in exercise capacity, and in acute exacerbation of COPD, reduces the requirement and duration of NIV treatment and reduces hospital length of stay. More long-term trials are required, particularly investigating the effect of OPEP as an adjunct to pulmonary rehabilitation.

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KW - Chronic obstructive pulmonary disease disease

KW - airway clearance

KW - Physiotherapy

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