A recent study reviewed the effectiveness of positive expiratory pressure (PEP) physiotherapy devices in clearing airways of cystic fibrosis (CF) patients and found that PEP vests do reduce pulmonary exacerbations. The paper, published in the Cochrane Database Systematic Reviews journal, is titled “Positive expiratory pressure physiotherapy for airway clearance in people with cystic fibrosis.”
CF is characterized by mucus accumulation in lung smooth muscle that results in frequent respiratory infections. Various chest physiotherapy methods are often utilized to clear the airways and improve the breathing process in CF patients. Among these techniques, positive expiratory pressure (PEP) devices provide pressure behind the accumulated mucus in order to evacuate it from the lungs.
As PEPs are extensively employed by CF patients, this study aimed to evaluate whether PEP devices are better or worse than other forms of chest physiotherapy for airways clearance. The study was performed by examining various references from different published sources up Dec. 2, 2014.
A total of 733 CF patients with different disease severity, ranging from 6 to 47 years of age, were included from 26 studies. PEP devices were compared to other methods of chest clearance, with treatment duration ranging from one physiotherapy session to two years of treatment.
The results suggest that PEPs have generally similar efficacy as other techniques of chest physiotherapy, such as active cycle of breathing techniques, postural drainage with percussion, autogenic drainage, and oscillatory PEP devices. No difference in lung function was recorded between CF patients using PEP devices and those employing other forms of chest physiotherapy. However, patients using PEP devices reported lower exacerbation rates when compared to other techniques. Additionally, some evidence shows that CF patients tend to prefer PEP devices over other forms of chest physiotherapy. The studies demonstrated that PEP devices are safe to use, and the only incident case is recorded with infants.
PEP devices have the advantage of reducing pulmonary exacerbations in CF patients when compared to other forms of physiotherapy. Altogether, the study notes that patients should be evaluated individually so as to choose the airway clearance method they will best adhere to, and hence will provide the best quality of life in the long term.