Annals of Rehabilitation Medicine

"Mechanical in-exsufflator"

Original Articles

Improvement of Peak Cough Flow After the Application of a Mechanical In-exsufflator in Patients With Neuromuscular Disease and Pneumonia: A Pilot Study: Ji Ho Jung, Hyeon Jun Oh, Jang Woo Lee, Mi Ri Suh, Jihyun Park, Won Ah Choi, Seong-Woong Kang; Ann Rehabil Med 2018;42(6):833-837. Published online December 28, 2018; DOI: https://doi.org/10.5535/arm.2018.42.6.833

Abstract
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Objective
To investigate and demonstrate persistent increase of peak cough flow after mechanical in-exsufflator application, in patients with neuromuscular diseases and pneumonia.
Methods
A mechanical in-exsufflator was applied with patients in an upright or semi-upright sitting position (pressure setting, +40 and −40 cmH2O; in-exsufflation times, 2–3 and 1–2 seconds, respectively). Patients underwent five cycles, with 20–30 second intervals to prevent hyperventilation. Peak cough flow without and with assistive maneuvers, was evaluated before, and 15 and 45 minutes after mechanical in-exsufflator application.
Results
Peak cough flow was 92.6 L/min at baseline, and 100.4 and 100.7 L/min at 15 and 45 minutes after mechanical in-exsufflator application, respectively. Assisted peak cough flow at baseline, 15 minutes, and 45 minutes after mechanical in-exsufflator application was 170.7, 179.3, and 184.1 L/min, respectively. While peak cough flow and assisted peak cough flow increased significantly at 15 minutes after mechanical in-exsufflator application compared with baseline (p=0.030 and p=0.016), no statistical difference was observed between 15 and 45 minutes.
Conclusion
Increased peak cough flow after mechanical in-exsufflator application persists for at least 45 minutes.

Citations

Citations to this article as recorded by

Physiological Effects of Mechanical Insufflation-Exsufflation in Patients With Neuromuscular Disease: A Scoping Review
Lisa Edel, Tiina Andersen, Emma Shkurka
Respiratory Care.2025;[Epub] CrossRef
Pearls and pitfalls of respiratory testing in a patient with amyotrophic lateral sclerosis and COPD
Stephen W. Littleton, Franco Laghi
Breathe.2023; 19(2): 230043. CrossRef
The use of cough peak flow in the assessment of respiratory function in clinical practice- A narrative literature review
M. Brennan, M.J. McDonnell, N. Duignan, F. Gargoum, R.M. Rutherford
Respiratory Medicine.2022; 193: 106740. CrossRef
Comparison of two mechanical insufflation-exsufflation devices in patients with amyotrophic lateral sclerosis: a preliminary study
Antonello NICOLINI, Paola PRATO, Laura BECCARELLI, Bruna GRECCHI, Giancarlo GARUTI, Paolo BANFI, Francesco D’ABROSCA
Panminerva Medica.2022;[Epub] CrossRef
Analysis of Pneumothorax in Noninvasive Ventilator Users With Duchenne Muscular Dystrophy
Han Eol Cho, Justin Byun, Won Ah Choi, Myungsang Kim, Kyeong Yeol Kim, Seong-Woong Kang
Chest.2021; 159(4): 1540. CrossRef

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The Efficacy of Pulmonary Rehabilitation Using Mechanical In-Exsufflator in Cervical Cord Injured Patients.: Park, Chang Il , Shin, Ji Cheol , Kang, Seong Woong , Lee, Byung Ho , choi, Young Seok , Kim, Yong Rae , Jeon, Sang Chul; J Korean Acad Rehabil Med 2002;26(4):403-408.

Abstract
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Objective: It is known that Mechanical in-exsufflator (MI-E) can reduce pulmonary complications such as pneumonia, atelectasis in tetraplegia by increasing inspiratory and expiratory capacity. The aim of this study is to clarify the effectiveness of MI-E on pulmonary function and coughing capacity in tetraplegia.

Method: Thirty tetraplegic patients who had neither history nor radiologic finding of pulmonary disease were divided into two groups; control (n=15) and experimental (n=15) groups. Control group received conventional pulmonary rehabilitation, while experimental group received additional MI-E therapy for one month. The pulmonary function was evaluated by measuring percentage of predicted value of vital capacity (% VC), maximal insufflation capacity (MIC), unassisted peak cough flow (UPCF), volume assisted peak cough flow (VPCF), manual assisted peak cough flow (MPCF), manual and volume assisted peak cough flow (MVPCF). These data of pulmonary function before and after treatment were compared between two groups.

Results: 1) There are significant improvement of pulmonary function in both groups (p＜0.05) except UPCF in control group before and after treatment. 2) The experimental group showed more improvement in MIC, VPCF, MPCF and MVPCF than control group (p＜0.05).

Conclusion: MI-E therapy can be used as an effective therapeutic modality for the improvement of pulmonary function in combination with conventional pulmonary rehabilitation. (J Korean Acad Rehab Med 2002; 26: 403-408)