Figures
- FIGURE 1
Flow of participants through the study. AD: autogenic drainage; AE: adverse event; AWC: airway clearance; MBW: multiple breath washout; oPEP: oscillating positive expiratory pressure; PEx: pulmonary exacerbation.
- FIGURE 2
Results of lung clearance index (LCI) before and after 4 weeks of daily airway clearance according to method of airway clearance. Each coloured line represents one individual participant. AD: autogenic drainage; oPEP: oscillating positive expiratory pressure.
Tables
- TABLE 1
Baseline characteristics of patients
Parameter AD oPEP Subjects n 26 25 Age years (mean±sd) 66.7±12.3 65.7±13.4 Sex (female n(%)/male n(%)) 19 (73.1)/7(26.9) 14 (56.0)/11 (44.0) Lung function: FEV1 % (mean±sd) 96.1±18.3** 81.3±18.1** Lung function: FVC % (mean±sd) 101.7±16.5* 89.6±20.0* LCI (mean±sd) 10.0±2.1 9.0±2.5 Daily sputum production mL (median; IQR) 17.5 (5.0; 41.3) 15.0 (5.0; 20.0) Sputum bacterial infection* n (%) 9 (34.6) 13 (54.2) Sputum purulence scale (0–1/2–3) n (%) 13 (59.1)/9 (40.9) 15 (62.5)/9 (37.5) Previous PEx/year (median, IQR) n=26 2 (1; 4)* n=24 1 (0; 2)* Treatment at baseline n (%) ICS 5 (19.2) 8 (32.0) LABA 5 (20.0) 9 (36.0) LAMA 0 (0) 3 (12.0) Hypertonic saline 19 (73.1) 20 (80.0) Performing exercise 14 (53.8) 12 (48.0) CT findings Number of infected lobes on CT (median, IQR) n=21 2.0 (2.0, 3.5) n=20 2.0 (2.0, 3.75) Reiff index (median, IQR) n=24 3.0 (2.0, 4.0) n=25 3 (2, 4.5) Findings on auscultation n (%) Wheeze 1 (3.8) 3 (12.0) Rales 9 (34.6) 9 (36.0) Sputum bacterial infection relates to any positive culture from a respiratory sample in the past 12 months. Sputum purulence was noted on a scale from 0 to 3, with 0 indicating transparent-yellow and 3 being green with traces of blood. AD: autogenic drainage; oPEP: oscillating positive expiratory pressure; sd, standard deviation; FEV1 %: forced expiratory volume in 1 s, per cent predicted; FVC: forced vital capacity, percent predicted; LCI: lung clearance index; IQR: interquartile range; PEx: pulmonary exacerbations in the previous 12 months; ICS: inhaled corticosteroids; LABA: long-acting β-agonists; LAMA: long-acting muscarinic agonists; CT: computed tomography. *: p<0.05; **: p<0.001.
- TABLE 2
Effects of treatment on symptoms and lung function
AD oPEP p-value Subjects n 25 24 Change in sputum purulence# n (%) >0.99 Improved 4 (20) 5 (23) Unchanged 13 (65) 13 (59) Worsened 3 (15) 4 (18) Change in sputum quantity n (%) 0.044 Less sputum 6 (24) 12 (52) More sputum 19 (76) 11 (48) Change in sputum quantity (mL); median (range) randomisation to end of study 17.5 (5–42.5) to 15 (5–45) 15 (5–25) to 5 (5–20) 0.386 LCI change after 4 weeks¶ n (%) 0.847 Improved 8 (32) 6 (25) Unchanged 7 (28) 8 (33) Worsened 10 (40) 10 (42) FEV1 % change after 4 weeks, median (range) 0.05 (−23–7.6) 0 (−11.8–10.5) 0.71 AD: autogenic drainage; oPEP: oscillating positive expiratory pressure; LCI: lung clearance index; FEV1: forced expiratory volume in 1 s. #: sputum purulence was recorded on a four-point scale. Values in bold represent p<0.05. ¶: improvement, a decrease of 0.5 or more; worsening, an increase of 0.5 or more; unchanged, difference <0.5 in any direction.
- TABLE 3
Effects on quality of life
QoL domain AD oPEP Baseline 4 weeks p-value Baseline 4 weeks p-value Subjects n 25 24 Respiratory symptoms 67 (44–79.5) 70 (50–79.5) 0.732 65 (46–77) 72 (48.8–80.3) 0.139 Physical functioning 60 (20–83.5) 67 (37–86.5) 0.393 53.5 (21.8–93) 60 (36.5–87) 0.412 Vitality 44 (27.5–66.8) 67 (44–67) 0.027 44 (1–100) 50 (33–67) 0.231 Role functioning 73 (53–87) 87 (56.5–93) 0.073 70 (41.8–87) 73 (48.5–80) 0.970 Emotional functioning 83 (54–100) 83 (62.5–100) 0.611 79 (60.3–92) 79 (67–98) 0.690 Social functioning 50 (21–67) 58 (37.5–76.5) 0.042 n=23 58 (42–83) n=23 58 (44–75) 0.919 Treatment burden n=20 56 (33–78) n=20 44 (33–64.3) 0.085 n=20 56 (35.8–75.3) n=20 56 (33.3–67) 0.458 Health perceptions 42 (33–67) 58 (42–75) 0.177 33 (25–58) 42 (33–64.8) 0.048 Scores presented as median (interquartile range) unless otherwise stated. Domains of the quality of life questionnaire for bronchiectasis (QoL-B) [21] were scored on a scale of 0 (worst) to 100 (best) and compared between baseline and end-of-study visits. QoL: quality of life; AD: autogenic drainage; oPEP: oscillating positive expiratory pressure. Values in bold represent p<0.05.
