Table 4.
Studies investigating the immediate effect of a single session of assisted inflation in medically stable participants with NMD.
| Author/s | Year | Number of participants | Population | Trial design | Hyperinflation therapy | Results |
|---|---|---|---|---|---|---|
| Sinha and Bergofsky (202) | 1972 | 6 | Restrictive CWD | Prospective pre-post intervention study | 5 min IPPB | Dynamic CL increased immediately post; sustained 1 h. Elastic WOB decreased |
| De Troyer and Deisser (197) | 1981 | 10 | Slow NMD | Prospective pre-post intervention study | 15 min IPPB (also performed maximal inflations using VCV-NIV in sub-set) | No change in VC, FRC, CL |
| McCool et al. (51) | 1986 | 14 NMD 6 Controls |
Chronic SCI, slow NMD | Prospective pre-post intervention study | 20 min IPPB | No change in Crs (or CL and CCW in sub-set with measurements) |
| Simonds et al. (203) | 1989 | 10 | Restrictive CWD | 5 min MI (volume or pressure NIV) | No change in accessible alveolar volume or oxygenation | |
| Stiller et al. (204) | 1992 | 5 | Recent SCI | 20 min IPPB (4 reps × 6 sets) | Statistically significant but small change in VC post therapy (0.4 ± 0.9 L) | |
| Lechtzin et al. (198) | 2006 | 14 MND 4 Controls |
MND | Prospective pre-post intervention study | 5 min MI (bilevel NIV) | No group change in CL |
| Laffont et al. (205) | 2008 | 7 | Recent SCI | Prospective pre-post intervention study | 20 min IPPB | No change in dynamic CL or WOB post |
| Guerin et al. (206) | 2010 | 14 | Slow NMD | Prospective pre-post intervention study | 30 maximal inflations via IPPB | Improved tidal volume (VT) on EIT, up to 3 h post single session |
| Cleary et al. (177) | 2013 | 26 PCF data 15 FVC data | MND | Prospective, pre-post cross-over study | 5 maximal inflations via LVR | Improved PCF post, no change in FVC |
| Meric et al. (201) | 2017 | 9 | DMD | Prospective pre-post intervention study | 15 maximal insufflations via MI-E | Statistically significant increase in VC post therapy, but small magnitude & diminished by 1 h. No change in VT |
| Molgat-Seon et al. (29) | 2017 | 12 NMD 12 Controls |
Slow NMD, Chronic SCI | Prospective pre-post intervention study | 10 maximal inflations via LVR | Immediate increase in Crs, diminished by 1 h. No change in VC, FRC, PCF |
| Sarmento et al. (192) | 2017 | 12 MND 12 Controls |
MND, Controls | Prospective pre-post intervention study | 3 maximal inflations via LVR | Increase in PCF, IC, and VC (measured via OEP) immediately post compared with baseline |
| Cesareo et al. (199) | 2018 | 20 | DMD | Prospective pre-post intervention study | 5 × 5 maximal insufflations via MI-E (for lung volume recruitment) | No change in VC, VT, or PCF post MI-E. No change in lung volumes via OEP |
| Cleary et al. (207) | 2021 | 29 | MND | Prospective pre-post cross-over study | 5 maximal inflations via LVR | LVR improved forced expiration, throat clearing, and other airway protection behaviours at 30 min |
| Pellegrino et al. (208) | 2021 | 15 | Slow NMD, MND | Prospective pre-post intervention study | 3 maximal inflations via LVR | Small improvement in dypnoea (Borg score) up to 2 h post. No change in SpO2 or ventilation distribution (FOT) |
| Veldhoen et al. (30) | 2022 | 67 | Paediatric and adult NMD | Prospective pre-post intervention study | ∼5 reps × 3 sets maximal inflations via LVR (n = 48), or ∼5 reps × 5 sets via MI-E (n = 19) |
LVR: Immediate increase in VC, diminished by 1 h. MI-E: Immediate increase in VC, diminished by 2 h. No change in PEF with either |
| Casaulta et al. (200) | 2022 | 8 | Paed NMD | Prospective pre-post intervention study | ∼5 reps × 5 sets via MI-E | No change in VC, PEF, LCI, or global inhomogeneity index (EIT) |
| Sheers et al. (23) | 2022 | 80 | Slow NMD MND |
Prospective pre-post intervention study | 5 reps × 2 sets maximal inflations via LVR | Increase in Crs, LIC, and PCFLIC. No change in VC, FRC, or static lung volumes, PCF |
The shaded rows highlight studies employing an LVR kit.
CWD, chest wall disease; NMD, neuromuscular disease; SCI, spinal cord injury; MND, motor neurone disease; DMD, Duchenne muscular dystrophy; IPPB, inspiratory positive pressure breathing; VCV-NIV, volume-limited mode (i.e., volume-controlled ventilation) of non-invasive ventilation; MI, mechanical insufflation; NIV, non-invasive ventilation; LVR, lung volume recruitment; MI-E, mechanical insufflation-exsufflation; CL, lung compliance; WOB, work of breathing; VC, vital capacity; FRC, functional residual capacity; Crs, respiratory system compliance; CCW, chest wall compliance; VT = tidal volume; EIT, electrical impedence tomography; FVC, forced vital capacity; PCF, peak cough flow; OEP, opto-electronic plethysmography; SpO2, oxygen saturation; FOT, forced oscillation technique; PEF, peak expiratory flow; LCI, lung clearance index; EIT, electrical impedence tomography; PCFLIC, PCF from LIC.