2. Study results grouped by outcome measures and interventions – cough augmentation therapy compared to alternative individual cough augmentation therapies.
| Outcome measure | Unassisted cough | MI | ME | MI‐E | MAC | Manual BS | Mechanical BS | Sham BS | GPB | Between‐group comparison |
| PCF (L/min) |
Chatwin 2003 (n = 22) Mean (95% CI) |
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| 169 (129 to 209)a |
182 ( 147 to 217) |
235 (186 to 284) |
297 (246 to 350) |
188 (146 to 229) |
— | — | — | — | ME vs unassisted cough: P < 0.01 MI‐E vs unassisted cough: P < 0.001 MI‐E vs ME: P < 0.001 |
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|
Toussaint 2016 (n = 52) Mean ± SD baseline to after intervention | ||||||||||
| — | — | — | — | — | 125 ± 52 to 186 ± 50; P < 0.001; n = 25 | 132 ± 55 to 199 ± 48; P = 0.001; n = 27 | — | — | P = 0.33 | |
|
Del Amo Castrillo 2019 (n = 20) Median/IQR | ||||||||||
| 176/68a | Data not reported | — | — | — | — | Data not reported | — | — | P < 0.001 comparing MI to baseline (favouring MI) P < 0.001 comparing MI to BS (favouring MI) P = 0.004 comparing BS to baseline (favouring BS) |
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|
Torres‐Castro 2016 (n = 14) MD ± SD (95% CI) baseline to after interventionb | ||||||||||
| — | — | — | — | — | 72.86 ± 61.84 (15.67 to 130.05); P = 0.02 | — | — | 32.14 ± 26.44 (7.69 to 56.59); P = 0.018 | P = 0.14 | |
| Transcutaneous oxygen saturation (%) |
Jenkins 2014 (n = 23) Mean ± SD before to after intervention |
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| — | — | — | — | — | 96 ± 3.2 to 96 ± 3 | — | 96 ± 3.6 to 96 ± 2.5 | — | NS | |
| Tidal volume (mL) |
Jenkins 2014 (n = 23) Mean ± SD before to after intervention |
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| — | — | — | — | — | 277 ± 131 to 310 ± 148; P < 0.001 | — | 303 ± 141 to 289 ± 128; NS | — | Significance levels not reported | |
| Maximum inspiratory or insufflation capacity (L or mL) |
Toussaint 2016 (n = 52) mean ± SD, L |
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| — | — | — | — | — | 1.344 ± 0.520; n = 25 | 1.481 ± 0.477; n = 27 | — | — | Mechanical vs manual BS: MD 0.14, 95% CI –0.13 to 0.41; P = 0.3 | |
|
Del Amo Castrillo 2019 (n = 20) median (IQR), L | ||||||||||
| — | 1.630 (1.247 to 1.870) |
— | — | — | — | 1.320 (1.085–1.755) |
— | — | P = 0.12 | |
|
Torres‐Castro 2016 (n = 14) MD between baseline vital capacity and postintervention maximum inspiratory capacityb mean ± SD (95% CI), mL | ||||||||||
| — | — | — | — | — | 435.0 ± 364.5 (98.61 to 772.82); P = 0.02 |
— | — | 454.29 ± 408.16 (76.80 to 831.77); P = 0.03 | MD 19.29, 95% CI –386.09 to 424.67; P = 0.93 | |
| Minute ventilation (L/min) |
Jenkins 2014 (n = 23) Mean ± SD before to after intervention |
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| — | — | — | — | — | 6.8 ± 3.1 to 8.0 ± 3.5; P < 0.001 | — | 7.4 ± 4.9 to 6.9 ± 3.3; NS | — | Significance levels not reported | |
| Maximal expiratory pressure (cmH2O) |
Toussaint 2016 (n = 52) Mean ± SD |
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| — | — | — | — | — | 26 ± 9 | 28 ± 10 | — | — | P = 0.45 | |
| Respiratory rate (breaths/minute) |
Jenkins 2014 (n = 23) Mean ± SD before to after intervention |
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| — | — | — | — | — | 27 ± 9.2 to 28 ± 10.6; P < 0.05 | — | 26 ± 10.3 to 26 ± 10.4; NS | — | Significance levels not reported | |
| Ability to perform breath stacking (%) |
Toussaint 2016 (n = 52) | |||||||||
| — | — | — | — | — | 88 | 89 | — | — | P = 0.9 | |
| Number of insufflations to maximal insufflation capacity (n) |
Toussaint 2016 (n = 52) Mean ± SD |
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| — | — | — | — | — | 1.8 ± 0.6 | 2.6 ± 0.6 | — | — | P < 0.001 | |
| Comfort, distress, and strength of cough (VAS 10‐point score) |
Chatwin 2003 (n = 22) Mean (95% CI) |
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| 5.4 (4.5 to 6.3)a | 5.8 (4.8 to 6.8) (NS) |
6.9 (5.3 to 7.0) (NS) |
7.3 (6.6 to 8.0) (NS) |
5.9 (5.2 to 6.7) (NS) |
— | — | — | — | Separate VAS scores not presented Significance levels not reported |
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| Comfort (VAS 10‐point score) |
Del Amo Castrillo 2019 (n = 20) Median (IQR) |
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| — | 6.4 (5.2 to 7.6) | — | — | — | — | 6.5 (3.9–7.4) | — | — | P = 0.31 | |
| Subjective cough effectiveness (VAS 10‐point score) |
Del Amo Castrillo 2019 (n = 20) Median (IQR) |
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| — | 6.0 (4.85 to 8.2) | — | — | — | — | 6.2 (5.1–7.1) | — | — | P = 0.17 | |
BS: breathstacking; CI: confidence interval; GPB: glossopharyngeal breathing; IQR: interquartile range; PCF: peak cough flow; MAC: manually assisted cough; MD: mean difference; ME: mechanical exsufflation; MI: mechanical insufflation; MI‐E: mechanical insufflation/exsufflation; min: minute; n: number of participants; NS: not significant; SD: standard deviation; VAS: visual analogue scale. aBaseline value – not a randomly assigned control. bUsing raw first‐period data provided by the author on request.