Study design (if review, criteria of inclusion for studies)
Single centre UK study. RCT of cross-over design.
Participants
Mean age: 29.7 years. Mean FEV1: 37.7 % 30 participants recruited (22 males).
Interventions
4 days duration of study. Participants received either HFCWO on days 1 and 3 and the "usual" ACT on days 2 and 4 or vice versa. ACT session were 2x daily for 30 min. 83% of "usual" therapy was described as ACBT.
Outcome measures
Wet weight of expectorated sputum, respiratory function, oxygen saturation monitoring, perceived efficacy and preference were measured.
Main results
29 patients (72% male) of mean (SD) age 29.4 (8.4) years and mean (SD) forced expiratory volume in 1 s (FEV(1)) percentage predicted (FEV(1)%) 38 (16.7) completed the study. Significantly more sputum was expectorated during a single treatment session and over a 24 h period (mean difference 4.4 g and 6.9 g, respectively) with usual ACTs than with HFCWO (p<0.001). No statistically significant change in FEV(1)% or oxygen saturation was observed after either HFCWO or usual ACTs compared with baseline. 17 patients (55%) expressed a preference for their usual ACT.
Authors' conclusions
During both a finite treatment period and over 24 h, less sputum was cleared using HFCWO than usual ACT. HFCWO does not appear to cause any adverse physiological effects and may influence adherence.