Chronic Obstructive Pulmonary Disease, Healthy
Conditions
Brief summary
ELTGOL (Slow Expiration with the Opened Glottis in the Lateral posture) is an airway clearance technique performed in the lateral decubitus position. This technique focuses on optimizing ventilation of the infralateral lung (when the subject is lying in the lateral posture) to enhance local air-liquid interaction. Previous studies on ventilation differences between the infra- and supralateral lungs were conducted on healthy, young, male subjects, without the application of thoracic or abdominal pressure. This study aimed to assess ventilation distribution in right lateral recumbency in patients with chronic obstructive pulmonary disease (COPD), as well as healthy individuals, and investigate the impact of thoracic and abdominal manual pressures during ELTGOL on ventilation distribution.
Detailed description
Electrical impedance tomography will be used to verify the effect of the lateral posture and associated breathing techniques in COPD and healthy individuals. The subjects will be placed in a standardised position before the measurements begin. The subjects will be placed in a right lateral recumbency position. The protocol comprises four manoeuvres, each interrupted by a short rest phase. Each subject will begin the experiment with the spontaneous ventilation manoeuvre in order to obtain the reference ventilation distribution. This will be followed by four other manoeuvres during which ventilation was measured: 1) using an spirometer to obtain a tidal volume of 1L, 2) performing the ELTGOL technique independently, 3) performing the ELTGOL technique assisted by manual pressures applied by a physiotherapist. 4) using a positive expiratory pressure (PEP) device.
Interventions
BEHAVIORAL1L-Tidal-Breathing
The subject will be asked to breath with a fixed tidal-breathing of 1 liter per breath (monitored via a spirometer) while being in the right lateral posture.
BEHAVIORALSpontaneous Breathing
The subject will be asked to breath spontaneously while being in the right lateral posture.
BEHAVIORALELTGOL_Physio
The subject will be asked to slowly exhale with the glottis opened in the right lateral posture. The physiotherapist will accompany the subject by gently applying manual pressure on the chest wall and the abdomen during expiratory phases.
BEHAVIORALELTGOL_Auto
The subject will be asked to slowly exhale with the glottis opened in the right lateral posture. The physiotherapist will not intervene in this arm.
DEVICEPEP
The subject will be asked to exhale through a positive expiratory pressure (PEP) device (Threshold PEP) while being in the right lateral posture.
Sponsors
William Poncin, PT, PhD
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
40 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* Healthy subjects: No acute or chronic respiratory disease, normal lung function, non-smoker. * Patients with COPD: forced expiratory volume at one second (FEV1) ≤ 80% predicted value, in stable state.
Exclusion criteria
* Healthy subjects: obesity (BMI \> 35kg/m²); active or former smoker; severe scoliosis; cardiovascular or neuromuscular disease; active implant (cardiac pacemaker or an implantable cardioverter-defibrillator (ICD); thoracic skin lesion. * Patients with COPD: obesity (BMI \> 35kg/m²); severe scoliosis; severe cardiovascular disease; neuromuscular disease; active implant (cardiac pacemaker or an implantable cardioverter-defibrillator (ICD); thoracic skin lesion.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Impedance variation using Electrical Impedance Tomography | 2 minutes during intervention | Impedance change in the right and left lungs |
Countries
Belgium
Contacts
Primary ContactWilliam Poncin
Outcome results
None listed