Pulmonary impedance as a new marker of respiratory physiotherapy in adults with obstructive lung diseases: A systematic review

Abstract

Study design: Systematic review. Objective: evaluate whether physiotherapy resources modify pulmonary impedance assessed by forced oscillation techniques (FOT's) in adults with obstructive lung diseases (OLD). Method: This is a systematic review, through PubMed, Scielo, Lilacs, and PEDro databases. The following search strategy was used: Obstructive pulmonary disease OR chronic obstructive pulmonary disease OR COPD OR Bronchiectasis OR Bronchial diseases OR Cystic fibrosis OR mucoviscidosis AND impulse oscillometry OR forced oscillation techniques AND physical therapy OR physiotherapy AND Airway Resistance. Results: Of a total of 216 articles, only three were included. The samples totaled 64 participants, including subjects with cystic fibrosis (CF), chronic obstructive pulmonary disease (COPD), and bronchiectasis. Two studies used flutter® and one performed autogenic drainage. Pulmonary impedance was evaluated in two studies by the impulse oscillometry system (IOS) and in one by the modified FOT (m-FOT). There was a reduction in resistance in several frequencies, with the most frequent being of the total resistance (3/3), the central resistance (2/3), and the peripheral resistance (2/3). Besides, pulmonary reactance results were conflicting. Conclusion: It has been shown that the physiotherapeutic resources used to remove airway secretions modify the pulmonary impedance evaluated by FOT's in adults with OLD, in which total airway resistance (R5) is the parameter with the greatest therapeutic improvement.