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SOUZA LH. Acute flutter effects and thoracic compression over the secretion removal and impedance of the respiratory system in patients with bronchiectasis. [thesis]. Ribeirão Preto: University of São Paulo, Ribeirão Preto Medical School, 2017. INTRODUCTION: Bronchiectasis is characterized by abnormal and permanent bronchi dilatation, mainly caused by the progression of inflammatory processes and loss of the ability to clear mucus. Physical therapy is a fundamental part of these patients’ treatment. In this study we aimed to evaluate the effects of the flutter technique and thoracic compression on the mucus clearance and alterations in the total impedance of the respiratory system in individuals with bronchiectasis. METHODS: In a crossover randomized blinded study, subjects with bronchiectasis and healthy (control) ones were evaluated before and after control sections, flutter exercises, or thoracic compression (TC) manoeuvres. Dry and total weights, adhesiveness, and purulence of the expectorated mucus secretions were evaluated. For respiratory system impedance measurements, impulse oscillometry was used to evaluate the resistance at 5Hz, reactance at 5Hz, and resonant frequency. Additional factors that were evaluated included the dyspnoea scale of the Medical Research Council, acceptability and tolerance scale, pulse oximetry, expectoration difficulty, and bronchiectasis severity index. RESULTS: The flutter technique and TC were efficient for mucus clearance when compared with control (p <0.05). Acute total respiratory system resistance variation responded more favourably to the flutter technique in the bronchiectasis group when compared to the control group (p <0.05). Both techniques were well tolerated by the participants. CONCLUSION: Results suggest that the flutter technique and thoracic compression are efficient methods for removal of mucus secretions. They are safe and well tolerated by patients; acute effects in the total respiratory system resistance respond favourably to the flutter technique.

Efeitos agudos do flutter e da compressão torácica sobre a remoção de secreção e a impedância do sistema respiratório em pacientes com bronquiectasias