A systematic review on the effects of high frequency chest wall compression and intrapulmonary percussive ventilation in patients with neuromuscular disease

Background: Patients with neuromuscular disease develop progressively inspiratory and expiratory muscle weakness and can also present impaired glottic function. Airway obstruction is the result of secretion retention and it is known that respiratory insufficiency is the most common cause of death in this population. Therefore, it is important to main clear airways. At some point, the active participation of the patient is not possible due to muscle weakness and other options must be explored. High-frequency chest wall compression and intrapulmonary percussive ventilation are two interventions that do not require the active participation of patients. Objective: We performed a systematic review on the effects of high-frequency chest wall compression and intrapulmonary percussive ventilation in patients with neuromuscular disease Method: Our systematic review followed the recommendation of the PRISMA statement. We performed our research strategy on PubMed, CINHAL, Pedro, Cochrane, and EMBASE. The word combination was initially performed on PubMed and then adapted to the other databases. In our systematic review, we also assessed the risk of bias in the included studies. We used the risk of bias tool version 2.0 tools (9 October 2018 version). Result: The PRISMA checklist was complete to enable control that all points of the checklist are reported in the paper and in which section and page the information can be found (see document Prisma checklist). We found 161 records on PubMed, 229 on EMBASE, 118 on Cochrane, 312 on Pedro, and 760 CINAHL. More information can be found in the document called “Extended data File 1” of the research strategy of all databases. Regarding the risk of bias, we concluded that all included studies had a high risk of bias (see more detail for each point the extended data file 2). Conclusion: We make available our research strategy to enable other researchers to reproduce the research strategy to update the systematic review. Moreover, we make available our analysis of the risk of bias to be transparent.