Effects of chest wall compression on expiratory flow rates in patients with chronic obstructive pulmonary disease

Manual chest wall compression (CWC) during expiration is a technique for removing airway secretions in patients with respiratory disorders. However, there have been no reports about the physiological effects of CWC in patients with chronic obstructive pulmonary disease (COPD). To compare the effects of CWC on expiratory flow rates in patients with COPD and asymptomatic controls. Fourteen subjects were recruited from among patients with COPD who were receiving pulmonary rehabilitation at the University Hospital (COPD group). Fourteen age-matched healthy subjects were also consecutively recruited from the local community (Healthy control group). Airflow and lung volume changes were measured continuously with the subjects lying in supine position during 1 minute of quiet breathing (QB) and during 1 minute of CWC by a physical therapist. During CWC, both the COPD group and the healthy control group showed significantly higher peak expiratory flow rates (PEFRs) than during QB (mean difference for COPD group 0.14 L/sec, 95% confidence interval (CI) 0.04 to 0.24, p