Pieterse Alison, Hanekom Susan D
1Department of Physiotherapy, Tygerberg Hospital, Cape Town, South Africa.
2Division of Physiotherapy Department of Health and Rehabilitation Sciences Faculty of Medicine and Health Sciences, University of Stellenbosch, 4th Floor Education Building Tygerberg, PO Box 241, Cape Town, 8000 South Africa.
Multidiscip Respir Med. 2018 Jul 6;13:22. doi: 10.1186/s40248-018-0127-6. eCollection 2018.
Uncertainty exists regarding the physiological basis of physiotherapy strategies to facilitate mucus clearance. The aim of this review was to describe the physiological factors and intrinsic conditions that facilitate airway mucus transport.
A scoping review was performed. A systematic literature search of six databases was executed. Eligibility criteria were applied by two researchers to reach the aim of the review. Papers were identified independently by two reviewers on title, abstract and full-text level. Any discrepancies were discussed with a third reviewer.
The search identified 35 papers published between 1975 and 2015. These differed significantly in terms of outcome measures, measurement techniques and methodologies and included animal studies, laboratory investigations, and the use of small human samples. Nine key factors influencing mucus transport were identified. These include: temperature and humidity, bronchial perfusion, ATP, forced expiratory technique and cough, generation of oscillation, ventilation patterns/airflow, epithelial differences, mucus properties and positioning.
This review provides a framework for factors/conditions influencing mucus transport. Existing physiotherapy strategies for augmentation of airway mucus clearance can now be evaluated against the framework and new modalities informed.
关于促进黏液清除的物理治疗策略的生理基础尚存在不确定性。本综述的目的是描述促进气道黏液运输的生理因素和内在条件。
进行了一项范围综述。对六个数据库进行了系统的文献检索。两名研究人员应用纳入标准以达成综述的目的。两名审阅者分别在标题、摘要和全文层面独立识别论文。任何分歧都与第三名审阅者进行讨论。
检索确定了1975年至2015年间发表的35篇论文。这些论文在结局指标、测量技术和方法方面存在显著差异，包括动物研究、实验室调查以及对少量人体样本的研究。确定了影响黏液运输的九个关键因素。这些因素包括：温度和湿度、支气管灌注、三磷酸腺苷、用力呼气技术和咳嗽、振荡的产生、通气模式/气流、上皮差异、黏液特性和体位。
本综述提供了一个影响黏液运输的因素/条件的框架。现在可以根据该框架评估现有的增强气道黏液清除的物理治疗策略，并为新的治疗方式提供依据。
