Department of Rehabilitation Medicine, Gangnam Severance Hospital, Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul, Republic of Korea.
Biorobotics Laboratory, Department of Mechanical Engineering, Seoul National University, Seoul, Republic of Korea.
Phys Ther. 2022 Sep 4;102(9). doi: 10.1093/ptj/pzac092.
Although air stacking is a widely used lung expansion therapy essential for restrictive lung diseases, important details such as peak insufflation pressure (PIP) and number of squeezes have not been investigated. The purpose of this study was to standardize a method of air stacking to minimize problems with its application by identifying the optimal pressure and number of squeezes performed by professional physicians and investigating the current status of routine air stacking implementation in patients.
This prospective cross-sectional test-retest study involved individuals who had neuromuscular disorders and had performed air stacking exercise for longer than 1 year. PIP and number of squeezes were measured to identify the differences between caregivers and physicians. Cases of incorrectly performed air stacking were investigated and categorized. The problems associated with air stacking were evaluated.
A total of 45 participants were included. PIP was 41.4 (SD = 4.2; range = 34.8-50.0) cm H2O, and optimal number of squeezes was 3.1 (SD = 0.5; range = 2-4). When the air stacking methods used by caregivers were evaluated, 19 of 45 caregivers (42.2%) used methods inappropriately. Higher PIP and larger number of squeezes were observed with caregiver implementation. Thirty caregivers (66.7%) experienced finger or wrist pain; this problem was observed especially in female caregivers, who tended to incorrectly perform air stacking.
This pilot study showed that the optimal pressure of air stacking was 35 to 50 cm H2O. Caregivers often perform air stacking inappropriately, leading to complications without achieving the purpose of air stacking. The introduction of a new method, such as manometry, can be helpful for achieving optimal air stacking.
Optimal pressure of air stacking can be measured with inexpensive, simple, and commercially available digital manometry. This approach enables air stacking to be performed and taught more accurately and efficiently and reduces complications in both patients and caregivers.
尽管空气堆叠是一种广泛应用于限制性肺部疾病的肺部扩张治疗方法，但重要细节，如峰压（PIP）和挤压次数等，尚未得到研究。本研究的目的是标准化空气堆叠的方法，通过确定专业医生进行的最佳压力和挤压次数，并调查患者常规空气堆叠实施的现状，最大限度地减少其应用中的问题。
这是一项前瞻性的横断面测试-再测试研究，涉及患有神经肌肉疾病且进行空气堆叠运动超过 1 年的个体。测量 PIP 和挤压次数，以确定护理人员和医生之间的差异。调查并分类不正确执行空气堆叠的情况。评估与空气堆叠相关的问题。
共纳入 45 名参与者。PIP 为 41.4（SD=4.2；范围=34.8-50.0）cm H2O，最佳挤压次数为 3.1（SD=0.5；范围=2-4）。当评估护理人员使用的空气堆叠方法时，45 名护理人员中有 19 名（42.2%）使用方法不当。在护理人员实施过程中观察到更高的 PIP 和更多的挤压次数。30 名护理人员（66.7%）出现手指或手腕疼痛；在女性护理人员中尤其观察到这个问题，她们往往不正确地进行空气堆叠。
这项初步研究表明，空气堆叠的最佳压力为 35 至 50 cm H2O。护理人员经常不恰当地进行空气堆叠，导致并发症而未能达到空气堆叠的目的。引入新的方法，如测压法，可能有助于实现最佳的空气堆叠。
空气堆叠的最佳压力可以使用廉价、简单且市售的数字测压法进行测量。这种方法使空气堆叠能够更准确和高效地进行和教学，减少患者和护理人员的并发症。
