Sahardin Siti Nurhanis, Jailaini Mas Fazlin Mohamad, Abeed Nik Nuratiqah Nik, Ban Andrea Yu-Lin, Hau Ng Boon, Azmel Azat Azrai, Shah Shamsul Azhar, Hamid Mohamed Faisal Abdul
Respiratory Unit, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Department of Community Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Front Med (Lausanne). 2023 Jun 2;10:1202380. doi: 10.3389/fmed.2023.1202380. eCollection 2023.
Aerobika oscillating positive expiratory pressure (OPEP) device promotes airway clearance in many respiratory diseases. However, studies have yet to focus on its effectiveness in improving small airway resistance impulse oscillometry (IOS) measurement in COPD subjects. We aim to evaluate the improvement of small airway resistance ( IOS), lung function (spirometry), exercise capacity [ 6-min walking test (6MWT)], symptoms [COPD assessment test (CAT)] and severe exacerbation events among COPD subjects using Aerobika OPEP.
This was a prospective, single-arm interventional study among COPD subjects with small airway disease. Subjects were instructed to use twice daily Aerobika OPEP (10 min each session); for 24 weeks; as an additional to standard therapy. IOS, spirometry, 6MWT, CAT score and severe exacerbation events were evaluated at baseline, 12 weeks and 24 weeks.
Fifty-three subjects completed the study. Aerobika usage showed improvement of IOS parameters; e.g. measurement of airway resistance at 5 Hz (R5), cmH20/L/s, (12-week = 0.008, 24-week < 0.001), R5% predicted (12-week = 0.007, 24-week < 0.001) and small airway resistance (R5-R20), cmH20/L/s, (12-week 0.021, 24-week < 0.001). There were improvement of lung function; e.g. FEV, L (12-week = 0.018, 24-week = 0.001), FEV% predicted (12-week = 0.025, 24-week = 0.001), FEF, L (12-week = 0.023, 24-week = 0.002), and FEF% predicted (12-week = 0.024, 24-week < 0.001). CAT score improved at 12 weeks ( < 0.001) and 24 weeks ( < 0.001). Subjects had improved exercise capacity (6MWT, metres) after 24 weeks ( = 0.016). However, there was no significant difference in severe exacerbation events 24 weeks before and after Aerobika usage.
Aerobika OPEP demonstrated significant improvement in small airway resistance as early as 12 weeks of usage, with sustained improvement at 24 weeks. Aerobika OPEP administration had significantly improved lung function, 6MWT, and CAT scores over 24 weeks. There was no difference in severe exacerbation events.
Aerobika振荡呼气末正压（OPEP）装置可促进多种呼吸系统疾病患者的气道清除。然而，尚无研究关注其对改善慢性阻塞性肺疾病（COPD）患者小气道阻力脉冲振荡法（IOS）测量结果的有效性。我们旨在评估使用Aerobika OPEP对COPD患者小气道阻力（IOS）、肺功能（肺量计）、运动能力[6分钟步行试验（6MWT）]、症状[COPD评估测试（CAT）]及严重急性加重事件的改善情况。
这是一项针对患有小气道疾病的COPD患者的前瞻性单臂干预研究。受试者被要求每天使用两次Aerobika OPEP（每次10分钟），持续24周，作为标准治疗的补充。在基线、12周和24周时评估IOS、肺量计、6MWT、CAT评分及严重急性加重事件。
53名受试者完成了研究。使用Aerobika后，IOS参数有所改善；例如，5Hz时气道阻力测量值（R5），cmH20/L/s，（12周时为0.008，24周时<0.001），预测R5%（12周时为0.007，24周时<0.001）以及小气道阻力（R5-R20），cmH20/L/s，（12周时为0.021，24周时<0.001）。肺功能也有改善；例如，第一秒用力呼气容积（FEV），L（12周时为0.018，24周时为0.001），预测FEV%（12周时为0.025，24周时为0.001），用力呼气流量（FEF），L（12周时为0.023，24周时为0.002），以及预测FEF%（12周时为0.024，24周时<0.001）。CAT评分在12周时（<0.001）和24周时（<0.001）有所改善。24周后受试者的运动能力（6MWT，米）有所提高（P=0.016）。然而，使用Aerobika前后24周严重急性加重事件无显著差异。
Aerobika OPEP在使用12周时小气道阻力即有显著改善，24周时持续改善。在24周内，Aerobika OPEP给药显著改善了肺功能、6MWT及CAT评分。严重急性加重事件无差异。
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