Cho Han Eol, Choi Won Ah, Lee Seul, Kang Seong-Woong
Department of Rehabilitation Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Republic of Korea.
Rehabilitation Institute of Neuromuscular Disease, Yonsei University College of Medicine, Seoul 03722, Republic of Korea.
Biomedicines. 2025 Mar 3;13(3):616. doi: 10.3390/biomedicines13030616.
Airstacking is a technique to improve lung compliance and maximum insufflation capacity (MIC) in patients with neuromuscular disorders by sequentially inflating the lungs using a manual resuscitation bag. Traditional methods lack standardization and rely on subjective feedback. A pilot study established optimal pressure ranges using a digital manometer, suggesting its potential to standardize airstacking. This study evaluates the longitudinal effects of airstacking with and without digital pressure feedback on pulmonary function. A stratified randomized controlled trial was conducted with 40 patients allocated into three groups: those performing airstacking appropriately (Group 1), those previously performing airstacking inappropriately but using digital pressure feedback during the study (Group 2), and those previously performing airstacking inappropriately without feedback (Group 3). Pulmonary function parameters, including forced vital capacity expressed as a percentage of the predicted normal value (FVC%), MIC, and assisted peak cough flow (aPCF), were measured at baseline, 3, 6, and 12 months. Caregiver outcomes, musculoskeletal pain, and satisfaction were assessed. Digital pressure feedback did not significantly alter pulmonary function. Changes in FVC% ( = 0.164), MIC ( = 0.218) and aPCF ( = 0.787) were not statistically significant. However, Group 2 caregivers showed significant reductions in musculoskeletal pain than Group 3 ( = 0.036) and higher satisfaction (mean: 8.92/10). The proportion of caregivers achieving optimal pressure increased by 25% in Group 2 compared to 16.67% in Group 3. While digital pressure feedback did not significantly alter pulmonary function, it contributed to improved caregiver adherence and reduced musculoskeletal pain. These findings suggest that integrating objective pressure feedback into airstacking training may enhance technique standardization and caregiver experience, though its impact on pulmonary function remains uncertain.
气流叠加是一种通过使用手动复苏袋依次给肺部充气来提高神经肌肉疾病患者肺顺应性和最大充气容量（MIC）的技术。传统方法缺乏标准化，且依赖主观反馈。一项试点研究使用数字压力计确定了最佳压力范围，表明其具有使气流叠加标准化的潜力。本研究评估了有无数字压力反馈的气流叠加对肺功能的纵向影响。进行了一项分层随机对照试验，40名患者被分为三组：正确进行气流叠加的患者（第1组）、之前气流叠加操作不当但在研究期间使用数字压力反馈的患者（第2组），以及之前气流叠加操作不当且无反馈的患者（第3组）。在基线、3个月、6个月和12个月时测量肺功能参数，包括以预测正常值百分比表示的用力肺活量（FVC%）、MIC和辅助峰值咳嗽流量（aPCF）。评估了护理人员的结果、肌肉骨骼疼痛和满意度。数字压力反馈并未显著改变肺功能。FVC%（ = 0.164）、MIC（ = 0.218）和aPCF（ = 0.787）的变化无统计学意义。然而，第2组护理人员的肌肉骨骼疼痛明显低于第3组（ = 0.036），满意度更高（平均：8.92/10）。与第3组的16.67%相比，第2组达到最佳压力的护理人员比例增加了25%。虽然数字压力反馈并未显著改变肺功能，但它有助于提高护理人员的依从性并减轻肌肉骨骼疼痛。这些发现表明，将客观压力反馈纳入气流叠加训练可能会提高技术标准化和护理人员的体验，尽管其对肺功能的影响仍不确定。
