Effects of a home programme of airway clearance techniques on adventitious respiratory sounds in patients with bronchiectasis: a randomised controlled trial

Aim: To assess the ability of computerized respiratory sound (CRS), crackles and wheezes, to significantly change following an airway clearance techniques (ACTs) programme in patients with bronchiectasis. This study also aimed to analyse their responsiveness. Design: A pilot, single-blind, randomised-controlled trial with concealed allocation and ITT analysis was conducted. Participants: Adult outpatients with bronchiectasis and daily expectoration. Intervention: The experimental group completed a 3-week home programme comprising ACTs (using an oscillatory positive expiratory pressure device and autogenic drainage) and education. Participants performed at least one session per day (30 min) and received twice therapist-guided sessions per week. The control group completed 3 weeks of education (once session per week) at home. Data analysis: A linear mixed model was used and data were reported as median difference [(95% CI)]. Outcome measures: CRS and Leicester Cough Questionnaire (LCQ) were registered at baseline and at the end of the programme. The primary outcome was a between-group comparison of the change in the number of expiratory crackles. Secondary outcomes included: inspiratory crackles and wheezes during both respiratory phases and CRS responsiveness. Results: In 12 participants [mean age 60.5(14.1), mean FEV1 2.11(0.8)], there was no significant between-group difference on expiratory crackles change [-0.04 (95%CI -1.38 to 1.47] at week 3. Inspiratory crackles and wheezes did not show significant differences. A LCQ clinical significant change was observed in experimental group [4.2 (95%CI 1.55 to 7.01]. No correlation was found between LCQ change and any change in CRS. Conclusion: A home programme of ACTs does not impact on CRS. Arguably, a larger sample size is needed.