Vibration and its effect on the respiratory system

Vibration is a manual technique used widely to assist with the removal of pulmonary secretions. Little is known about how vibration is applied or its effect on the respiratory system. The purpose of this study was to describe mechanical consequences of vibration on the chest wall of a normal subject and the effects of vibration on expiratory flow rates and volumes. The effects of vibration were compared to other interventions of chest wall compression, chest wall oscillation, cough, huff from high lung volume, inspiration to total lung capacity with relaxed expiration, tidal breathing, and sham. Sixteen physiotherapists applied vibration and other interventions in a randomised order to the chest wall of a healthy adult female subject. The magnitude and direction of the force and the frequency of vibration were measured by an instrumented bed with seven load cells. Inductive plethsysmography measured the change in chest wall circumference with vibration. A heated pneumotachometer measured inspiratory and expiratory flow rates, which were integrated to provide volumes. Vibration was applied with a mean resultant force of 74.4 N (SD 47.1). The mean (SD) change in chest wall circumference and frequency of vibration were 0.8 cm (SD 0.4) and 5.5 Hz (SD 0.8) respectively. The mean peak expiratory flow rate was 0.97 l/s (SD 0.27). Peak expiratory flow rates with vibration were less than 20% of those achieved with cough or huff from high lung volume but greater than with chest wall compression, chest wall oscillation, relaxed expiration from total lung capacity, sham treatment or tidal breathing.