The effect of passive thoracic flexion-rotation movement on the total static compliance of the respiratory system and respiratory responses in ventilated patients

[摘要] AIM: The aim of this study was threefold. Firstly to determine the effect of passive thoracicflexion-rotation (PTFR) movement on the total static compliance of the respiratory system,tidal volume, respiratory rate and plateau pressure. Secondly, to identify the interventionsused by physiotherapists to influence compliance and thirdly to compare the effects ofthese interventions. DESIGN: A one group, pre-test-post-test physiological study and asystematic review of the literature were performed. METHOD: A randomised sampleconsisting of 18 intubated and ventilated subjects of varying periods of ventilation andvarious conditions was obtained. The interventions used included tactile stimulation andPTFR movements. Subjects acted as their own controls. Objective variables namely tidalvolume, respiratory rate and plateau pressure were recorded by a research assistant.These measurements were taken immediately following the intervention and repeatedagain three times in an interval of 20 minutes after the movement was discontinued. Totalstatic compliance of the respiratory system was calculated as tidal volume divided by thedifference between plateau pressure and positive end-expiratory pressure. The searchstrategy for the systematic review included the searching of five databases, a secondarysearch (pearling) and a hand search. Two independent reviewers agreed on the inclusionof articles and their methodological quality. A critical review form (Law et al 1998) wasused for scoring methodological quality and a hierarchy of evidence for allocating the levelof evidence of each study. Inclusion criteria were experimental studies, written in Englishand published after January 1995. Participants were intubated, ventilated humans, overthe age of 18.

[发布机构] Stellenbosch University