Acute effect of use of the Flutter on expectoration of sputum in patients with chronic respiratory diseases

Abstract

The acute effects of use of the Flutter on expectoration of sputum were studied in patients with chronic respiratory diseases who had problems expectorating sputum. The Flutter is a handy, simple, physiotherapy device that is easy to use. Seventeen patients were enrolled in the study. For three consecutive days, the patients were asked to use the Flutter for 15 min when they had the hardest time expectorating sputum. They were also asked to measure the volume of the expectorant obtained during those 15 min and the following 30 min. Expectoration, coughing, and breathlessness were graded with visual analogue scales designed by us. Peak expiratory flow rate was also measured. For the control condition, the patients were asked to remove the stainless steel ball from the device and then to use the device as stated above on the three consecutive days immediately before or after the experimental days. Scores of "difficulty in expectoration" and "chest discomfort" were lower on the second and third experimental days than on the control days (mean+/-SE of difficulty in expectoration on the second day: 3.8+/-0.6 vs 4.4+/-0.6, p<0.05: on the third day: 3.0+/-0.5 vs 4.2+/- 0.6, p<0.02; chest discomfort on the second day: 2.9+/-0.6 vs 3.5/+-0.7, p<0.04; on the third day: 2.3+/-0.6 vs 2.9+/-0.6, p<0.01). No significant differences were noted in cough intensity, cough frequency, breathlessness, or peak expiratory flow. Sputum volume was larger on the second and third experimental days than on the control days (second day: 13.9+/-3.6 vs 11.3+/-3.1 ml, p<0.04; third day: 13.2+/-2.8 vs 9.9+/-2.1 ml, p<0.01). We conclude that use of the Flutter can increase the expectoration of sputum and can relieve related symptoms.