Abstract
BackgroundNon-pharmacological options for symptomatic management of cough are desired. Although chest wall mechanical vibration is known to ameliorate cough reflex sensitivity, the effect of mechanical vibrations on perceptions of urge-to-cough has not been studied. Therefore, we investigated the effect of mechanical vibration of cervical trachea, chest wall and femoral muscle on cough reflex sensitivity, perceptions of urge-to-cough as well as dyspnea.MethodsTwenty-four healthy male never-smokers were investigated for cough reflex sensitivity, perceptions of the urge-to-cough and dyspnea with or without mechanical vibration. Cough reflex sensitivity and urge-to-cough were evaluated by the inhalation of citric acid. The perception of dyspnea was evaluated by Borg scores during applications of external inspiratory resistive loads. Mechanical vibration was applied by placing a vibrating tuning fork on the skin surface of cervical trachea, chest wall and femoral muscle.ResultsCervical trachea vibration significantly increased cough reflex threshold, as expressed by the lowest concentration of citric acid that elicited five or more coughs (C5), and urge-to-cough threshold, as expressed by the lowest concentration of citric acid that elicited urge-to-cough (Cu), but did not significantly affect dypnea sensation during inspiratory resistive loading. On the other hand, the chest wall vibration not only significantly increased C5 and Cu but also significantly ameliorated the load-response curve of dyspnea sensation.ConclusionsBoth cervical and trachea vibrations significantly inhibited cough reflex sensitivity and perception of urge-to-cough. These vibration techniques might be options for symptomatic cough management.
Highlights
Non-pharmacological options for symptomatic management of cough are desired
Small urge-to-cough sensations were induced by cervical trachea (0.01 ± 0.02 [SE] point), chest wall (0.09 ± 0.05 point) and femoral muscle (0.07 ± 0.03 point) vibrations and sham application (0.11 ± 0.08 point) by themselves even without tussigen inhalation
Small dyspnea sensations were induced by cervical trachea (0.11 ± 0.04 point), chest wall (0.07 ± 0.03 point) and femoral muscle (0.09 ± 0.05 point) vibrations and sham applications (0.37 ± 0.12 point) by themselves even without inspiratory resistive loads
Summary
Non-pharmacological options for symptomatic management of cough are desired. Chest wall mechanical vibration is known to ameliorate cough reflex sensitivity, the effect of mechanical vibrations on perceptions of urge-to-cough has not been studied. We investigated the effect of mechanical vibration of cervical trachea, chest wall and femoral muscle on cough reflex sensitivity, perceptions of urge-to-cough as well as dyspnea. The currently available medications for symptomatic management. External mechanical vibration of chest wall induced cough in patients with acute upper respiratory tract infection [5] and idiopathic pulmonary fibrosis [6]. External mechanical vibration of cervical trachea induced cough in healthy adults, patients with acute upper respiratory tract infection [7,8], and respiratory patients with cough as a leading symptom [8]
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