Advancing knowledge of factors affecting the personalisation of airway clearance in bronchiectasis

Bronchiectasis is a chronic and progressive lung disease associated with cough, sputum, and respiratory infection. The increasing burden on healthcare systems has led to renewed interest in clinical trials and developing therapies for this patient population. Airway clearance techniques (ACTs) are recommended as an integral part of management to facilitate secretion removal, improve symptoms and health-related quality of life (HRQOL). Guidelines recommend that ACTs should be personalised to improve outcomes. Our understanding about ACTs in bronchiectasis however remains limited. Currently there are no definitive guidelines on the optimal prescription of ACTs. Personalised prescription appears to be dependent upon clinical expertise, local training, and workplace culture. Significant knowledge gaps exist in literature regarding optimisation of ACTs for individuals with bronchiectasis. The overarching aim of this thesis was to enhance the personalised prescription of ACTs in bronchiectasis. Four studies were completed. The first study commenced at the airway clearance device itself and the properties of different commonly prescribed devices. The second study summarised outcome measures used in ACT studies and the final two studies examined separately the patient and physiotherapist perspectives of ACTs. Positive expiratory pressure (PEP) devices are a type of ACT device widely used in clinical settings. The comparative performance characteristics of these devices remain unknown. Study One (Chapter Three) was an experimental bench study which compared the performance characteristics (mean PEP, peak PEP, amplitude PEP and oscillation frequency) of six different PEP devices by varying resistance and flow. Results showed the performance characteristics of the devices differed across flows and resistance settings. Some commonly used devices (e.g. Acapella Choice, Acapella DH, Aerobika and Pari PEP S) were flow-dependent, whilst the performance characteristics of other devi
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
School of Health Sci & Soc Wrk
Griffith Health
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