Respiratory mechanics and expectorated sputum volume were assessed before and after each intervention, in order to assess the Flutter Valve effect on tracheobronchial sputum removal. Our study is a pilot study which showed the benefits of use of acapella device at home among severe COPD patients, but is limited due to the low. The search terms used were flutter VRP1, flutter valve, flutter desitin, intrathoracic oscillation, oscillating positive pressure. CLINICAL IMPLICATIONS: Flutter valve device can be an adjunct to pulmonary rehabilitation especially in low to middle income countries and lower the cost and morbidity associated with the disease. (Physiotherapy Evidence Database), and Scielo databases. According to eligibility criteria and in a randomized order, the patients were submitted to two protocols (control and Flutter Valve intervention), with one-week interval between them (washout). The effects of flutter on pulmonary function are controversial with no changes or improvement in some studies. The forced oscillation technique (FOT), a non-invasive alternative to characterize respiratory mechanics, allows the evaluation of respiratory mechanics at different frequencies without special maneuvers (Dubois e cols., 1956). Airway oscillating devices (e.g. This approach however, does not allow the characterization of mucus transportation along the airways (Williams, 1994). The effects of the Flutter Valve on respiratory mechanics of patients with bronchiectasis have been evaluated by forced spirometry (Pryor e cols, 1994 Gondor e cols, 1999 Thompson e cols, 2002). The Flutter Valve was initially proposed for the treatment of children with cystic fibrosis (CF) (Lindemann, 1992), but there is not enough evidence about its utilization in patients with bronchiectasis (Van der Shans & cols, 1999). For this purpose, a number of techniques has been introduced in the last decades. The application of airway clearance techniques is considered an important component in the treatment of bronchiectasis patients (Van der Shans, 1997). Modern devices to facilitate airway clearance of secretions include the Flutter valve, Acapella valve, and high-frequency chest compression vests (see Table 48-3).
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