Evidence for IMT & PEP
Both IMT and PEP have been used in various settings for many years in patients with respiratory diseases.
The latest physiotherapy guidelines1 recommend the following for these two methods of respiratory assistance:
|IMT||Consider inspiratory muscle training in the management of COPD to improve respiratory muscle strength and/or endurance||Consider the use of inspiratory muscle training in conjunction with conventional pulmonary rehabilitation to enhance the maintenance of the training effect.|
|PEP||Consider the active cycle of breathing techniques (which includes the forced expiration technique), autogenic drainage and plain or oscillating positive expiratory pressure for patients with stable COPD who need an airway clearance technique to assist in the removal of secretions.||Consider oscillating positive expiratory pressure when recommending an airway clearance technique for adults with non-cystic fibrosis-related bronchiectasis.|
|IMT||Research is needed to support or refute the use of inspiratory muscle training for airway clearance in patients with cystic fibrosis||Further research is required to ascertain clinical relevance of inspiratory muscle training in this patient group|
|PEP||Consider oscillating positive expiratory pressure when recommending an airway clearance technique for adults with cystic fibrosis.
Consider mechanical vibration when recommending an airway clearance technique for adults with cystic fibrosis.
|Further research is required for the evaluation of airway clearance techniques in the management of secretions in asthma.|
- Bott J et al. Guidelines for the physiotherapy management of the adult, medical, spontaneously breathing patient. Thorax 2009;64:i1-i52 doi:10.1136/thx.2008.110726.