AUTHOR=Sahardin Siti Nurhanis , Jailaini Mas Fazlin Mohamad , Abeed Nik Nuratiqah Nik , Ban Andrea Yu-Lin , Hau Ng Boon , Azmel Azat Azrai , Shah Shamsul Azhar , Hamid Mohamed Faisal Abdul 

TITLE=Impact of Aerobika® oscillating positive expiratory pressure in improving small airway resistance, lung function, symptoms and exercise capacity in chronic obstructive pulmonary disease

JOURNAL=Frontiers in Medicine

VOLUME=10

YEAR=2023

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1202380

DOI=10.3389/fmed.2023.1202380

ISSN=2296-858X

ABSTRACT=<sec><title>Background</title><p>Aerobika<sup>®</sup> oscillating positive expiratory pressure (OPEP) device promotes airway clearance in many respiratory diseases. However, studies have yet to focus on its effectiveness in improving small airway resistance <italic>via</italic> impulse oscillometry (IOS) measurement in COPD subjects. We aim to evaluate the improvement of small airway resistance (<italic>via</italic> IOS), lung function (spirometry), exercise capacity [<italic>via</italic> 6-min walking test (6MWT)], symptoms [COPD assessment test (CAT)] and severe exacerbation events among COPD subjects using Aerobika<sup>®</sup> OPEP.</p></sec><sec><title>Methods</title><p>This was a prospective, single-arm interventional study among COPD subjects with small airway disease. Subjects were instructed to use twice daily Aerobika<sup>®</sup> OPEP (10 min each session); for 24 weeks; as an additional to standard therapy. IOS, spirometry, 6MWT, CAT score and severe exacerbation events were evaluated at baseline, 12 weeks and 24 weeks.</p></sec><sec><title>Results</title><p>Fifty-three subjects completed the study. Aerobika<sup>®</sup> usage showed improvement of IOS parameters; e.g. measurement of airway resistance at 5 Hz (R5), cmH20/L/s, (12-week <italic>p</italic> = 0.008, 24-week <italic>p</italic> &lt; 0.001), R5% predicted (12-week <italic>p</italic> = 0.007, 24-week <italic>p</italic> &lt; 0.001) and small airway resistance (R5–R20), cmH20/L/s, (12-week <italic>p =</italic> 0.021, 24-week <italic>p</italic> &lt; 0.001). There were improvement of lung function; e.g. FEV<sub>1</sub>, L (12-week <italic>p</italic> = 0.018, 24-week <italic>p</italic> = 0.001), FEV<sub>1</sub>% predicted (12-week <italic>p</italic> = 0.025, 24-week <italic>p</italic> = 0.001), FEF<sub>25–75</sub>, L (12-week <italic>p</italic> = 0.023, 24-week <italic>p</italic> = 0.002), and FEF<sub>25–75</sub>% predicted (12-week <italic>p</italic> = 0.024, 24-week <italic>p</italic> &lt; 0.001). CAT score improved at 12 weeks (<italic>p</italic> &lt; 0.001) and 24 weeks (<italic>p</italic> &lt; 0.001). Subjects had improved exercise capacity (6MWT, metres) after 24 weeks (<italic>p</italic> = 0.016). However, there was no significant difference in severe exacerbation events 24 weeks before and after Aerobika<sup>®</sup> usage.</p></sec><sec><title>Conclusion</title><p>Aerobika<sup>®</sup> OPEP demonstrated significant improvement in small airway resistance as early as 12 weeks of usage, with sustained improvement at 24 weeks. Aerobika<sup>®</sup> OPEP administration had significantly improved lung function, 6MWT, and CAT scores over 24 weeks. There was no difference in severe exacerbation events.</p></sec>