Physiotherapy
Volume 95, Issue 1 , Pages 36-42, March 2009

Repeatability of physiotherapy chest wall vibrations applied to spontaneously breathing adults

  • Harriet Shannon

      Affiliations

    • University College London, Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK
    • Corresponding Author InformationCorresponding author. Tel.: +44 207 242 9789x2689; fax: +44 207 829 8634.
    • ,
  • Rachael Gregson

      Affiliations

    • University College London, Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK
    • Great Ormond Street Hospital for Children NHS Trust, London, UK
    • ,
  • Janet Stocks

      Affiliations

    • University College London, Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK
    • ,
  • Tim J. Cole

      Affiliations

    • University College London, Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK
    • ,
  • Eleanor Main

      Affiliations

    • University College London, Institute of Child Health, 30 Guilford Street, London WC1N 1EH, UK

Abstract 

Objective

Chest wall vibrations are commonly used techniques that remain largely unquantified. In order to understand their effects, it is essential to measure the forces applied and their repeatability over time. This study investigated the repeatability of vibrations within and between test occasions.

Design

Test–retest repeatability study.

Participants

Eight physiotherapists applied vibrations to two healthy female adults.

Intervention

Physiotherapists performed seven vibrations on each subject, and measurements were repeated after 24hours and 6 months.

Outcome measures

A force-sensing mat placed over the subject’s chest measured the amplitude, duration and force profile of each physiotherapist’s vibrations.

Results

There were no significant differences in maximum force, duration, frequency of oscillation or amplitude of oscillation within each set of seven chest wall vibrations, confirmed by repeated measures analysis of variance (P=0.42). However, there were wide variations in vibrations between different physiotherapists. Maximum forces ranged from 71 to 258N, with frequency and amplitude of oscillation ranging from 3 to 11Hz and 2 to 66N, respectively. Duration of vibration ranged from 2 to 5seconds. While there was no systematic bias in forces applied between test occasions, limits of agreement were wide following an interval of 24hours (−34 to 58N) and wider still after 6 months (−84 to 76N).

Conclusion

Physiotherapists exhibit fine control of techniques, delivering vibrations uniformly within single test occasions. However, the variation between therapists and test occasions precludes accurate prediction of applied forces when treating stable patients on consecutive occasions. Furthermore, this study raises important questions about factors influencing the pattern and magnitude of forces applied, and the clinical and physiological effects of such variations.

Keywords: Physiotherapy (techniques), Vibration, Respiration

To access this article, please choose from the options below

Login to an existing account or Register a new account.

  • Purchase this article for 31.50 USD (You must login/register to purchase this article)

    Online access for 24 hours. The PDF version can be downloaded as your permanent record.

  • Subscribe to this title

    Get unlimited online access to this article and all other articles in this title 24/7 for one year.

  • Claim access now

    For current subscribers with Society Membership or Account Number.

  • Visit SciVerse ScienceDirect to see if you have access via your institution.
 

PII: S0031-9406(08)00106-5

doi:10.1016/j.physio.2008.08.004

Physiotherapy
Volume 95, Issue 1 , Pages 36-42, March 2009

Article Tools

* Image Usage & Resolution