Impact of Airstacking and Digital Pressure Feedback on Pulmonary Function in Restrictive Lung Disease: A Stratified Randomized Controlled Trial

<b>Background/Objectives:</b> Airstacking is a technique to improve lung compliance and maximum insufflation capacity (MIC) in patients with neuromuscular disorders by sequentially inflating the lungs using a manual resuscitation bag. Traditional methods lack standardization and rely on...

Full description

Saved in:
Bibliographic Details
Main Authors: Han Eol Cho, Won Ah Choi, Seul Lee, Seong-Woong Kang
Format: Article
Language:English
Published: MDPI AG 2025-03-01
Series:Biomedicines
Subjects:
Online Access:https://www.mdpi.com/2227-9059/13/3/616
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850090317541277696
author Han Eol Cho
Won Ah Choi
Seul Lee
Seong-Woong Kang
author_facet Han Eol Cho
Won Ah Choi
Seul Lee
Seong-Woong Kang
author_sort Han Eol Cho
collection DOAJ
description <b>Background/Objectives:</b> Airstacking is a technique to improve lung compliance and maximum insufflation capacity (MIC) in patients with neuromuscular disorders by sequentially inflating the lungs using a manual resuscitation bag. Traditional methods lack standardization and rely on subjective feedback. A pilot study established optimal pressure ranges using a digital manometer, suggesting its potential to standardize airstacking. This study evaluates the longitudinal effects of airstacking with and without digital pressure feedback on pulmonary function. <b>Methods:</b> A stratified randomized controlled trial was conducted with 40 patients allocated into three groups: those performing airstacking appropriately (Group 1), those previously performing airstacking inappropriately but using digital pressure feedback during the study (Group 2), and those previously performing airstacking inappropriately without feedback (Group 3). Pulmonary function parameters, including forced vital capacity expressed as a percentage of the predicted normal value (FVC%), MIC, and assisted peak cough flow (aPCF), were measured at baseline, 3, 6, and 12 months. Caregiver outcomes, musculoskeletal pain, and satisfaction were assessed. <b>Results:</b> Digital pressure feedback did not significantly alter pulmonary function. Changes in FVC% (<i>p</i> = 0.164), MIC (<i>p</i> = 0.218) and aPCF (<i>p</i> = 0.787) were not statistically significant. However, Group 2 caregivers showed significant reductions in musculoskeletal pain than Group 3 (<i>p</i> = 0.036) and higher satisfaction (mean: 8.92/10). The proportion of caregivers achieving optimal pressure increased by 25% in Group 2 compared to 16.67% in Group 3. <b>Conclusions:</b> While digital pressure feedback did not significantly alter pulmonary function, it contributed to improved caregiver adherence and reduced musculoskeletal pain. These findings suggest that integrating objective pressure feedback into airstacking training may enhance technique standardization and caregiver experience, though its impact on pulmonary function remains uncertain.
format Article
id doaj-art-87604bce577c4809acc6340f60effcea
institution DOAJ
issn 2227-9059
language English
publishDate 2025-03-01
publisher MDPI AG
record_format Article
series Biomedicines
spelling doaj-art-87604bce577c4809acc6340f60effcea2025-08-20T02:42:35ZengMDPI AGBiomedicines2227-90592025-03-0113361610.3390/biomedicines13030616Impact of Airstacking and Digital Pressure Feedback on Pulmonary Function in Restrictive Lung Disease: A Stratified Randomized Controlled TrialHan Eol Cho0Won Ah Choi1Seul Lee2Seong-Woong Kang3Department of Rehabilitation Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Republic of KoreaDepartment of Rehabilitation Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Republic of KoreaDepartment of Rehabilitation Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Republic of KoreaDepartment of Rehabilitation Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul 06273, Republic of Korea<b>Background/Objectives:</b> Airstacking is a technique to improve lung compliance and maximum insufflation capacity (MIC) in patients with neuromuscular disorders by sequentially inflating the lungs using a manual resuscitation bag. Traditional methods lack standardization and rely on subjective feedback. A pilot study established optimal pressure ranges using a digital manometer, suggesting its potential to standardize airstacking. This study evaluates the longitudinal effects of airstacking with and without digital pressure feedback on pulmonary function. <b>Methods:</b> A stratified randomized controlled trial was conducted with 40 patients allocated into three groups: those performing airstacking appropriately (Group 1), those previously performing airstacking inappropriately but using digital pressure feedback during the study (Group 2), and those previously performing airstacking inappropriately without feedback (Group 3). Pulmonary function parameters, including forced vital capacity expressed as a percentage of the predicted normal value (FVC%), MIC, and assisted peak cough flow (aPCF), were measured at baseline, 3, 6, and 12 months. Caregiver outcomes, musculoskeletal pain, and satisfaction were assessed. <b>Results:</b> Digital pressure feedback did not significantly alter pulmonary function. Changes in FVC% (<i>p</i> = 0.164), MIC (<i>p</i> = 0.218) and aPCF (<i>p</i> = 0.787) were not statistically significant. However, Group 2 caregivers showed significant reductions in musculoskeletal pain than Group 3 (<i>p</i> = 0.036) and higher satisfaction (mean: 8.92/10). The proportion of caregivers achieving optimal pressure increased by 25% in Group 2 compared to 16.67% in Group 3. <b>Conclusions:</b> While digital pressure feedback did not significantly alter pulmonary function, it contributed to improved caregiver adherence and reduced musculoskeletal pain. These findings suggest that integrating objective pressure feedback into airstacking training may enhance technique standardization and caregiver experience, though its impact on pulmonary function remains uncertain.https://www.mdpi.com/2227-9059/13/3/616airstackingneuromuscular disorderspulmonary rehabilitationdigital feedbackcaregiver outcomes
spellingShingle Han Eol Cho
Won Ah Choi
Seul Lee
Seong-Woong Kang
Impact of Airstacking and Digital Pressure Feedback on Pulmonary Function in Restrictive Lung Disease: A Stratified Randomized Controlled Trial
Biomedicines
airstacking
neuromuscular disorders
pulmonary rehabilitation
digital feedback
caregiver outcomes
title Impact of Airstacking and Digital Pressure Feedback on Pulmonary Function in Restrictive Lung Disease: A Stratified Randomized Controlled Trial
title_full Impact of Airstacking and Digital Pressure Feedback on Pulmonary Function in Restrictive Lung Disease: A Stratified Randomized Controlled Trial
title_fullStr Impact of Airstacking and Digital Pressure Feedback on Pulmonary Function in Restrictive Lung Disease: A Stratified Randomized Controlled Trial
title_full_unstemmed Impact of Airstacking and Digital Pressure Feedback on Pulmonary Function in Restrictive Lung Disease: A Stratified Randomized Controlled Trial
title_short Impact of Airstacking and Digital Pressure Feedback on Pulmonary Function in Restrictive Lung Disease: A Stratified Randomized Controlled Trial
title_sort impact of airstacking and digital pressure feedback on pulmonary function in restrictive lung disease a stratified randomized controlled trial
topic airstacking
neuromuscular disorders
pulmonary rehabilitation
digital feedback
caregiver outcomes
url https://www.mdpi.com/2227-9059/13/3/616
work_keys_str_mv AT haneolcho impactofairstackinganddigitalpressurefeedbackonpulmonaryfunctioninrestrictivelungdiseaseastratifiedrandomizedcontrolledtrial
AT wonahchoi impactofairstackinganddigitalpressurefeedbackonpulmonaryfunctioninrestrictivelungdiseaseastratifiedrandomizedcontrolledtrial
AT seullee impactofairstackinganddigitalpressurefeedbackonpulmonaryfunctioninrestrictivelungdiseaseastratifiedrandomizedcontrolledtrial
AT seongwoongkang impactofairstackinganddigitalpressurefeedbackonpulmonaryfunctioninrestrictivelungdiseaseastratifiedrandomizedcontrolledtrial