The effect of passive thoracic flexion-rotation movement on the total static compliance of the respiratory system and respiratory responses in ventilated patients
AIM: The aim of this study was threefold. Firstly to determine the effect of passive thoracic flexion-rotation (PTFR) movement on the total static compliance of the respiratory system, tidal volume, respiratory rate and plateau pressure. Secondly, to identify the interventions used by physiotherapists to influence compliance and thirdly to compare the effects of these interventions. DESIGN: A one group, pre-test-post-test physiological study and a systematic review of the literature were performed. METHOD: A randomised sample consisting of 18 intubated and ventilated subjects of varying periods of ventilation and various conditions was obtained. The interventions used included tactile stimulation and PTFR movements. Subjects acted as their own controls. Objective variables namely tidal volume, respiratory rate and plateau pressure were recorded by a research assistant. These measurements were taken immediately following the intervention and repeated again three times in an interval of 20 minutes after the movement was discontinued. Total static compliance of the respiratory system was calculated as tidal volume divided by the difference between plateau pressure and positive end-expiratory pressure. The search strategy for the systematic review included the searching of five databases, a secondary search (pearling) and a hand search. Two independent reviewers agreed on the inclusion of articles and their methodological quality. A critical review form (Law et al 1998) was used for scoring methodological quality and a hierarchy of evidence for allocating the level of evidence of each study. Inclusion criteria were experimental studies, written in English and published after January 1995. Participants were intubated, ventilated humans, over the age of 18.