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CompletedNCT02282202Updated Jun 27, 2018

Evaluation of Oscillatory Positive Expiratory Pressure (oPEP) in Bronchiectasis and COPD

An interventional study of Oscillating Positive Expiratory Pressure (Aerobika ®) in Chronic Obstructive Pulmonary Disease and Bronchiectasis, sponsored by Western University, Canada. Completed at 1 site in Canada. Open to participants aged 40 Years to 85 Years. Per ClinicalTrials.gov, last updated 2018-06-27.

Sponsored by Western University, Canada · Not applicable, Interventional, and Treatment

Phase
Not applicable
Study type
Interventional
Enrollment
32
Ages
40 Years to 85 Years
Sex
All
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Study summary

The purpose of this study is to evaluate the safety and efficacy of four times daily Positive Expiratory Pressure (oPEP) (Aerobika ®) maneuvers over three weeks in individuals with bronchiectasis and chronic obstructive pulmonary disease (COPD) with chronic sputum production. The investigators hypothesize that four times daily positive expiratory pressure using the Aerobika ® will significantly improve dyspnea, movement of mucus, St. George's Respiratory Questionnaire (SGRQ) score, and six-minute walk distance (6MWD) after three weeks of four times daily administration.

Read the detailed description

Cough and sputum production are common in Bronchiectasis and chronic obstructive pulmonary disease (COPD), both of which are associated with significant morbidity and other adverse clinical outcomes. Airway clearance techniques (ACTs) such as afforded by oscillatory Positive Expiratory Pressure (oPEP) (Aerobika ®) aim to remove sputum from the lungs, however evidence of their efficacy during stable disease is unclear.

The objective of this study is to evaluate the safety and efficacy of four times daily Positive Expiratory Pressure maneuvers over three weeks in individuals with bronchiectasis and COPD with chronic sputum production. The oPEP device (Aerobika ®) combines positive expiratory pressure therapy and airway vibrations to help mobilize pulmonary secretions. oPEP therapy enforces a resistance to exhalation at the mouth while the airway vibration technology transmits movements upstream during exhalation so that airway walls may become free from mucus. An adjustable dial allows users to adjust the frequency and the flow resistance based on their individual needs. Subjects will take a device home and use four times daily during the active part of the study. We hypothesize that daily oPEP use will significantly improve dyspnea, movement of mucus, SGRQ score, and 6MWD after three weeks of four times daily administration.

This is a randomized cross-over unblinded study in 30 subjects: ten with bronchiectasis and 20 with COPD (with chronic bronchitis and chronic mucus production identified). Five subjects from the Bronchiectasis group and ten from the COPD group will start with oPEP and use for three weeks. All subjects will crossover at Visit Two after three weeks of oPEP therapy or three weeks of no therapy. Each subject will visit the centre on three occasions: Baseline, Crossover Visit, and Final Visit for approximately one hour each and will perform: 1) spirometry and plethysmography, 2) 6MWT, and 3) health status evaluation using a self-administered SGRQ. Subjects will first provide written informed consent and will complete: 1) SGRQ after inhaling 2-4 puffs (200-400µg) of the short-acting bronchodilator (eg. Salbutamol), 2) plethysmography and spirometry 35 (±five minutes) post-salbutamol. Vital signs will be documented and subjects will rest for approximately 15 minutes before the six-minute walk test (6MWT) post-salbutamol. Subjects will be given an oPEP therapy system (Aerobika ®) to use at home, four times per day. Instruction and training on the use of the device will be given at the baseline visit. Subjects will be required to return the device upon completion of the study.

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Conditions studied

  • Chronic Obstructive Pulmonary Disease
  • Bronchiectasis

Keywords

  • Sputum
  • Bronchiectasis
  • Chronic Obstructive Pulmonary Disease
  • Airway clearance therapy
  • Oscillatory Positive Expiratory Pressure
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In context

Lung Diseases

3,303 studies on the registry are indexed under Lung Diseases; 355 are open to participants now.

This study's enrollment of 32 is below the median of 72 across 2,118 interventional studies indexed under Lung Diseases.

Browse Lung Diseases studies →

Lead sponsor

Western University, Canada is the lead sponsor of 221 studies on the registry; 56 are open to participants now.

Counted across the registry records on this site, refreshed daily.

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Who can participate

Ages eligible
40 Years to 85 Years
Sexes eligible
All
Accepts healthy volunteers
No

Inclusion criteria

  • Subjects male and female aged 40-85 with either a clinical diagnosis of bronchiectasis or COPD with chronic bronchitis and chronic mucous production identified
  • Subject understands the study procedures and is willing to participate in the study as indicated by signature on the informed consent
  • Subject is judged to be in otherwise stable health on the basis of medical history
  • Subject is ambulatory and can perform the 6MWT
  • Subject able to perform reproducible pulmonary function testing (i.e., the 3 best acceptable spirograms have FEV1 values that do not vary more than 5% of the largest value or more than 100 ml, whichever is greater.)
  • FEV1 >25% predicted -FVC > 25% predicted and >0.5L

Exclusion criteria

Exclusion Criteria:

  • Patient is, in the opinion of the investigator, mentally or legally incapacitated, preventing informed consent from being obtained, or cannot read or understand the written material. Capacity to consent will be determined by either Dr. McCormack at the time of the clinic visit or Sandra Blamires, the study coordinator.
  • Patient is unable to perform spirometry or plethysmography maneuvers
  • Patient is pregnant
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Study design

Phase
Not applicable
Primary purpose
Treatment
Intervention model
Crossover assignment
Masking
None (open label)
Enrollment
32 participants (actual)

Study arms

  • Other
    Off/on for 3 weeks followed by on/off for 3 weeks

    Subjects are randomized to either Oscillating Positive Expiratory Pressure device (Aerobika ®) or no device for three weeks, then crossover for the following three weeks.

    Device: Oscillating Positive Expiratory Pressure (Aerobika ®)

Interventions

  • DeviceOscillating Positive Expiratory Pressure (Aerobika ®)

    The oPEP system (Aerobika ®) combines positive expiratory pressure therapy and airway vibrations to help mobilize pulmonary secretions. oPEP therapy (Aerobika ®) enforces a resistance to exhalation at the mouth, while the airway vibration technology transmits movements upstream during exhalation so that airway walls may become free from mucous. Subjects will take home the device and use four times daily during the active part of the study. There is only one intervention for this study. Subjects are "on" treatment for three weeks and "off" for the alternate three weeks.

    Also known as: oPEP (Aerobika ®)

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What researchers measure

Primary outcomes

  1. Change in sputum production

    Change in sputum production from subject self-reported questionnaires performed weekly

    Time frame: weekly for six weeks

Secondary outcomes

  1. Six Minute Walk Distance (6MWD)

    Time frame: Baseline, 3-weeks (cross-over), 6-weeks

  2. Pulmonary function measurements

    Pulmonary function measurements include FEV1 (Forced expiratory volume in 1 second); FVC (forced vital capacity); FEV1/FVC ratio; TLC (total lung capacity); RV (residual volume); DLCO (Diffusing capacity of the lung)

    Time frame: Baseline, 3-weeks (cross-over), 6-weeks

  3. St. George's Respiratory Questionnaire (SGRQ)

    Time frame: Baseline, 3-weeks (cross-over), 6-weeks

  4. Dyspnea (Patient Evaluation Questionnaire)

    Time frame: Completed weekly for 6 weeks

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Study locations

1 site
  • Robarts Research Insitute; The University of Western Ontario; London Health Sciences Centre
    London, Ontario N6A 5B7, Canada
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References and documents

Publications

  • Cochrane GM, Webber BA, Clarke SW. Effects of sputum on pulmonary function. Br Med J. 1977 Nov 5;2(6096):1181-3. doi: 10.1136/bmj.2.6096.1181. PubMed 589074 ↗
  • Ambrosino N, Callegari G, Galloni C, Brega S, Pinna G. Clinical evaluation of oscillating positive expiratory pressure for enhancing expectoration in diseases other than cystic fibrosis. Monaldi Arch Chest Dis. 1995 Aug;50(4):269-75. PubMed 7550205 ↗
  • Oberwaldner B, Evans JC, Zach MS. Forced expirations against a variable resistance: a new chest physiotherapy method in cystic fibrosis. Pediatr Pulmonol. 1986 Nov-Dec;2(6):358-67. doi: 10.1002/ppul.1950020608. PubMed 3543830 ↗
  • Capaldi DPI, Guo F, Xing L, Parraga G. Pulmonary Ventilation Maps Generated with Free-breathing Proton MRI and a Deep Convolutional Neural Network. Radiology. 2021 Feb;298(2):427-438. doi: 10.1148/radiol.2020202861. Epub 2020 Dec 8. PubMed 33289613 ↗
  • Svenningsen S, Paulin GA, Sheikh K, Guo F, Hasany A, Kirby M, Rezai RE, McCormack DG, Parraga G. Oscillatory Positive Expiratory Pressure in Chronic Obstructive Pulmonary Disease. COPD. 2016;13(1):66-74. doi: 10.3109/15412555.2015.1043523. Epub 2015 Oct 2. PubMed 26430763 ↗
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Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Jun 27, 2018, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT02282202
Lead sponsor
Western University, Canada
Collaborators
London Health Sciences Centre
Responsible party
Dr. Grace Parraga (PhD, Scientist. Robarts Research Institute, Western University, Canada) — Principal investigator
First posted
Nov 4, 2014
Start date
Sep 2013
Primary completion
Sep 2014
Completion
Sep 2014
Last update
Jun 27, 2018

Study contacts

Grace E Parraga, PhD
principal investigator · Robarts Research Institute, The University of Western Ontario
David G McCormack, MD
principal investigator · London Health Sciences Centre

Oversight

Data monitoring committee
No
View the source record on ClinicalTrials.gov ↗

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