{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T12:04:59Z","timestamp":1793189099366,"version":"4.5.0"},"reference-count":125,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2021,12,3]],"date-time":"2021-12-03T00:00:00Z","timestamp":1638489600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"},{"start":{"date-parts":[[2021,12,3]],"date-time":"2021-12-03T00:00:00Z","timestamp":1638489600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"funder":[{"name":"Monaghan Medical Corporation"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pulm Ther"],"published-print":{"date-parts":[[2022,3]]},"DOI":"10.1007\/s41030-021-00178-1","type":"journal-article","created":{"date-parts":[[2021,12,3]],"date-time":"2021-12-03T11:02:56Z","timestamp":1638529376000},"page":"1-41","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Non-Pharmaceutical Techniques for Obstructive Airway Clearance Focusing on the Role of Oscillating Positive Expiratory Pressure (OPEP): A Narrative Review"],"prefix":"10.1007","volume":"8","author":[{"given":"Dominic P.","family":"Coppolo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Judy","family":"Schloss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason A.","family":"Suggett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5456-8425","authenticated-orcid":false,"given":"Jolyon P.","family":"Mitchell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2021,12,3]]},"reference":[{"issue":"1","key":"178_CR1","doi-asserted-by":"crossref","first-page":"5","DOI":"10.1097\/ACI.0b013e3280114eef","volume":"7","author":"MB Antunes","year":"2007","unstructured":"Antunes MB, Cohen NA. Mucociliary clearance: a critical upper airway host defense mechanism and methods of assessment. Curr Opin Allergy Clinical Immunol. 2007;7(1):5\u201310.","journal-title":"Curr Opin Allergy Clinical Immunol"},{"key":"178_CR2","doi-asserted-by":"crossref","first-page":"028241","DOI":"10.1101\/cshperspect.a028241","volume":"9","author":"XM Bustamante-Marin","year":"2017","unstructured":"Bustamante-Marin XM, Ostrowski LE. Cilia and mucociliary clearance. Cold Spring Harb Perspect Biol. 2017;9:028241.","journal-title":"Cold Spring Harb Perspect Biol"},{"issue":"4","key":"178_CR3","first-page":"341","volume":"6","author":"JA Ohar","year":"2019","unstructured":"Ohar JA, Donohue JF, Spangenthal S. The role of guaifenesin in the management of chronic mucus hypersecretion associated with stable chronic bronchitis: a comprehensive review. Chron Obs Pulmon Dis. 2019;6(4):341\u20139.","journal-title":"Chron Obs Pulmon Dis"},{"key":"178_CR4","doi-asserted-by":"crossref","first-page":"40","DOI":"10.3390\/cells5040040","volume":"5","author":"A Yaghi","year":"2016","unstructured":"Yaghi A, Dolovich MB. Airway epithelial cell cilia and obstructive lung disease. Cells. 2016;5:40.","journal-title":"Cells"},{"key":"178_CR5","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1016\/j.resp.2008.05.010","volume":"163","author":"A Braiman","year":"2008","unstructured":"Braiman A, Priel Z. Efficient mucociliary transport relies on efficient regulation of ciliary beating. Respir Physiol Neurobiol. 2008;163:202\u20137.","journal-title":"Respir Physiol Neurobiol"},{"key":"178_CR6","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/j.resp.2008.04.020","volume":"163","author":"B Button","year":"2008","unstructured":"Button B, Boucher RC, University of North Carolina Virtual Lung Group. Role of mechanical stress in regulating airway surface hydration and mucus clearance rates. Respir Physiol Neurobiol. 2008;163:189\u2013201.","journal-title":"Respir Physiol Neurobiol"},{"key":"178_CR7","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1165\/rcmb.2006-0082SF","volume":"35","author":"SH Randell","year":"2006","unstructured":"Randell SH, Boucher RC. Effective mucus clearance is essential for respiratory health. Am J Respir Cell Mol Biol. 2006;35:20\u20138.","journal-title":"Am J Respir Cell Mol Biol"},{"key":"178_CR8","first-page":"1","volume":"2019","author":"B Lewis","year":"2019","unstructured":"Lewis B, Patial S. Immunopathology of airway surface liquid dehydration disease. J Immunol Res. 2019;2019:1\u201316.","journal-title":"J Immunol Res"},{"issue":"5","key":"178_CR9","doi-asserted-by":"crossref","first-page":"1631","DOI":"10.1378\/chest.07-0288","volume":"132","author":"SH Donaldson","year":"2007","unstructured":"Donaldson SH, Boucher RC. Sodium channels and cystic fibrosis. Chest. 2007;132(5):1631\u20136.","journal-title":"Chest"},{"issue":"Suppl. 2","key":"178_CR10","first-page":"S177","volume":"13","author":"MA Mall","year":"2016","unstructured":"Mall MA. Unplugging mucus in cystic fibrosis and chronic obstructive pulmonary disease. Ann Am Thorac Soc. 2016;13(Suppl. 2):S177\u201385.","journal-title":"Ann Am Thorac Soc"},{"key":"178_CR11","doi-asserted-by":"crossref","first-page":"1333","DOI":"10.1183\/09031936.95.08081333","volume":"8","author":"E Prescott","year":"1995","unstructured":"Prescott E, Lange P, Vestbo J. Chronic mucus hypersecretion in COPD and death from pulmonary infection. Eur Respir J. 1995;8:1333\u20138.","journal-title":"Eur Respir J"},{"key":"178_CR12","doi-asserted-by":"crossref","first-page":"1068","DOI":"10.1183\/09031936.00172007","volume":"32","author":"PR Burgel","year":"2008","unstructured":"Burgel PR, Nadel JA. Epidermal growth factor receptor-mediated innate immune responses and their roles in airway diseases. Eur Respir J. 2008;32:1068\u201381.","journal-title":"Eur Respir J"},{"issue":"116","key":"178_CR13","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1183\/09059180.00004410","volume":"19","author":"PR Burgel","year":"2010","unstructured":"Burgel PR, Martin C. Mucus hypersecretion in COPD: Should we only rely on symptoms? Eur Respir Rev. 2010;19(116):94\u20136.","journal-title":"Eur Respir Rev"},{"key":"178_CR14","doi-asserted-by":"crossref","first-page":"1900419","DOI":"10.1183\/13993003.00419-2019","volume":"55","author":"VY Lin","year":"2020","unstructured":"Lin VY, Kaza N, Birket SE, et al. Excess mucus viscosity and airway dehydration impact COPD airway clearance. Eur Respir J. 2020;55:1900419.","journal-title":"Eur Respir J"},{"key":"178_CR15","doi-asserted-by":"crossref","first-page":"E828","DOI":"10.1503\/cmaj.160830","volume":"189","author":"M Smith","year":"2017","unstructured":"Smith M. Diagnosis and management of bronchiectasis. CMAJ. 2017;189:E828\u201335.","journal-title":"CMAJ"},{"key":"178_CR16","doi-asserted-by":"crossref","first-page":"557","DOI":"10.12688\/f1000research.18411.1","volume":"8","author":"AE Jasper","year":"2019","unstructured":"Jasper AE, McIver WJ, Sapey E, et al. Understanding the role of neutrophils in chronic inflammatory airway disease. F1000 Research. 2019;8:557.","journal-title":"F1000 Research."},{"issue":"1","key":"178_CR17","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1097\/MCP.0b013e32831da8d3","volume":"15","author":"CM Evans","year":"2009","unstructured":"Evans CM, Kim K, Tuvim MJ. Mucus hypersecretion in asthma: Causes and effects. Curr Opin Pulm Med. 2009;15(1):4\u201311.","journal-title":"Curr Opin Pulm Med"},{"issue":"10","key":"178_CR18","doi-asserted-by":"crossref","first-page":"1669","DOI":"10.4187\/respcare.02590","volume":"58","author":"TA Volsko","year":"2013","unstructured":"Volsko TA. Airway clearance therapy: finding the evidence. Respir Care. 2013;58(10):1669\u201378.","journal-title":"Respir Care"},{"issue":"6","key":"178_CR19","doi-asserted-by":"crossref","first-page":"825","DOI":"10.4187\/respcare.04087","volume":"16","author":"BK Rubin","year":"2015","unstructured":"Rubin BK. Aerosol medications for the treatment of mucus clearance disorders. Respir Care. 2015;16(6):825\u201332.","journal-title":"Respir Care"},{"key":"178_CR20","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1378\/chest.129.1_suppl.250S","volume":"129","author":"F McCool","year":"2006","unstructured":"McCool F, Rosen MJ. Nonpharmacologic airway clearance therapies: ACCP Evidence-based clinical practice guidelines. Chest. 2006;129:250\u20139.","journal-title":"Chest"},{"key":"178_CR21","doi-asserted-by":"crossref","first-page":"83","DOI":"10.1191\/1479972306cd097rs","volume":"3","author":"AE Holland","year":"2006","unstructured":"Holland AE, Button BM. Is there a role for airway clearance techniques in chronic obstructive pulmonary disease? Chron Respir Dis. 2006;3:83\u201391.","journal-title":"Chron Respir Dis"},{"key":"178_CR22","doi-asserted-by":"crossref","first-page":"160086","DOI":"10.1183\/16000617.0086-2016","volume":"26","author":"M McIlwaine","year":"2017","unstructured":"McIlwaine M, Bradley J, Elborn JS, et al. Personalising airway clearance in chronic lung disease. Eur Respir Rev. 2017;26:160086.","journal-title":"Eur Respir Rev"},{"issue":"8","key":"178_CR23","doi-asserted-by":"crossref","first-page":"009720","DOI":"10.1101\/cshperspect.a009720","volume":"3","author":"BM Button","year":"2013","unstructured":"Button BM, Button B. Structure and function of the mucus clearance of the lung. Cold Spring Harb Perspect Med. 2013;3(8):009720.","journal-title":"Cold Spring Harb Perspect Med"},{"key":"178_CR24","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/j.jcf.2010.01.004","volume":"9","author":"JA Pryor","year":"2010","unstructured":"Pryor JA, Tannenbaum E, Scott SF. Beyond postural drainage and percussion: airway clearance in people with cystic fibrosis. J Cystic Fibrosis. 2010;9:187\u201392.","journal-title":"J Cystic Fibrosis"},{"key":"178_CR25","unstructured":"Ontario Ministry of Health and Long-Term Care - Medical Advisory Secretariat. Airway clearance devices for cystic fibrosis. Ontario Health Technology Assessment Series 2009; 9(26):1\u201350. Available at: https:\/\/www.hqontario.ca\/Portals\/0\/Documents\/evidence\/reports\/rev_airway_20091201.pdf , visited August 6, 2021."},{"issue":"4","key":"178_CR26","first-page":"321","volume":"4","author":"M Chatwin","year":"2008","unstructured":"Chatwin M. How to use a mechanical insufflator\u2013exsufflator \u201ccough assist machine.\u201d Breathe. 2008;4(4):321\u20135.","journal-title":"Breathe"},{"key":"178_CR27","unstructured":"Goncavles MR, Winck JC. Commentary: Exploring the potential of mechanical insufflation\u2013exsufflation. Breathe. 2008;4(4):326\u20139."},{"key":"178_CR28","doi-asserted-by":"crossref","first-page":"1526","DOI":"10.1016\/j.rmed.2006.01.010","volume":"100","author":"S Nava","year":"2006","unstructured":"Nava S, Barbarito N, Piaggi G, et al. Physiological response to intrapulmonary percussive ventilation in stable COPD patients. Respir Med. 2006;100:1526\u201333.","journal-title":"Respir Med"},{"issue":"5","key":"178_CR29","doi-asserted-by":"crossref","first-page":"735","DOI":"10.4187\/respcare.01441","volume":"57","author":"M Touissant","year":"2012","unstructured":"Touissant M, Guillet M-C, Paternotte S, et al. Intrapulmonary effects of setting parameters in portable intrapulmonary percussive ventilation devices. Respir Care. 2012;57(5):735\u201342.","journal-title":"Respir Care"},{"issue":"10","key":"178_CR30","first-page":"940","volume":"48","author":"M Toussaint","year":"2003","unstructured":"Toussaint M, De Win H, Steens M, et al. Effect of intrapulmonary percussive ventilation on mucus clearance in Duchenne muscular dystrophy patients: a preliminary report. Respir Care. 2003;48(10):940\u20137.","journal-title":"Respir Care"},{"issue":"7","key":"178_CR31","doi-asserted-by":"crossref","first-page":"1116","DOI":"10.4187\/respcare.02727","volume":"59","author":"G Riffard","year":"2014","unstructured":"Riffard G, Buzenet J, Gu\u00e9rin C. Intrapulmonary percussive ventilation superimposed on conventional mechanical ventilation: Comparison of volume controlled and pressure-controlled modes. Respir Care. 2014;59(7):1116\u201322.","journal-title":"Respir Care"},{"issue":"1","key":"178_CR32","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1155\/2005\/525813","volume":"12","author":"C Dosman","year":"2005","unstructured":"Dosman C, Jones R. High-frequency chest compression: a summary of the literature. Can Respir J. 2005;12(1):37\u201341.","journal-title":"Can Respir J"},{"key":"178_CR33","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1177\/1753466620932508","volume":"14","author":"TL Barto","year":"2020","unstructured":"Barto TL, Marcelli DJ, Daignault S, et al. Real-life experience with high-frequency chest wall oscillation vest therapy in adults with non-cystic fibrosis bronchiectasis. Ther Adv Respir Dis. 2020;14:1\u201311.","journal-title":"Ther Adv Respir Dis"},{"issue":"3","key":"178_CR34","first-page":"159","volume":"29","author":"AM Cantin","year":"2006","unstructured":"Cantin AM, Bacon M, Berthiaune Y. Mechanical airway clearance using the Frequencer electro-acoustical transducer in cystic fibrosis. Clin Invest Med. 2006;29(3):159\u201365.","journal-title":"Clin Invest Med"},{"key":"178_CR35","unstructured":"Cantin A, Bacon M. Mechanical clearance of human airways using the Frequencer electro-acoustical transducer \u2013 a white paper. Dymedso Inc. 2020. Available at: www.dymedso.com \u203a White_paper_rev0_Sept20_041 (visited August 5, 2021)."},{"issue":"12","key":"178_CR36","first-page":"1831","volume":"65","author":"CM Benoit","year":"2020","unstructured":"Benoit CM, Christensen E, Nickel AJ, et al. Objective measures of Vest therapy adherence among pediatric subjects with cystic fibrosis. Respir Care. 2020;65(12):1831\u20137.","journal-title":"Respir Care"},{"issue":"3","key":"178_CR37","doi-asserted-by":"crossref","first-page":"482","DOI":"10.4187\/respcare.08150","volume":"66","author":"AM Demchuk","year":"2021","unstructured":"Demchuk AM, Chatburn RL. Performance characteristics of positive expiratory pressure devices. Respir Care. 2021;66(3):482\u201393.","journal-title":"Respir Care"},{"issue":"5","key":"178_CR38","first-page":"516","volume":"38","author":"AARC Clinical Practice Guideline","year":"1993","unstructured":"AARC Clinical Practice Guideline. Use of positive airway pressure adjuncts to bronchial hygiene therapy. Respir Care. 1993;38(5):516\u201321.","journal-title":"Respir Care"},{"issue":"2","key":"178_CR39","first-page":"150","volume":"50","author":"EF Christensen","year":"1995","unstructured":"Christensen EF, Jensen RH, Sch\u00f8nemann NK, et al. Flow dependent properties of positive expiratory pressure devices. Monaldi Arch Chest Dis. 1995;50(2):150\u20133.","journal-title":"Monaldi Arch Chest Dis"},{"key":"178_CR40","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1067\/mpd.2001.114017","volume":"138","author":"PM McIlwaine","year":"2001","unstructured":"McIlwaine PM, Wong LT, Peacock D, et al. Long-term comparative trial of positive expiratory pressure versus oscillating positive expiratory pressure (flutter) physiotherapy in the treatment of cystic fibrosis. J Pediatr. 2001;138:845\u201350.","journal-title":"J Pediatr"},{"issue":"5","key":"178_CR41","doi-asserted-by":"crossref","first-page":"862","DOI":"10.4187\/respcare.08003","volume":"66","author":"MF Ols\u00e9n","year":"2021","unstructured":"Ols\u00e9n MF, Olofsson P, Frejd P, et al. Technical aspects of devices and equipment for positive expiratory pressure with and without oscillation. Respir Care. 2021;66(5):862\u201377.","journal-title":"Respir Care"},{"issue":"10","key":"178_CR42","first-page":"1308","volume":"52","author":"TR Myers","year":"2007","unstructured":"Myers TR. Positive expiratory pressure and oscillatory positive expiratory pressure therapies. Respir Care. 2007;52(10):1308\u201326.","journal-title":"Respir Care"},{"key":"178_CR43","first-page":"260","volume":"60","author":"J Andersen","year":"1979","unstructured":"Andersen J, Qvist J, Kann T. Recruiting collapsed lung through collateral channels with positive expiratory pressure. Scand J Respir Dis. 1979;60:260\u20136.","journal-title":"Scand J Respir Dis"},{"key":"178_CR44","first-page":"419","volume":"65","author":"P Tonnesen","year":"1984","unstructured":"Tonnesen P, Stovring S. Positive expiratory pressure (PEP) as lung physiotherapy in cystic fibrosis: a pilot study. Eur J Respir Dis. 1984;65:419\u201322.","journal-title":"Eur J Respir Dis"},{"key":"178_CR45","doi-asserted-by":"crossref","first-page":"951","DOI":"10.1136\/thx.41.12.951","volume":"41","author":"JL Hofmeyer","year":"1986","unstructured":"Hofmeyer JL, Webber BA, Hodson ME. Evaluation of positive expiratory pressure as an adjunct to chest physiotherapy in the treatment of cystic fibrosis. Thorax. 1986;41:951\u20134.","journal-title":"Thorax"},{"key":"178_CR46","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1111\/j.1651-2227.1991.tb11729.x","volume":"80","author":"HJ Steen","year":"1991","unstructured":"Steen HJ, Redmond AOB, O\u2019Neill D, et al. Evaluation of the PEP mask in cystic fibrosis. Acta Pediatr Scand. 1991;80:51\u20134.","journal-title":"Acta Pediatr Scand"},{"key":"178_CR47","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1016\/S0022-3476(97)70064-7","volume":"131","author":"PM McIlwaine","year":"1997","unstructured":"McIlwaine PM, Wong LTK, Peacock D, et al. Long-term comparative trial of conventional postural drainage and percussion versus positive expiratory pressure physiotherapy in the treatment of cystic fibrosis. J Pediatr. 1997;131:570\u20133.","journal-title":"J Pediatr"},{"key":"178_CR48","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD003147.pub5","author":"PM McIlwaine","year":"2015","unstructured":"McIlwaine PM, Button B, Dwan K. Positive expiratory pressure physiotherapy for airway clearance in people with cystic fibrosis (Review). Cochrane Database Syst Rev. 2015. https:\/\/doi.org\/10.1002\/14651858.CD003147.pub5.","journal-title":"Cochrane Database Syst Rev"},{"issue":"12","key":"178_CR49","doi-asserted-by":"crossref","first-page":"2160","DOI":"10.4187\/respcare.02704","volume":"58","author":"J Andrews","year":"2013","unstructured":"Andrews J, Sathe NA, Krishnaswami S, et al. Nonpharmacologic airway clearance technique s in hospitalized patients: a systematic review. Respir Care. 2013;58(12):2160\u20136.","journal-title":"Respir Care"},{"issue":"4","key":"178_CR50","doi-asserted-by":"crossref","first-page":"451","DOI":"10.4187\/respcare.04570","volume":"62","author":"H Van Fleet","year":"2017","unstructured":"Van Fleet H, Dunn DK, McNinch ML, et al. Evaluation of functional characteristics of 4 oscillatory positive pressure devices in a simulated cystic fibrosis model. Respir Care. 2017;62(4):451\u20138.","journal-title":"Respir Care"},{"issue":"1","key":"178_CR51","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1378\/chest.114.1.171","volume":"114","author":"EM App","year":"1998","unstructured":"App EM, Kieselmann R, Reinhardt D, et al. Sputum rheology changes in cystic fibrosis lung disease following two different types of physiotherapy: flutter vs autogenic drainage. Chest. 1998;114(1):171\u20137.","journal-title":"Chest"},{"key":"178_CR52","doi-asserted-by":"crossref","first-page":"1316","DOI":"10.1016\/j.rmed.2011.04.017","volume":"105","author":"J Tambascio","year":"2011","unstructured":"Tambascio J, de Souza L, Lisboa R, et al. The influence of Flutter VRP1 components on mucus transport of patients with bronchiectasis. Respir Med. 2011;105:1316\u201321.","journal-title":"Respir Med"},{"issue":"3","key":"178_CR53","doi-asserted-by":"crossref","first-page":"1203","DOI":"10.1152\/jappl.1988.65.3.1203","volume":"65","author":"HK Chang","year":"1988","unstructured":"Chang HK, Weber ME, King M. Mucus transport by high-frequency nonsymmetrical oscillatory airflow. J Appl Physiol. 1988;65(3):1203\u20139.","journal-title":"J Appl Physiol"},{"issue":"4","key":"178_CR54","doi-asserted-by":"crossref","first-page":"492","DOI":"10.4187\/respcare.07271","volume":"65","author":"W Poncin","year":"2020","unstructured":"Poncin W, Reychler G, Liistro M, et al. Comparison of 6 oscillatory positive expiratory pressure devices during active expiratory flow. Respir Care. 2020;65(4):492\u20139.","journal-title":"Respir Care"},{"key":"178_CR55","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1136\/thorax.58.4.333","volume":"58","author":"M Chilvers","year":"2003","unstructured":"Chilvers M, Rutman A, O\u2019Callaghan C. Functional analysis of cilia and ciliated epithelial ultrastructure in healthy children and young adults. Thorax. 2003;58:333\u20138.","journal-title":"Thorax"},{"issue":"2","key":"178_CR56","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1177\/1479972306075483","volume":"4","author":"J Patterson","year":"2007","unstructured":"Patterson J, Hewitt O, Kent L, et al. Acapella\u00ae versus usual airway clearance during acute exacerbation in bronchiectasis: a randomized crossover trial. Chron Respir Dis. 2007;4(2):67\u201374.","journal-title":"Chron Respir Dis"},{"key":"178_CR57","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1152\/jappl.2000.89.1.283","volume":"89","author":"MR Miller","year":"2000","unstructured":"Miller MR, Pedersen OF. Peak flowmeter resistance decreases peak expiratory flow in subjects with COPD. J Appl Physiol. 2000;89:283\u201390.","journal-title":"J Appl Physiol"},{"issue":"2","key":"178_CR58","first-page":"124","volume":"48","author":"TA Volsko","year":"2003","unstructured":"Volsko TA, DiFiore J, Chatburn RL. Performance comparison of two oscillating positive expiratory pressure devices: acapella versus flutter. Respir Care. 2003;48(2):124\u201330.","journal-title":"Respir Care"},{"key":"178_CR59","first-page":"CD006842","volume":"5","author":"L Morrison","year":"2017","unstructured":"Morrison L, Innes S. Oscillating devices for airway clearance in people with cystic fibrosis. Cochrane Database Syst Rev. 2017;5:CD006842.","journal-title":"Cochrane Database Syst Rev"},{"key":"178_CR60","unstructured":"Nicholson C, Lee A. Bronchiectasis Toolbox: Oscillating positive expiratory pressure therapy. 2021. https:\/\/bronchiectasis.com.au\/physiotherapy\/techniques\/oscillating-positive-expiratory-pressure-therapy, visited August 5, 2021."},{"issue":"6","key":"178_CR61","doi-asserted-by":"crossref","first-page":"899","DOI":"10.1111\/j.1440-1843.2009.01584.x","volume":"14","author":"A Fujita","year":"2009","unstructured":"Fujita A, Murata K, Takamori M. Novel method for sputum induction using the Lung Flute in patients with suspected pulmonary tuberculosis. Respirology. 2009;14(6):899\u2013902.","journal-title":"Respirology"},{"key":"178_CR62","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1186\/s40169-014-0029-y","volume":"3","author":"S Sethi","year":"2014","unstructured":"Sethi S, Yin J, Anderson PK. Lung flute improves symptoms and health status in COPD with chronic bronchitis: a 26 week randomized controlled trial. Clin Translat Med. 2014;3:29.","journal-title":"Clin Translat Med"},{"key":"178_CR63","doi-asserted-by":"crossref","first-page":"440","DOI":"10.1055\/s-2000-7685","volume":"54","author":"UH Cegla","year":"2000","unstructured":"Cegla UH. Physiotherapy with oscillating PEP systems (RC-Cornet, VRP1 in COPD). Pneumologie. 2000;54:440\u20136.","journal-title":"Pneumologie"},{"key":"178_CR64","unstructured":"Mercury Medical. ShurClear* oscillating positive expiratory pressure device: Instructions for use. 2020. Available at: https:\/\/www.mercurymed.com\/product\/airway-clearance-devices\/, visited August 5, 2021."},{"key":"178_CR65","unstructured":"Westmed Inc. Vibralung* acoustical percussor: Online manual for healthcare professionals. 2014. Available at: http:\/\/westmedinc.com\/vibralung\/, visited August 6, 2021."},{"key":"178_CR66","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD006842.pub4","author":"L Morrison","year":"2020","unstructured":"Morrison L, Milroy S. Oscillating devices for airway clearance in people with cystic fibrosis. Cochrane Database Syst Rev. 2020. https:\/\/doi.org\/10.1002\/14651858.CD006842.pub4.","journal-title":"Cochrane Database Syst Rev"},{"issue":"Suppl 36","key":"178_CR67","first-page":"357","volume":"48","author":"CM Wheatley","year":"2013","unstructured":"Wheatley CM, Baker SE, Daines C, et al. Influence of the VibraLung device on pulmonary function and sputum expectoration in patients with cystic fibrosis. Pediatr Pulmonol. 2013;48(Suppl 36):357.","journal-title":"Pediatr Pulmonol"},{"key":"178_CR68","unstructured":"Medical Holdings LLC. VibraPEP* oscillatory PEP device: Instructions for use. 2020. Available at: https:\/\/www.vibrapep.com\/wp-content\/uploads\/2018\/04\/IFU-MEDICA-44F50-44F10-01072018.pdf , visited August 5, 2021."},{"issue":"13","key":"178_CR69","first-page":"e3287","volume":"9","author":"HP Goodell","year":"2019","unstructured":"Goodell HP, Shenoy SK, Shenkute NT, et al. Adhesive and cohesive peel force measurement of human airway mucus. BioProtocol LLC. 2019;9(13):e3287.","journal-title":"BioProtocol LLC"},{"key":"178_CR70","doi-asserted-by":"crossref","first-page":"2004035","DOI":"10.1183\/13993003.04015-2020","volume":"58","author":"F Anastasio","year":"2021","unstructured":"Anastasio F, Barbuto F, Scamechcia E, et al. Medium-term impact of COVID-19 on pulmonary function, functional capacity and quality of life. Eur Respir J. 2021;58:2004035.","journal-title":"Eur Respir J"},{"key":"178_CR71","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1016\/j.ccm.2012.02.009","volume":"33","author":"L Flude","year":"2012","unstructured":"Flude L, Agent P, Bilton D. Chest physiotherapy techniques in bronchiectasis. Clin Chest Med. 2012;33:351\u201361.","journal-title":"Clin Chest Med"},{"issue":"3","key":"178_CR72","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1113\/jphysiol.1955.sp005276","volume":"127","author":"JR Womersley","year":"1955","unstructured":"Womersley JR. Method for the calculation of velocity, rate of flow and viscous drag in arteries when the pressure gradient is known. J Physiol. 1955;127(3):553\u201363.","journal-title":"J Physiol"},{"key":"178_CR73","unstructured":"Global Initiative for Chronic Obstructive Lung Disease Inc. Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease: 2021 Report. Available at: https:\/\/goldcopd.org\/wp-content\/uploads\/2020\/11\/GOLD-REPORT-2021-v1.1-25Nov20_WMV.pdf , visited August 5, 2021."},{"issue":"1","key":"178_CR74","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1164\/rccm.2112059","volume":"166","author":"N Hart","year":"2002","unstructured":"Hart N, Polkey MI, Cl\u00e9ment A, et al. Changes in pulmonary mechanics with increasing disease severity in children and young adults with cystic fibrosis. Am J Respir Crit Care Med. 2002;166(1):61\u20136.","journal-title":"Am J Respir Crit Care Med"},{"key":"178_CR75","first-page":"137","volume-title":"Physiotherapy for respiratory and cardiac problems","author":"BA Webber","year":"1998","unstructured":"Webber BA, Pryor JA, Bethune DD, et al. Physiotherapy techniques. In: Pryor JA, Webber BA, editors., et al., Physiotherapy for respiratory and cardiac problems. London: Churchill Livingstone; 1998. p. 137\u2013210."},{"key":"178_CR76","doi-asserted-by":"crossref","first-page":"1418","DOI":"10.1183\/09031936.99.14614189","volume":"14","author":"JA Pryor","year":"1999","unstructured":"Pryor JA. Physiotherapy for airway clearance in adults. Eur Respir J. 1999;14:1418\u201324.","journal-title":"Eur Respir J"},{"issue":"1","key":"178_CR77","doi-asserted-by":"crossref","first-page":"66","DOI":"10.3109\/15412555.2015.1043523","volume":"13","author":"S Svenningson","year":"2016","unstructured":"Svenningson S, Paulin GP, Sheikh K, et al. Oscillatory positive expiratory pressure in chronic obstructive pulmonary disease. J Chron Obstruct Pulmon Dis. 2016;13(1):66\u201374.","journal-title":"J Chron Obstruct Pulmon Dis"},{"issue":"4","key":"178_CR78","doi-asserted-by":"crossref","first-page":"540","DOI":"10.1002\/jmri.20154","volume":"20","author":"EJR Van Beek","year":"2004","unstructured":"Van Beek EJR, Wild JM, Kauczor H-U, et al. Functional MRI of the lung using hyperpolarized 3-helium gas. J Magn Reson Imaging. 2004;20(4):540\u201354.","journal-title":"J Magn Reson Imaging"},{"issue":"6","key":"178_CR79","doi-asserted-by":"crossref","first-page":"1398","DOI":"10.1002\/jmri.22375","volume":"32","author":"S Fain","year":"2010","unstructured":"Fain S, Schiebler ML, McCormack DG. Imaging of lung function using hyperpolarized helium-3 magnetic resonance imaging: Review of current and emerging translational methods and applications. J Magn Reson Imaging. 2010;32(6):1398\u2013408.","journal-title":"J Magn Reson Imaging"},{"issue":"2","key":"178_CR80","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1016\/j.acra.2011.10.007","volume":"19","author":"M Kirby","year":"2012","unstructured":"Kirby M, Heydarian M, Svenningsen S, et al. Hyperpolarized 3He magnetic resonance functional imaging semiautomated segmentation. Acad Radiol. 2012;19(2):141\u201352.","journal-title":"Acad Radiol"},{"issue":"23","key":"178_CR81","doi-asserted-by":"crossref","first-page":"2233","DOI":"10.1056\/NEJMra0910061","volume":"363","author":"JV Fahy","year":"2010","unstructured":"Fahy JV, Dickey BF. Airway mucus function and dysfunction. N Engl J Med. 2010;363(23):2233\u201347.","journal-title":"N Engl J Med"},{"key":"178_CR82","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1016\/j.addr.2008.09.008","volume":"61","author":"RA Cone","year":"2009","unstructured":"Cone RA. Barrier properties of mucus. Adv Drug Deliv Rev. 2009;61:75\u201385.","journal-title":"Adv Drug Deliv Rev"},{"key":"178_CR83","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1186\/s12931-020-01484-z","volume":"21","author":"E Lauwers","year":"2020","unstructured":"Lauwers E, Ides K, van Hoorenbeeck K, et al. Outcome measures for airway clearance techniques in children with chronic obstructive lung diseases: A systematic review. Respir Res. 2020;21:217.","journal-title":"Respir Res"},{"key":"178_CR84","doi-asserted-by":"crossref","first-page":"2553","DOI":"10.2147\/COPD.S213546","volume":"14","author":"S Milan","year":"2019","unstructured":"Milan S, Bondalapati P, Megally M, et al. Positive expiratory pressure therapy with and without oscillation and hospital length of stay for acute exacerbation of chronic obstructive pulmonary disease. Int J COPD. 2019;14:2553\u201361.","journal-title":"Int J COPD"},{"issue":"1","key":"178_CR85","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1016\/j.acra.2016.08.021","volume":"24","author":"S Svenningson","year":"2017","unstructured":"Svenningson S, Guo F, McCormack DG, et al. Noncystic fibrosis bronchiectasis: Regional abnormalities and response to airway clearance therapy using pulmonary functional magnetic resonance imaging. Acad Radiol. 2017;24(1):4\u201312.","journal-title":"Acad Radiol"},{"key":"178_CR86","unstructured":"US Food and Drug Administration. Premarket approval (PMA). Silver Spring, MD, USA. 2019 \u2013 available at: https:\/\/www.fda.gov\/medical-devices\/premarket-submissions\/premarket-approval-pma - visited Oct 5 2021."},{"issue":"10","key":"178_CR87","first-page":"1348","volume":"52","author":"BK Rubin","year":"2007","unstructured":"Rubin BK. Designing clinical trials to evaluate mucus clearance therapy. Respir Care. 2007;52(10):1348\u201358.","journal-title":"Respir Care"},{"issue":"10","key":"178_CR88","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1136\/thoraxjnl-2019-214360","volume":"75","author":"SM Alghamdi","year":"2020","unstructured":"Alghamdi SM, Barker RE, Alsulayyaim ASS. Use of oscillatory positive expiratory pressure (OPEP) devices to augment sputum clearance in COPD: a systematic review and meta-analysis. Thorax. 2020;75(10):855\u201363.","journal-title":"Thorax"},{"issue":"4","key":"178_CR89","first-page":"233","volume":"3","author":"J Bourbeau","year":"2019","unstructured":"Bourbeau J, McIvor RA, Devlin HM, et al. Oscillating positive expiratory pressure (OPEP) device therapy in Canadian respiratory disease management: Review, care gaps and suggestion for use. Can J Resp Crit Care Sleep Med. 2019;3(4):233\u201340.","journal-title":"Can J Resp Crit Care Sleep Med"},{"issue":"3","key":"178_CR90","first-page":"138","volume":"11","author":"VP Shabari","year":"2011","unstructured":"Shabari VP, Alaparthi GP, Vishakacharya V. Comparison of Acapella and RC-Cornet for airway clearance in bronchiectasis: a pilot study. Int J Curr Res Rev. 2011;11(3):138\u201348.","journal-title":"Int J Curr Res Rev"},{"issue":"3","key":"178_CR91","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1016\/j.physio.2004.03.005","volume":"90","author":"AM Valente","year":"2004","unstructured":"Valente AM, Gastaldi AC, Cravo SL. The effect of two techniques on the characteristics and transport of sputum in patients with bronchiectasis: a pilot study. Physiotherapy. 2004;90(3):158\u201364.","journal-title":"Physiotherapy"},{"key":"178_CR92","doi-asserted-by":"crossref","first-page":"421","DOI":"10.2147\/COPD.S51012","volume":"9","author":"JA Woods","year":"2014","unstructured":"Woods JA, Wheeler JS, Finch CK, et al. Corticosteroids in the treatment of acute exacerbations of chronic obstructive pulmonary disease. Int J COPD. 2014;9:421\u201330.","journal-title":"Int J COPD"},{"issue":"5","key":"178_CR93","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1590\/S1413-35552011005000025","volume":"15","author":"CR Carvalho","year":"2011","unstructured":"Carvalho CR, Paisani DM, Lunardi AC. Incentive spirometry in major surgeries: a systematic review. Braz J Phys Ther. 2011;15(5):343\u201350.","journal-title":"Braz J Phys Ther"},{"issue":"9","key":"178_CR94","doi-asserted-by":"crossref","first-page":"815","DOI":"10.1136\/thx.2009.123083","volume":"65","author":"P Agostini","year":"2010","unstructured":"Agostini P, Cieslik H, Rathinam S, et al. Postoperative pulmonary complications following thoracic surgery: are there any modifiable risk factors? Thorax. 2010;65(9):815\u20138.","journal-title":"Thorax"},{"key":"178_CR95","first-page":"161","volume":"3","author":"C Burudpakdee","year":"2017","unstructured":"Burudpakdee C, Seetasith A, Dunne P, et al. A real-world study of 30-day exacerbation outcomes in chronic obstructive pulmonary disease (COPD) patients managed with Aerobika OPEP. Pulm Ther. 2017;3:161\u201371.","journal-title":"Pulm Ther"},{"key":"178_CR96","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1007\/s41030-018-0055-9","volume":"4","author":"C Burudpakdee","year":"2018","unstructured":"Burudpakdee C, Near AM, Huang H, et al. A real-world evidence study assessing the impact of adding the Aerobika oscillating positive expiratory pressure device to standard of care upon healthcare resource utilization and costs in post-operative patients. Pulm Ther. 2018;4:87\u2013101.","journal-title":"Pulm Ther"},{"issue":"10","key":"178_CR97","doi-asserted-by":"crossref","first-page":"1600","DOI":"10.4187\/respcare.01471","volume":"56","author":"AARC Clinical Practice Guideline","year":"2011","unstructured":"AARC Clinical Practice Guideline. Incentive spirometry: 2011. Respir Care. 2011;56(10):1600\u201314.","journal-title":"Respir Care"},{"key":"178_CR98","doi-asserted-by":"crossref","first-page":"2527","DOI":"10.2147\/COPD.S256866","volume":"15","author":"J Tse","year":"2020","unstructured":"Tse J, Wada K, Wang Y, et al. Impact of oscillating positive expiratory pressure device use on post-discharge hospitalizations: A retrospective cohort study comparing patients with COPD or chronic bronchitis using the Aerobika\u00ae and Acapella\u00ae Devices. Int J COPD. 2020;15:2527\u201338.","journal-title":"Int J COPD"},{"key":"178_CR99","first-page":"9176504","volume":"2019","author":"NX Thanh","year":"2019","unstructured":"Thanh NX, Jacobs P, Suggett J, et al. Cost-effectiveness of the Aerobika\u00ae oscillating positive expiratory pressure device in the management of chronic obstructive pulmonary disease exacerbations in Canada. Can Respir J. 2019;2019:9176504.","journal-title":"Can Respir J"},{"issue":"4","key":"178_CR100","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1177\/0272989X9301300409","volume":"13","author":"FA Sonnenberg","year":"1993","unstructured":"Sonnenberg FA, Beck JR. Markov models in medical decision making: a practical guide. Med Decis Making. 1993;13(4):322\u201339.","journal-title":"Med Decis Making"},{"key":"178_CR101","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1164\/ajrccm.164.4.2009033","volume":"164","author":"DD Sin","year":"2001","unstructured":"Sin DD, Tu JV. Inhaled corticosteroids and the risk of mortality and readmission in elderly patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2001;164:580\u20134.","journal-title":"Am J Respir Crit Care Med"},{"key":"178_CR102","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1183\/09031936.00211911","volume":"40","author":"WG Boersma","year":"2012","unstructured":"Boersma WG. Antibiotics in acute exacerbations of COPD: the good, the bad and the ugly. Eur Respir J. 2012;40:1\u20133.","journal-title":"Eur Respir J"},{"issue":"Suppl. 1","key":"178_CR103","first-page":"1","volume":"74","author":"AT Hill","year":"2019","unstructured":"Hill AT, Sullivan AL, Chalmers JD, et al. British Thoracic Society guideline for bronchiectasis in adults. Thorax. 2019;74(Suppl. 1):1\u201369.","journal-title":"Thorax"},{"key":"178_CR104","unstructured":"Global Initiative for Asthma. Global strategy for asthma management and prevention. 2020 Report. Available at: https:\/\/ginasthma.org\/reports\/ , visited August 5 2021."},{"key":"178_CR105","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/j.jcf.2018.02.006","volume":"17","author":"C Castellani","year":"2018","unstructured":"Castellani C, Duff AJA, Bell SC, et al. ECFS best practice guidelines: the 2018 revision. J Cystic Fibrosis. 2018;17:153\u201378.","journal-title":"J Cystic Fibrosis"},{"issue":"7","key":"178_CR106","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1164\/rccm.201207-1160OE","volume":"187","author":"PJ Mogayzel","year":"2013","unstructured":"Mogayzel PJ, Naureckas ET, Robinson KA. Cystic fibrosis pulmonary guidelines: chronic medications for maintenance of lung health. Am J Respir Crit Care Med. 2013;187(7):680\u20139.","journal-title":"Am J Respir Crit Care Med"},{"issue":"Suppl. 1","key":"178_CR107","first-page":"i1","volume":"64","author":"J Bott","year":"2008","unstructured":"Bott J, Blumenthal S, Muxton M, et al. Guidelines for the physiotherapy management of the adult, medical, spontaneously breathing patient. Thorax. 2008;64(Suppl. 1):i1\u201351.","journal-title":"Thorax"},{"issue":"10","key":"178_CR108","first-page":"655","volume":"88","author":"H Lee","year":"2013","unstructured":"Lee H, Kim J, Tagmazyan K. Treatment of stable chronic obstructive pulmonary disease: the GOLD guidelines. Am Fam Phys. 2013;88(10):655\u201363.","journal-title":"Am Fam Phys."},{"issue":"3","key":"178_CR109","first-page":"105","volume":"45","author":"EF Christensen","year":"1991","unstructured":"Christensen EF, N\u00f8rregaard O, Dahl R. Nebulized terbutaline and positive expiratory pressure in chronic obstructive pulmonary disease. Pneumologie. 1991;45(3):105\u20139.","journal-title":"Pneumologie"},{"issue":"3","key":"178_CR110","doi-asserted-by":"crossref","first-page":"328","DOI":"10.4187\/respcare.02291","volume":"59","author":"FO Mesquita","year":"2014","unstructured":"Mesquita FO, Galindo-Filho VC, Neto JL. Scintigraphic assessment of radio-aerosol pulmonary deposition with the Acapella positive expiratory pressure device and various nebulizer configurations. Respir Care. 2014;59(3):328\u201333.","journal-title":"Respir Care"},{"issue":"2","key":"178_CR111","doi-asserted-by":"crossref","first-page":"216","DOI":"10.4187\/respcare.02698","volume":"59","author":"A Berlinski","year":"2014","unstructured":"Berlinski A. In vitro evaluation of positive expiratory pressure devices attached to nebulizers. Respir Care. 2014;59(2):216\u201322.","journal-title":"Respir Care"},{"key":"178_CR112","unstructured":"Mitchell JP, Suggett J, Nagel M. et al. Combining inhalation by a breath-actuated nebulizer with exhalation through an oscillating positive pressure device (OPEP) offers the potential for combined therapy. Drug Delivery to the Lungs-24, Edinburgh, UK, December 2013, 322\u20135."},{"issue":"Suppl 10","key":"178_CR113","first-page":"3016143","volume":"63","author":"D Copelin","year":"2018","unstructured":"Copelin D. Implementation of a breath-actuated nebulizer regimen may reduce nosocomial influenza acquired by exposure to fugitive droplet emissions from continuous nebulizers whose droplets produced during exhalation are vented to the environment. Respir Care. 2018;63(Suppl 10):3016143.","journal-title":"Respir Care"},{"key":"178_CR114","doi-asserted-by":"crossref","first-page":"105987","DOI":"10.1016\/j.rmed.2020.105987","volume":"167","author":"A Ari","year":"2020","unstructured":"Ari A. Practical strategies for a safe and effective delivery of aerosolized medications to patients with COVID-19. Respir Med. 2020;167:105987.","journal-title":"Respir Med"},{"key":"178_CR115","unstructured":"Costella S, Kirchner A, Morton R. et al. Smart oscillating positive expiratory pressure device. 2018; US Patent Application 0008790 A1."},{"key":"178_CR116","doi-asserted-by":"crossref","first-page":"1503","DOI":"10.2147\/COPD.S170848","volume":"14","author":"JL L\u00f3pez-Campos","year":"2019","unstructured":"L\u00f3pez-Campos JL, Gallego EQ, Hern\u00e1ndez L. Status of and strategies for improving adherence to COPD treatment. Int J Chron Obstruct Pulm Dis. 2019;14:1503\u201315.","journal-title":"Int J Chron Obstruct Pulm Dis"},{"issue":"2","key":"178_CR117","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1378\/chest.09-3074","volume":"140","author":"T Daniels","year":"2011","unstructured":"Daniels T, Goodacre L, Sutton C, et al. Accurate assessment of adherence: self-report and clinician report vs electronic monitoring of nebulizers. Chest. 2011;140(2):425\u201332.","journal-title":"Chest"},{"key":"178_CR118","first-page":"3241","volume":"16","author":"Y Ni","year":"2018","unstructured":"Ni Y, Ding L, Yu Y, et al. Oscillatory positive expiratory pressure treatment in lower respiratory tract infection. Exp Ther Med. 2018;16:3241\u20138.","journal-title":"Exp Ther Med"},{"key":"178_CR119","first-page":"131","volume":"126","author":"CM Rossman","year":"1982","unstructured":"Rossman CM, Waldes R, Sampson D, et al. Effect of chest physiotherapy on the removal of mucus in patients with cystic fibrosis. Am Rev Respir Dis. 1982;126:131\u20135.","journal-title":"Am Rev Respir Dis"},{"issue":"2","key":"178_CR120","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1513\/pats.200502-015AW","volume":"2","author":"MJ Holtzman","year":"2005","unstructured":"Holtzman MJ, Tyner JW, Kim EY, et al. Acute and chronic airway responses to viral infection: implications for asthma and chronic obstructive pulmonary disease. Proc Am Thorac Soc. 2005;2(2):132\u201340.","journal-title":"Proc Am Thorac Soc"},{"issue":"11","key":"178_CR121","doi-asserted-by":"crossref","first-page":"992","DOI":"10.1136\/thx.2003.018879","volume":"59","author":"PR Burgel","year":"2004","unstructured":"Burgel PR, Nadel JA. Roles of epidermal growth factor receptor activation in epithelial cell repair and mucin production in airway epithelium. Thorax. 2004;59(11):992\u20136.","journal-title":"Thorax"},{"key":"178_CR122","first-page":"139","volume":"9","author":"FL Ramos","year":"2014","unstructured":"Ramos FL, Krahnke JS, Kim V. Clinical issues of mucus accumulation in COPD. Int J COPD. 2014;9:139\u201350.","journal-title":"Int J COPD"},{"key":"178_CR123","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1177\/2050312117697505","volume":"5","author":"S Gursli","year":"2017","unstructured":"Gursli S, Sandvik L, Bakkeheim E, et al. Evaluation of a novel technique in airway clearance therapy\u2014Specific Cough Technique (SCT) in cystic fibrosis: a pilot study of a series of N-of-1 randomised controlled trials. SAGE Open Med. 2017;5:1\u20138.","journal-title":"SAGE Open Med."},{"issue":"6","key":"178_CR124","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1093\/ptj\/76.6.609","volume":"76","author":"ND Ciesla","year":"1996","unstructured":"Ciesla ND. Chest physical therapy for patients in the intensive care unit. Phys Ther. 1996;76(6):609\u201325.","journal-title":"Phys Ther"},{"key":"178_CR125","unstructured":"COPD Support. The huff-cough technique. 2021. Available at: https:\/\/www.copdsupport.ie\/about-copd\/how-to-manage-with-c-o-p-d\/controlled-coughing\/cough-technique , visited August 5, 2021."}],"container-title":["Pulmonary Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s41030-021-00178-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s41030-021-00178-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s41030-021-00178-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,2,21]],"date-time":"2022-02-21T21:13:15Z","timestamp":1645477995000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s41030-021-00178-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,12,3]]},"references-count":125,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2022,3]]}},"alternative-id":["178"],"URL":"https:\/\/doi.org\/10.1007\/s41030-021-00178-1","relation":{},"ISSN":["2364-1754","2364-1746"],"issn-type":[{"value":"2364-1754","type":"print"},{"value":"2364-1746","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,12,3]]},"assertion":[{"value":"9 August 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"29 October 2021","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 December 2021","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}]}}