{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T17:00:47Z","timestamp":1770224447259,"version":"3.49.0"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2019,6,11]],"date-time":"2019-06-11T00:00:00Z","timestamp":1560211200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Prolonged slow expiration (PSE) is a manual chest physical therapy technique routinely performed in clinical practice. However, the reliability and agreement of the technique have not been tested.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>The objective of this study was to assess reliability and agreement between physical therapists during the application of PSE in infants with wheezing.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>This was a cross-sectional study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Infants with a mean age of 59 weeks (SD\u00a0=\u00a026 weeks) were included in this study. Two physical therapists (physical therapist 1 and physical therapist 2) randomly performed 3 PSE sequences (A, B, and C). The expiratory reserve volume (ERV) was measured with a pneumotachograph connected to a face mask. ERV was used to evaluate the reproducibility of the technique between sequences and between physical therapist 1 and physical therapist 2.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The mean ERV of the infants was 63 mL (SD\u00a0=\u00a021 mL). There was no statistically significant difference between the ERV values in the 3 sequences for physical therapist 1 (A: mean\u00a0=\u00a046.6 mL [SD\u00a0=\u00a017.8 mL]; B: mean\u00a0=\u00a045.7 mL [SD\u00a0=\u00a019.9 mL]; C: mean\u00a0=\u00a053.3 mL [SD\u00a0=\u00a026.3 mL]) and physical therapist 2 (A: mean\u00a0=\u00a043.5 mL [SD\u00a0=\u00a015.4 mL]; B: mean\u00a0=\u00a043.2 mL [SD\u00a0=\u00a018.3 mL]; C: mean\u00a0=\u00a044.8 mL [SD\u00a0=\u00a025.0 mL]). There was excellent reliability between the sequences for physical therapist 1 (ICC\u00a0=\u00a00.88 [95% CI\u00a0=\u00a00.63\u20130.95]) and physical therapist 2 (ICC\u00a0=\u00a00.82 [95% CI\u00a0=\u00a00.48\u20130.93]). Moderate agreement was observed between physical therapist 1 and physical therapist 2 (ICC\u00a0=\u00a00.67 [95% CI\u00a0=\u00a00.01\u20130.88]). According to Bland-Altman analysis, the mean difference between physical therapist 1 and physical therapist 2 was 4.1 mL (95% CI\u00a0=\u00a0\u221238.5 to 46.5 mL).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Limitations<\/jats:title>\n                  <jats:p>The data were collected in infants with wheezing who were not in crisis. This decreased lung mucus; however, it also reduced evaluation risks.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>PSE was a reproducible chest physical therapy technique between physical therapists.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ptj\/pzz080","type":"journal-article","created":{"date-parts":[[2019,6,10]],"date-time":"2019-06-10T19:14:04Z","timestamp":1560194044000},"page":"1224-1230","source":"Crossref","is-referenced-by-count":5,"title":["Is Prolonged Slow Expiration a Reproducible Airway Clearance Technique?"],"prefix":"10.1093","volume":"99","author":[{"given":"M\u00e1rcia C Pires","family":"Nogueira","sequence":"first","affiliation":[{"name":"Discipline of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Universidade Federal de Sao Paulo\u2013UNIFESP, SP, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simone N S","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Department of Physical Therapy Pediatric, Instituto de Previd\u00eancia dos Servidores do Estado de Minas Gerais-IPSEMG, Belo Horizonte, MG, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"\u00c9lida P","family":"Silva","sequence":"additional","affiliation":[{"name":"Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho\u2013UNINOVE, SP, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carolina Lopes","family":"Guimar\u00e3es","sequence":"additional","affiliation":[{"name":"Discipline of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Universidade Federal de Sao Paulo\u2013UNIFESP, SP, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gustavo F","family":"Wandalsen","sequence":"additional","affiliation":[{"name":"Discipline of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Universidade Federal de Sao Paulo\u2013UNIFESP, SP, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dirceu","family":"Sol\u00e9","sequence":"additional","affiliation":[{"name":"Discipline of Allergy, Clinical Immunology and Rheumatology, Department of Pediatrics, Universidade Federal de Sao Paulo\u2013UNIFESP, SP, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fernanda C","family":"Lanza","sequence":"additional","affiliation":[{"name":"Postgraduate Program in Rehabilitation Sciences, Department of Physical Therapy, Universidade Federal de Minas Gerais - UFMG, Belo Horizonte, MG, Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2019,6,11]]},"reference":[{"key":"2023011903530991000_bib1","first-page":"CD004873","article-title":"Chest physiotherapy for acute bronchiolitis in paediatric patients between 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