[Long-term treatment of chronic bronchitis with pulmonary physiotherapy with and without positive expiratory pressure].

In a prospective, randomized, controlled study, treatment of chronic bronchitis with self-administered chest physiotherapy alone (control) or with positive expiratory pressure (PEP) by mask was studied. Forty-three patients completed the study (n = 20 PEP, and n = 23 control). After instruction, the treatments were self-administered twice daily for 12 months (34 patients) and five months (9 patients). The patients completed a diary concerning symptoms twice weekly. An acute exacerbation (AE) was defined as the appearance of mucopurulent or purulent sputum and increasing cough and one or more of the following symptoms: temperature greater than or equal to 38 degrees C, general malaise, increased dyspnea, increased mucus production, increased thickness of mucus or increased difficulty in expectoration. The number of AE were calculated from the diaries. The incidence of AE was significantly lower in the PEP group (p less than 0.0005). In the PEP group, three patients had a total of six AE, compared to 12 patients with 28 AE in the control group. The PEP group also used less antibiotics (p less than 0.005). Treatment with a simple PEP device can reduce morbidity in patients with chronic bronchitis.