The use of computer aided lung sound analysis to characterise adventitious lung sounds: a potential outcome measure for respiratory therapy

Abstract

A barrier to assessing the effectiveness of respiratory physiotherapy has been insufficient accurate, reliable and sensitive outcome measures. Lung sounds provide useful, specific information for assessing and monitoring respiratory patients. However, standard auscultation techniques are too subjective to allow them to be used as an outcome measure. In this research, Computer Aided Lung Sound Analysis (CALSA) was used to assess whether adventitious lung sounds’ characteristics could be quantified clinically and used as a new objective, non-invasive, bedside clinical outcome measure for physiotherapy alveolar recruitment and airway clearance techniques. Two experimental studies were conducted incorporating ‘before-and-after’ and ‘repeated measures’ components. Fifty four participants with productive lung disorders (cystic fibrosis and bronchiectasis) were recruited from out-patient clinics. Demographic, anthropometric, lung function, oxygen saturation, breathlessness and lung sound data were collected at baseline and after a single intervention (selfintervention in the first study and intervention applied by a physiotherapist in the second study). The intra-subject reliability of crackle frequency (f) within each session was found to be ‘good’ to ‘excellent’, estimated by the Analysis of Variance, Intraclass Correlation Coefficient, Smallest Real Difference and Bland and Altman 95% limits of agreement. Crackle initial deflection width (IDW) and crackle two cycles deflection width (2CD) were reliable over short time periods. The f of crackles increased in the majority of participants post interventions. Agreement on the number (N) and timing (T) of crackles between CALSA and a physiotherapist‘s auscultatory findings was found to be poor in anterior chest sites, but higher in posterior sites. Conclusion: the use of CALSA to identify the type and f of adventitious lung sounds collected clinically is feasible; crackle IDW and 2CD are both reliable measures but crackle 2CD is more consistent; crackle f was more responsive than the N or T of crackles per breathing cycle to the interventions. In future, CALSA may provide an objective and responsive tool for assessing and monitoring respiratory interventions in clinical settings.

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Identifiers

ORCID for Anne Bruton: orcid.org/0000-0002-4550-2536

ORCID for Anna Barney: orcid.org/0000-0002-6034-1478

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