Table 1

Treatment order details

Treatment orderDetail
Treatment order A: HTS before ACT

  • ▸ Bronchodilator (Salbutamol 200 mcg);

  • ▸ Wait 15 min;

  • ▸ Single inhalation (4 mL) of 7% HTS (Nebusal) via updraft nebuliser (Portex) (∼20 min);

  • ▸ Immediately followed by an airways clearance session of 10 supervised cycles using the Acapella and forced expiration techniques (∼20 min).

Treatment order B: HTS during ACT

  • ▸ Bronchodilator (Salbutamol 200 mcg);

  • ▸ Wait 15 min;

  • ▸ Single inhalation (4 mL) of 7% HTS (Nebusal) through the Acapella Duet (with Portex updraft nebuliser attached) device;

  • ▸ During inhalation, an airways clearance session of 10 supervised cycles using the Acapella and forced expiration techniques was carried out (∼20 min).

  • Detailed content of the supervised cycles using the Acapella is provided in online supplement 1. Subjects received the treatments at the same time each day, in the same position (high sitting) and the treatment duration was recorded.

  • ACT, airway clearance treatment; HTS, hypertonic saline.