Factors associated with PCF
cough, PCF
The PCF during voluntary cough significantly differed between the positions with a mean PCF of 1.56 ± 0.51 L/s at supine and 1.36 ± 0.62 L/s at reclined positions, respectively (The linear mixed-model (LMM) analysis demonstrated no main effect of assigned group (There was a significant main effect of TIV (Linear mixed-effect model summarizing estimated mean differences of peak cough flow values by associated factors.CI, confidence interval; est. coeff, estimated coefficient; MI-E, mechanical insufflation–exsufflation; MT, manual thrust; TIV, total insufflation volume.*The final model specification was as follows:After adjusting for TIV and individual differences, the estimated mean PCF [95% confidence interval] was 1.808 [1.610–2.006] L/s in the supine position and 1.672 [1.471–1.873] L/s in the reclined position during voluntary coughing. For MI-E assisted coughs, the PCF increased to 3.529 [3.335–3.723] L/s in the supine position and 3.598 [3.405–3.792] L/s in the reclined position. When MI-E was combined with manual thrust, the PCF further improved to 3.925 [3.732–4.118] L/s in the supine position and 3.909 [3.716–4.103] L/s in the reclined position (Fig. Jitter plots described all measured peak cough flow values with estimated mean and standard error from linear mixed models during voluntary cough, MI-E-assisted cough, and MI-E-assisted with manual thrust, comparing supine and reclined positions, respectively.