Appendices A. Search Strategy Table A-1. Search strategy for Key Question 1 Search terms Result "PEP therapy"[tiab] OR "PEP mask"[tiab] OR "Oscillating PEP"[tiab] OR "Chest Wall Oscillation"[mh] 2981 OR "postural drainage"[tiab] OR "Drainage, Postural"[mh] OR ((respiratory[tiab] OR lung[tiab] OR Lung[mh] OR chest[tiab]) AND ("Physical Therapy Modalities"[Mesh:NoExp] OR "physical therapy"[tiab] OR physiotherapy[tiab])) OR "HFCC"[tiab] OR ("high frequency"[tiab] AND chest[tiab] AND (compression[tiab] OR oscillation[tiab])) OR "intrapulmonary percussive ventilation"[tiab] OR Frequencer[tiab] OR "lung flute"[tiab] OR autogenic drainage[tiab] OR ACBT[tiab] OR "active cycle of breathing"[tiab] OR "cough assist"[tiab] OR "cough assistance"[tiab] OR "assisted cough"[tiab] OR "MI-E"[tiab] OR "mechanical insufflation-exsufflation"[tiab] OR "thoracic squeeze"[tiab] ((Positive-Pressure Respiration[mh] OR "positive expiratory pressure"[tiab] OR Flutter[tiab] OR 3696 Quake[tiab] OR Cornet[tiab] OR "RC-Cornet"[tiab] OR Acapella[tiab]OR Percussion[mh] OR percussion[tiab] OR percussing[tiab] OR Vibration[mh] OR vibration[tiab] OR oscillating[tiab] OR oscillation[tiab] OR Sound[mh] OR "sound waves"[tiab] OR Bronchoscopy[mh] OR Suction[mh] OR suction*[tiab] OR IPV[tiab] OR "Breathing Exercises"[mh] OR "non-drug"[tiab] OR "non- pharmacological"[tiab]) AND (Airway Obstruction/therapy[mh] OR "airway clearance"[tiab] OR "airway clearing"[tiab] OR "airway obstruction"[tiab] OR "airflow obstruction"[tiab] OR "lung clearance"[tiab] OR "lung clearing"[tiab] OR "sputum clearance"[tiab] OR "mucus clearance"[tiab] OR "mucous clearance"[tiab] OR "mucous clearing"[tiab] OR "mucociliary clearance"[tiab] OR "respiratory function"[tiab] OR "pulmonary function"[tiab] OR "lung function"[tiab])) (#2 OR #3) AND humans[MeSH] AND English[lang] 4612 #4 limited to 1990 to present 3619 #5 NOT (cystic fibrosis[majr] OR "Sleep Apnea Syndromes"[majr] OR infant, newborn[mh] OR 2857 intensive care units, neonatal[mh] OR newborn[tiab] OR neonatal[tiab]) #6 NOT (editorial[pt] OR letter[pt] OR comment[pt] OR case reports[pt] OR review[pt] OR news[pt] 1771* OR guideline[pt] OR practice guideline[pt] OR historical article[pt] OR jsubsetk) Table A-2. Search strategy for Key Question 2 Search terms Result (("Neuromuscular Diseases"[mh] OR "Neuromuscular Manifestations"[mh] OR neuromuscular[tiab]) 12201 AND ("Lung"[mh] OR Cough[mh] OR pulmonary[tiab] OR respiratory[tiab] OR Respiration[mh] OR "Work of Breathing"[mh] OR breathing[tiab])) OR "respiratory muscle weakness"[tiab] OR "impaired cough"[tiab] "PEP therapy"[tiab] OR "PEP mask"[tiab] OR "Oscillating PEP"[tiab] OR "Chest Wall Oscillation"[mh] 2981 OR "postural drainage"[tiab] OR "Drainage, Postural"[mh] OR ((respiratory[tiab] OR lung[tiab] OR Lung[mh] OR chest[tiab]) AND ("Physical Therapy Modalities"[Mesh:NoExp] OR "physical therapy"[tiab] OR physiotherapy[tiab])) OR "HFCC"[tiab] OR ("high frequency"[tiab] AND chest[tiab] AND (compression[tiab] OR oscillation[tiab])) OR "intrapulmonary percussive ventilation"[tiab] OR Frequencer[tiab] OR "lung flute"[tiab] OR autogenic drainage[tiab] OR ACBT[tiab] OR "active cycle of breathing"[tiab] OR "cough assist"[tiab] OR "cough assistance"[tiab] OR "assisted cough"[tiab] OR "MI-E"[tiab] OR "mechanical insufflation-exsufflation"[tiab] OR "thoracic squeeze"[tiab] Appendix-1 Table A-2. Search strategy for Key Question 2, continued Search terms Result ((Positive-Pressure Respiration[mh] OR "positive expiratory pressure"[tiab] OR Flutter[tiab] OR 3696 Quake[tiab] OR Cornet[tiab] OR "RC-Cornet"[tiab] OR Acapella[tiab]OR Percussion[mh] OR percussion[tiab] OR percussing[tiab] OR Vibration[mh] OR vibration[tiab] OR oscillating[tiab] OR oscillation[tiab] OR Sound[mh] OR "sound waves"[tiab] OR Bronchoscopy[mh] OR Suction[mh] OR suction*[tiab] OR IPV[tiab] OR "Breathing Exercises"[mh] OR "non-drug"[tiab] OR "non- pharmacological"[tiab]) AND (Airway Obstruction/therapy[mh] OR "airway clearance"[tiab] OR "airway clearing"[tiab] OR "airway obstruction"[tiab] OR "airflow obstruction"[tiab] OR "lung clearance"[tiab] OR "lung clearing"[tiab] OR "sputum clearance"[tiab] OR "mucus clearance"[tiab] OR "mucous clearance"[tiab] OR "mucous clearing"[tiab] OR "mucociliary clearance"[tiab] OR "respiratory function"[tiab] OR "pulmonary function"[tiab] OR "lung function"[tiab])) #2 AND (#3 OR #4) AND humans[MeSH] AND English[lang] 251 #4 limited to 1990 to present 223 #6 NOT (cystic fibrosis[majr] OR "Sleep Apnea Syndromes"[majr] OR infant, newborn[mh] OR 207 intensive care units, neonatal[mh] OR newborn[tiab] OR neonatal[tiab]) #7 NOT (editorial[pt] OR letter[pt] OR comment[pt] OR case reports[pt] OR review[pt] OR news[pt] 113* OR guideline[pt] OR practice guideline[pt] OR historical article[pt] OR jsubsetk) Table A-3. Search strategy for Key Question 3 Search terms Result Postoperative Complications[Mesh] OR "Postoperative Care"[Mesh] OR "Postoperative 2867241 Period"[Mesh] OR post-operative[tiab] OR postoperative[tiab] OR post-surgical[tiab] OR postsurgical[tiab] OR "Surgical Procedures, Operative"[Mesh] OR surgery[sh] "PEP therapy"[tiab] OR "PEP mask"[tiab] OR "Oscillating PEP"[tiab] OR "Chest Wall Oscillation"[mh] 2981 OR "postural drainage"[tiab] OR "Drainage, Postural"[mh] OR ((respiratory[tiab] OR lung[tiab] OR Lung[mh] OR chest[tiab]) AND ("Physical Therapy Modalities"[Mesh:NoExp] OR "physical therapy"[tiab] OR physiotherapy[tiab])) OR "HFCC"[tiab] OR ("high frequency"[tiab] AND chest[tiab] AND (compression[tiab] OR oscillation[tiab])) OR "intrapulmonary percussive ventilation"[tiab] OR Frequencer[tiab] OR "lung flute"[tiab] OR autogenic drainage[tiab] OR ACBT[tiab] OR "active cycle of breathing"[tiab] OR "cough assist"[tiab] OR "cough assistance"[tiab] OR "assisted cough"[tiab] OR "MI-E"[tiab] OR "mechanical insufflation-exsufflation"[tiab] OR "thoracic squeeze"[tiab] ((Positive-Pressure Respiration[mh] OR "positive expiratory pressure"[tiab] OR Flutter[tiab] OR 3696 Quake[tiab] OR Cornet[tiab] OR "RC-Cornet"[tiab] OR Acapella[tiab]OR Percussion[mh] OR percussion[tiab] OR percussing[tiab] OR Vibration[mh] OR vibration[tiab] OR oscillating[tiab] OR oscillation[tiab] OR Sound[mh] OR "sound waves"[tiab] OR Bronchoscopy[mh] OR Suction[mh] OR suction*[tiab] OR IPV[tiab] OR "Breathing Exercises"[mh] OR "non-drug"[tiab] OR "non- pharmacological"[tiab]) AND (Airway Obstruction/therapy[mh] OR "airway clearance"[tiab] OR "airway clearing"[tiab] OR "airway obstruction"[tiab] OR "airflow obstruction"[tiab] OR "lung clearance"[tiab] OR "lung clearing"[tiab] OR "sputum clearance"[tiab] OR "mucus clearance"[tiab] OR "mucous clearance"[tiab] OR "mucous clearing"[tiab] OR "mucociliary clearance"[tiab] OR "respiratory function"[tiab] OR "pulmonary function"[tiab] OR "lung function"[tiab])) #2 AND (#3 OR #4) AND humans[MeSH] AND English[lang] 2180 #5 limited to 1990 to present 1723 #6 NOT (cystic fibrosis[majr] OR "Sleep Apnea Syndromes"[majr] OR infant, newborn[mh] OR 1502 intensive care units, neonatal[mh] OR newborn[tiab] OR neonatal[tiab]) #7 NOT (editorial[pt] OR letter[pt] OR comment[pt] OR case reports[pt] OR review[pt] OR news[pt] 844* OR guideline[pt] OR practice guideline[pt] OR historical article[pt] OR jsubsetk) *Note: There was significant duplication among the results of each search Appendix-2 B. Review Forms Non-Pharmacologic Airway Clearance Interventions: Abstract Review Form Cannot 1. Original research (exclude editorials, commentaries, letters, narrative reviews) Yes No Determine 2. Includes one of the following: 2a. Hospitalized or postoperative patients over 1 year of age and without cystic Cannot Yes No fibrosis receiving non-pharmacologic Determine airway clearance therapies 2b. Patients with neuromuscular disease or respiratory muscle weakness over 1 Cannot Yes No year of age and without cystic fibrosis and receiving non-pharmacologic airway Determine clearance therapies Cannot 2c. Patients with impaired cough over 1 year of age and without cystic fibrosis and Yes No Determine receiving non-pharmacologic airway clearance therapies 3. Study addresses an intervention used for mucus clearance If yes—circle below: Active cycle of breathing Autogenic drainage Bronchoscopy Cannot Chest physical therapy/physiotherapy (percussion, vibration, positioning, postural Yes No Determine drainage) Cough assist (insufflation/exsufflation, FET, device) Cuirass High frequency chest compression/oscillation vest Intrapulmonary percussive ventilation Positive expiratory pressure (oscillatory PEP, Flutter, Acapella) 4. Study measures effects of intervention on mucus clearance—if yes, circle outcomes below: Time to exacerbation of disease/condition Need for ventilatory assistance ICU or hospital LOS Time to re-admission Number of hospital admissions or hospital days Cannot Quality of life Yes No Determine Pulmonary function (FEV1, FVC, peak flow) Gas exchange Symptoms and signs (dyspnea, cough, HR, ER, breath sounds, retractions) Sputum clearance and expectoration (transport, weight, volume) Exercise tolerance Antibiotic use Harms (including mortality) related to ACT Oxygenation Cannot 5. Setting is hospital or inpatient Yes No Determine Does this study address pharmacologic interventions of interest (i.e., retain for review Cannot for future key questions)? Yes No Determine Comments: If excluded, retain for ____Background/Discussion ___Review of references ___Other: Appendix-3 Non-Pharmacologic Airway Clearance Interventions: Full Text Review Form 1. Original research (exclude editorials, commentaries, letters, narrative