Comparison between active cycles of breathing with postural drainage versus conventional chest physiotherapy in subjects with bronchiectasis

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• 作者：Hesham A. AbdelHalim^a ; ^{heshamatef@med.asu.edu.eg" class="auth_mail" title="E-mail the corresponding author} ; Heba H. AboElNaga^b ; Karim A. Fathy^c
• 关键词：Bronchiectasis ; Postural drainage ; Active cycle of breathing ; Conventional physical therapy ; Airway clearance
• 刊名：Egyptian Journal of Chest Diseases and Tuberculosis
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：65
• 期：1
• 页码：157-165
• 全文大小：961 K

文摘

Bronchiectasis is a chronic debilitating condition with abnormal permanent dilatation of the airways causing impaired mucus clearance, despite regular chest physiotherapy being mainstay of management for bronchiectasis, there is little evidence supporting regular chest physiotherapy in bronchiectasis which aims to mobilize secretions and facilitate effective expectoration, providing control of cough and improving airway clearance. The objective of this study was to compare between the efficacy of 2 techniques of chest physiotherapy ACBT with postural drainage and conventional chest physical therapy as a method of airway clearance in adults with productive bronchiectasis.

Methods

The study included 30 subjects, 20 males and 10 females; all having bronchiectasis, the study was carried out on October 6 at the University Hospital. The participating subjects underwent conventional chest physical therapy or ACBT following postural drainage as the airway clearance technique in random order on 14 successive days with twice daily frequency.

Results

There was a significant difference regarding mMRC before and after both ACBT and conventional physiotherapy, there was a significant improvement regarding FVC and MMEF after ACBT while there was a significant improvement of FEV1 and MMEF after conventional physiotherapy. As regards arterial blood gas data comparison, there were significant improvements regarding PaCO₂, PaO₂ and PAO₂ while there was no significant difference as regards P (A-a) O₂ after both types of physiotherapy techniques. Comparison between the 2 groups regarding mMRC dyspnea score, spirometry, arterial blood gas data, Leicester cough questionnaire (LCQ) and sputum wet volume before starting physiotherapy shows no significant difference while there were significant differences in advance to post ACBT physiotherapy sessions as regards PaO₂, P (A-a) O₂ gradient, LCQ (physical domain score and total score) and sputum wet volume.

Conclusion

ACBT with postural drainage is found to be more effective than conventional chest physical therapy management of bronchiectasis during infective exacerbation.