Thoracic Surgery
Conditions
Keywords
Thoracic Surgery Postoperative,ACBT
Brief summary
This randomized clinical trial aims to compare the effectiveness of Active Cycle of Breathing Techniques combined with Incentive Spirometry (ACBT + IS) versus High-Frequency Chest Wall Oscillation (HFCWO) in patients undergoing thoracic surgery. Postoperative pulmonary complications such as reduced lung function, ineffective cough, and sputum retention are common after thoracic procedures and can delay recovery. A total of 42 participants will be randomly allocated into two groups: one receiving ACBT with Incentive Spirometry and the other receiving HFCWO, along with standard postoperative care. Outcomes including cough effectiveness, sputum clearance, pulmonary function tests, and patient satisfaction will be assessed at baseline, postoperative day 3, and day 5. The study aims to determine the more effective airway clearance technique to improve respiratory outcomes and enhance patient recovery following thoracic surgery.
Detailed description
Postoperative pulmonary complications are common after thoracic surgery due to reduced lung function and impaired secretion clearance. Effective respiratory physiotherapy is essential to improve recovery and prevent complications such as atelectasis and pneumonia. This randomized clinical trial aims to compare the effectiveness of Active Cycle of Breathing Techniques combined with Incentive Spirometry (ACBT + IS) and High-Frequency Chest Wall Oscillation (HFCWO) in improving respiratory outcomes. A total of 42 patients undergoing elective thoracic surgery will be randomly assigned to either ACBT + IS or HFCWO, along with standard postoperative care. Outcomes including cough effectiveness, sputum clearance, pulmonary function (FEV₁, FVC), and patient satisfaction will be assessed at baseline, postoperative day 3, and day 5. The study seeks to identify the more effective airway clearance technique to enhance recovery and reduce postoperative complications.
Interventions
PROCEDUREActive Cycle of Breathing Techniques with Incentive Spirometry
A structured breathing intervention combining Active Cycle of Breathing Techniques (breathing control, thoracic expansion exercises, and forced expiratory technique) with incentive spirometry to promote lung expansion and secretion clearance. Performed multiple times daily during the early postoperative period.
A mechanical airway clearance technique delivered using an oscillatory vest that produces high-frequency chest wall vibrations to help mobilize and remove pulmonary secretions. The intervention is administered twice daily beginning on postoperative day 3.
Sponsors
Riphah International University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
SINGLE (Outcomes Assessor)
Masking description
Outcome assessors will be blinded to group allocation to reduce assessment bias, while participants and care providers will not be blinded due to the nature of the interventions.
Intervention model description
Participants will be randomly assigned into two parallel groups. Group A will receive Active Cycle of Breathing Techniques combined with Incentive Spirometry, while Group B will receive High-Frequency Chest Wall Oscillation. Both groups will receive standard postoperative care and outcomes will be compared between groups.
Eligibility
Sex/Gender
ALL
Age
18 Years to 40 Years
Healthy volunteers
No
Inclusion criteria
* Adults aged 18-40 years * Patients scheduled for elective thoracic surgery (e.g., lobectomy, pneumonectomy, thoracotomy, or VATS) * Hemodynamically stable in the postoperative period * Cognitively and physically able to perform breathing exercises and use devices (incentive spirometer/HFCWO vest) * Willing to participate and provide informed consent
Exclusion criteria
* Pre-existing severe pulmonary diseases (e.g., COPD, cystic fibrosis, bronchiectasis) * Contraindications to HFCWO (e.g., recent rib fractures, chest wall trauma, unstable cardiovascular status) * Cognitive, neuromuscular, or musculoskeletal impairments limiting participation in interventions * Prolonged mechanical ventilation (\>24 hours postoperatively) * Active pulmonary infection or hemoptysis within one week after surgery
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Forced Expiratory Volume in 1 second (FEV₁) | Baseline (preoperative), Postoperative Day 3, and Day 5 | Assessment of pulmonary function using spirometry parameters including Forced Expiratory Volume in 1 second (FEV₁) to evaluate respiratory recovery after thoracic surgery. |
| Forced Vital Capacity (FVC) | Baseline (preoperative), Postoperative Day 3, and Day 5 | Assessment of pulmonary function using spirometry parameters including Forced Vital Capacity (FVC) to evaluate respiratory recovery after thoracic surgery. |
| Cough Effectiveness | Baseline, Postoperative Day 3, and Day 5 | Evaluation of cough effectiveness using the Leicester Cough Questionnaire (LCQ), measuring physical, psychological, and social impact of cough. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Sputum Clearance | Postoperative Day 3 and Day 5 | Measurement of sputum volume to assess effectiveness of airway clearance techniques. |
Countries
Pakistan
Contacts
CONTACTMuhammad Iqbal Tariq, Phd*
PRINCIPAL_INVESTIGATORArjumand Bano, MSPT
Riphah International University
Outcome results
None listed