COPD (Chronic Obstructive Pulmonary Disease)
Conditions
Keywords
Autogenic drainage, COPD, Dyspnea, Flutter device, Functional capacity, Pulmonary function test
Brief summary
COPD is a progressive lung disease that includes emphysema and chronic bronchitis and is a major cause of morbidity and mortality worldwide. Airway clearance techniques help improve mucus removal, reduce dyspnea, and enhance quality of life in COPD patients. This study aims to compare the effects of autogenic drainage and flutter device on dyspnea, pulmonary function, and functional capacity in patients with COPD. A randomized clinical trial will be conducted at Gulab Devi Teaching Hospital using convenient sampling. Participants will be divided into two groups: Group A will receive autogenic drainage, while Group B will use the flutter device. Interventions will be performed daily for 20-30 minutes over 6 weeks. Outcome measures will include dyspnea severity scale, spirometry, and 6-minute walk test. Data will be analyzed using SPSS with significance set at p \< 0.05. The study may provide evidence for effective, non-invasive, and cost-effective management strategies for COPD patients.
Detailed description
Chronic obstructive pulmonary disease is progressive damage to lungs with a combination of airway diseases that are emphysema and chronic bronchitis. COPD is the major cause of chronic mortality and morbidity throughout the world. It's third leading cause of death in the world. Non pharmacological intervention Airway clearance techniques plays crucial role in managing COPD and enhancing patients quality of life by removal of bronchial secretions. Two popular techniques autogenic drainage and flutter are based on the same principle of mobilization and removal of secretions. These non-invasive techniques aimed at enhancing mucus clearance and reducing dyspnea. The objective of the study's primary goal is to compare the effect of autogenic drainage and flutter device on the dyspnea, pulmonary function test and functional capacity in the patients with COPD. The study design will be ramdomized clinical trial. It will be conducted at Ghulab Devi \|Teaching Hospital. Sample size will be conducted through non- probability convenient sampling as per inclusion criteria. Participants will be randomly added into two groups. Group A will receive autogenic drainage intervention and the Group B will receive flutter device intervention. Both interventions will be practiced daily for 5 days 6 weeks for 20-30 minutes. Pre and post intervention data will be collected. Outcome measures include dyspnea severity scale, spirometer and 6-minute walk test. Data will be analyzed by using SPSS. Data will be tested for normality distribution. Paired or Independent t-test will be used to compare variables between the two groups and within the two groups, with significance set at p\< 0.05. This study will provide evidence for the integration of non-invasive, cost effective strategies for the enhancement of PFT's and functional capacity and dyspnea.
Interventions
PROCEDUREAutogenic drainage
The patient begins by performing the diaphragmatic breathing at low lung volume inspiration will slow with a pause of three seconds allowing the collateral ventilation, and expiration will done as a sigh with an open glottis and with high velocity as possible but no forced expiration. During this low lung volume breathing, expiration will encourage to the expiratory reserve volume. When the patient feel secretions to be moving, the volume of inspiration became deeper and expiration did not go down as far as expiratory reserve volume. As the secretions moved up the bronchial tree to the large airways then the patient will ask to perform higher lung volume breathing, tidal volume to inspiratory reserve volume range. This middle to high lung volume breathing continued until the secretions will in the trachea and ready to be expectorated
DEVICEFlutter Device
The flutter device will hold horizontally and tilted slightly upwards to get maximal oscillatory effect and then it was placed in the mouth. Inspiration was done through the nose. A slow breath in, only slightly deeper than normal with a breath hold of 3-5 seconds will followed by breath out through the flutter device at a slightly faster rate than normal. After 4-8 breaths, a deep breath with a hold' at full inspiration will followed by a force expiration through the flutter device. This precipitated expectoration and will followed by a pause for breathing control, and then according to the subjects' preference a cough or huff was done
Sponsors
Riphah International University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Masking description
Because of the physical nature of the interventions, both participants and investigators will know which treatment is being given. No blinding will be applied.
Intervention model description
Participants will be randomly added into two groups. Group A will receive autogenic drainage intervention and the Group B will receive flutter device intervention. Both interventions will be practiced daily for 5 days 6 weeks for 20-30 minutes. Outcomes will be measured at baseline and after intervention to compare treatment effects.
Eligibility
Sex/Gender
ALL
Age
40 Years to 60 Years
Healthy volunteers
No
Inclusion criteria
* Age group: Middle age adults (40-60 years), medically stable * Both gender * Diagnosis based on GOLD criteria ((FEV₁/FVC ratio \< 0.70). * Moderate COPD with no acute exacerbations in the past 4-6 weeks. * Participants must be able to perform Autogenic drainage and Flutter device physically and mentally. * Voluntary participation with consent.
Exclusion criteria
* Cardic Diseases (Acute MI, Congestive Heart Failure) * Musculoskeletal Impairements * Using Non-invasive Ventilation * Recent lung diseases (Respiratory failure, pneumothorax) * Hemodynamic instability * Uncoorperative patients * Cognitive Impairement scale * Participants excluded if they did not consent * Comorbidities affecting exercise tolerance
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Dyspnea | Baseline and after 6 weeks of intervention | The modified medical research council; (mMRC) Dyspnea Scale is a simple and widely used scale |
| Forced Vital Capacity | Baseline and after 6 weeks of intervention | Forced Vital Capacity (FVC) will be measured in liters (L) using spirometry. FVC represents the maximum volume of air that can be forcefully exhaled after a maximal inspiration. |
| Forced Expiratory Volume in One Second | Baseline and after 6 weeks of intervention | Forced Expiratory Volume in One Second (FEV₁) will be measured in liters (L) using spirometry. FEV₁ represents the volume of air exhaled during the first second of a forced expiratory maneuver. |
| FEV₁/FVC ratio | Baseline and after 6 weeks of intervention | The FEV₁/FVC ratio will be expressed as a percentage (%) and calculated from spirometric measurements to assess the degree of airflow limitation. |
| Peak Expiratory Flow | Baseline and after 6 weeks of intervention | Peak Expiratory Flow (PEF) will be measured in liters per minute (L/min) and represents the maximum expiratory flow achieved during forced expiration. |
Countries
Pakistan
Contacts
CONTACTMuhammad Iqbal Tariq Tariq, Phd*
CONTACTNimra noor Noor, MS-CPPT
PRINCIPAL_INVESTIGATORArjumand Bano, MS
Riphah International University
Outcome results
None listed