Postural Drainage With and Without Percussion in Chronic Obstructive Pulmonary Disease

Chronic respiratory diseases refer to chronic diseases of the airways and other structures like alveoli bronchi and bronchioles of the lung. Some of the most common diseases include asthma, chronic obstructive pulmonary disease (COPD), and other respiratory allergies. COPD leads to permanent damaged airways, which causes them to become narrower making it difficult for air to go into and out of lungs it belongs to a group of progressive lung diseases that make it difficult to breathe - including chronic bronchitis and emphysema (assessed by pulmonary function and x-ray evidence).

People have difficulty breathing due to long-term damage to their lungs, caused mainly due to cigarette smoking, exposure to air pollution, exposure to fumes or particles at work, for example, welding fumes or coal dust and Alpha-1-antitrypsin deficiency, a genetic condition. Symptoms that badly effects the health of the patient includes cough, decreased exercise tolerance production, shortness of breath, and shortness of breath.

In this research, the effects of postural drainage with and without percussion on mucus clearance, dyspnea and quality of life would be determined. Chest physiotherapy is the term for a group of treatments designed to eliminate secretions, thus helping to decrease work of breathing, promote the expansion of the lungs, and prevent the lungs from collapse.

There is a large impact on quality of life for individuals living with COPD, decreased exercise tolerance, decreased ability to carry out activities of daily living (ADLs), anxiety, feelings of isolation, decreased social participation etc.

This study will be a randomized controlled trial. The study will be conducted in Sheikh Zaid hospital Lahore. In the present study under considerations we mainly look on the subjects meeting predetermined inclusion and exclusion criteria will be divided into two groups using lottery method. Sample size will be 34 which would include both male and female. Subjects irrespective of gender aged between 35-65 years of age are involved.

• POSTURAL DRAINAGE WITH PERCUSSION (Other): Each position should be held for a minimum of five minutes. In each position, your chest should be lower than your hips to allow mucus to drain. On your back: Patient's chest should be lower than his hips, which you can achieve by lying on a slanted surface up about 18 to 20 inches. On your sides: With pillows under your hips, lie on one side. To clear congestion from the right and left lobes. On your stomach: Drape patient's body over a stack of pillows, this is best in clearance of mucus from the lower back area of the lungs. Percussion The equipment required here is cupped hands of caregiver to deliver the force required to drain the thick secretions. Patient should be in a comfortable position to enhance the effect. This loosens the thick, sticky secretions from the walls of the lung allowing them to into the larger airways, The sound heard must be hollow. The force applied must be equal.
• Postural drainage (Other): * Each position should be held for a minimum of five minutes. * In each position, your chest should be lower than your hips to allow mucus to drain On your back: Patient's chest should be lower than your hips, which you can achieve by lying on a slanted surface or propping patient's hips up about 18 to 20 inches * This position is best for draining the bottom front parts of your lungs. On your sides: With pillows under your hips, lie on one side so that your chest is lower than your hips. To clear congestion from the bottom part of the right lung, lie on your left side. To clear congestion from the bottom part of your left lung, lie on your right side. On your stomach: Drape patient's body over a stack of pillows or other object, and rest his arms by his head, with his chest lower than his hips. This position is best for clearing mucus in the lower back area of the lungs.

Primary outcomes

• For Airway Clearance [8weeks]: Sputum diary Questionnaire will be used
• St. George's Respiratory Questionnaire (SGRQ) quality of life assessment [8 weeks]: For assessment and changes in Quality of life Questionnaire will be used
• Spirometry For Airway clearance [8 weeks]: Spirometer will be used for evaluating the Forced Expiratory values in 1 second

Other outcomes

• Dyspnea-12 [8 weeks]: Dyspnea-12 questionnaire is used to check for the dyspnea.

Sex: All, ages: 35 Years to 65 Years

Inclusion Criteria:

* • Age 35-65 years

  * Patients who have had exacerbations in the past month
  * Agreeing to participate in the study after having provided a written consent.
  * Patients with heavy Mucus secretions in Lungs Field
  * Diagnosed Patients of Chronic Obstructive Pulmonary Disease Stage 2(COPD)

Exclusion Criteria:

* • Patients on bronchodilators and steroids

  * Patients with severe Pulmonary Edema
  * Patients with severe rib fractures
  * History of any recent thoraco abdominal surgery(35)
  * Left ventricular Ejection Fraction (EF)
  * Anemic patients
  * Pregnant women

• Sumera Abdulhameed, MS, Principal investigator, Riphah International University