Icing and Airflow Stimulation in Obstructive Lung Diseases
Condition: Chronic Obstructive Pulmonary Disease
MeSH terms: Lung Diseases; Lung Diseases, Obstructive; Pulmonary Disease, Chronic Obstructive
Study type: Interventional

Summary: 
      A randomized controlled trial in which icing and airflow stimulation for reduction of dyspnea
      in patients of obstructive lung disease was done which is characterized as condition of
      infection described by constant improvement of perpetual constraint of flow of air that is
      partially reversible and incorporates chronic bronchitis, emphysema and small airway diseases
      . The tools used were RR, Spirometry, Saturation, Borg Scale, MRC scale, shuttle walk test
      and St George's Respiratory Questionnaire (St.GRQ) score. Pulse oximeter measured the
      saturation levels and respiratory rates were alse observed. Borg scale measured rate of
      perceived exertion ranges from 6(easy physical activity) and 20(worst activity) and MRC
      measure dyspnea levels. In St.GRQ score between 1 to 8 is symptoms related and 9 to 17 was
      activity related.Literature review indicate that icing and airflow stimulation reduce dyspnea
      in patients of obstructive lung diseases.
    

Detailed description: 
      Constant obstructive Pulmonary disease (COPD) is an essential reason of mortality and
      bleakness everywhere throughout the world. In United States, COPD stands third in the causes
      of mortality with annual 100,000 deaths .An estimated 15 million people had COPD diagnosed
      with health care provider in 2010 and un-diagnosed cases are 12 million in number. In China
      ,COPD stands first among disability causes and becoming a reason of public health
      attention.According to an interpretation COPD overall rate of prevalence is 8.2% in China
      mortality rate of COPD is 1.6%.

      In 12 countries/Cities of Asia-Pacific localies Model Projections of the commonness of
      Moderate-to-Severe instances of COPD in Those Persons > 30 years af age was total of
      56,553,000 with total prevalance of 6.30%.Data are from the study held by the COPD regional
      working group.

      Pakistan is a lower-middle-income country with a population of 182.1 million Pakistan, has a
      high load of chronic respiratory diseases a lower-middle-income country, with a population of
      182.1 million. Age standardized death rate due to respiratory diseases is 138.2 per 100,000
      in men and 41.3 per 100,000 in women in Pakistan.

      "Effects of smoking mediation and the utilization of a breathed in anticholinergic
      bronchodilator on the rate of decrease of FEV1" presuming that This single intercession with
      the most extreme ability to impact the common history of COPD.in a lung wellbeing study
      assessment of the smoking suspension part demonstrates that if appropriate assets and time
      are given to end of smoking 25% quit rates can be picked up for long term.

      an investigation in 2002 with the title of "Treating tobacco utilize and reliance" deriving
      that the act of conveying end of smoking help ought to take after "five A's" standards. The
      "five A's" of smoking discontinuance are Ask about utilization of tobacco, Advise to stop,
      Assess ability to influence an endeavor, To aid stop endeavor, Arrange development.

      an exploration on " COPD-related dreariness and mortality in the wake of smoking
      discontinuance " inferring that concentrate of all the accessible writing underpins the
      elucidation that smoking suspension moderates the expanded rate of lung work decay and
      enhances survival as contrasted and kept smoking even in serious COPD.

      " Arm situating adjusts lung volumes in subjects with COPD and solid subjects" which was
      distributed in Australian Journal of Physiotherapy reasoning that lung volumes were changed
      in subjects of COPD and sound subjects when looking at the arms situated over 90 degrees bear
      flexion with arms at or beneath 90 degrees bear flexion.In the COPD breathing at a higher
      volume of lung and having a diminished ability to take in a profound inhale when arms were
      over the head level may impact the capacity to do regular arm assignments that need height of
      the arms over the head. Change of the arm undertakings so arms are just lifted to 90 degrees
      may help in influencing arm to work more achievable for subjects with COPD.

      In International Journal of Chronic Obstructive Pulmonary Disease reasoning that inspiratory
      muscle quality and intense exercise cause change of activity and respiratory muscle
      continuance execution and reductions dynamic hyperinflation and shortness of inhale amid
      exercise.

      "Impact of cryotherapy and Airflow Stimulation Versus Controlled Breathing Exercise to Reduce
      Dyspnea in Patients With Obstructive Lung illness" In that they reasoned that facial icing
      and flow of air stimulation are viable and feasible technique for mitigating dyspnea in COPD
      patients.

      Facial icing and airflow stimulation both of them were effective dyspnea relieving therapies
      which could be easily learnt by the COPD patient to overcome shortness of breathe on daily
      grounds. The point of this investigation was to decide the impact of Ice and Airflow
      Stimulation Versus Controlled Breathing Exercise to decrease Dyspnea in COPD patients.
    

Intervention name(s): Group A-Diaphragmatic breathing; Group B-Icing and Airflow Stimulation
Intervention type(s): Other; Other
Intervention description(s): Patient was in casual and agreeable position in which gravity helped the stomach, for example, a semi fowler's position. Hand was put on the rectus abdominis just beneath the foremost costal edge and requested that the patient take in gradually and profoundly through the nose. Persistent was told to keep the shoulder casual and upper chest very, enabling the belly to rise marginally. At that point persistent was guided to remain loose and breathed out gradually through the mouth. The patient rehearsed this 3 to 4 times and the rest time frame was given so patient couldn't hyperventilate.This group was given 10 reps of 3 sets with 4 weeks of follow up; Patient was lying comfortable in semi fowler position. Facial muscle icing was given using ice pack wrapped in cloth over cheeks and nose in butterfly pattern and over forehead for 5 minutes. Ice pack was applied on the patients face (around the cheek & nose) and accessory muscles (sternocleidomastoid muscles, upper trapezius) for single session of 5 to 10 minutes.
After that airflow stimulation was given with the help of table fan. Table fan was placed on the central area of face. Duration of the fan for the patient was at least 5 minutes to relive dyspnea and distance kept approximate of 60 centimeter (2 rulers).
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Breathing Exercises; Icing and Airflow Stimulation; Chronic Obstructive Lung Diseases.