Effects of Blow Bottle Verses ACBTs Technique in Patients of Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease is a common disease worldwide. Pulmonary rehabilitation is an important part to decrease the complications of COPD. Blow bottle technique is an economical and subjective technique promote the lung expansion, as compare to ACBTs. It used to treat the different complications in COPD patients and also decrease the dependency of patient. To find the comparative effects of blow bottle and active cycle of breathing on sputum diary, oxygen saturation, pulmonary function and quality of life among the patients of chronic bronchitis.

A randomized clinical trial will be conducted at Gulab Devi hospital Lahore. Through convenient sampling technique on 56 patients, allocated through simple random sampling through computer generated technique into group A and Group B. Group A will be treated with blow bottle technique and group B will be treated by with ACBTs. Pretreatment values will be recorded for BCSS for sputum, pulse oximeter, pulmonary function test and st. George for quality of life will be assessed before and after 8 weeks of the treatment. Data will be analyzed using SPSS software version 25. After assessing normality of data by Shapiro-Wilk test, it will be decided either parametric or non-parametric test will be use within a group or between two groups.

Chronic obstructive pulmonary disease is defined as chronic airflow obstruction that is progressive. Patients with chronic obstructive pulmonary disease (COPD) are highly susceptible from respiratory exacerbations from viral respiratory tract infections. The pathological consequences of the COPD inflammation Induce series of physiological changes which eventually impact the quality of life and survival in the natural progress of COPD. Elastin proteolysis results in reduction in elastic recoil Pressures in the lungs, also the integrity and movement Of air in the bronchioles results in significant airway narrowing with air-trapping in lungs.

COPD is an increasingly important cause of morbidity, disability, and mortality worldwide. Researcher aimed to estimate global, regional, and national COPD prevalence and risk factors to guide policy and population interventions. Chronic Obstructive Pulmonary Disease (COPD) is attributable to household air pollution and is known to increase the Disability Adjusted Life Years (DALYs), morbidity and mortality and women are most susceptible groups for the exposure. In order to understand the global risk among women with COPD due to exposure of household air pollutants.

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide. Smoking remains the most important risk factor, but occupational exposures may play an essential role as well n 2019, Thirty-two sources of COPD prevalence rates, representing 17 countries and eight World Health Organization-classified regions, were identified and reviewed. Reported prevalence ranged from 0.23 to 18.3%. The lowest prevalence rates 0.2 to 2.5% were based on expert opinion. Sixteen studies had measured rates that could reasonably be extrapolated to an entire region or country.

The physiotherapist has a major role to assume in pre and post-exacerbation management of people with COPD and assess the patient and to put into place an individualized pulmonary rehabilitation program. In patients with a range of respiratory disorders such as chronic bronchitis, different technique are available for pulmonary rehabilitation, such as active cycle of breathing techniques which includes cycle of breathing control, thoracic expansion exercises and forced expiratory technique (FET), appears to have beneficial effects.

Rehabilitation exercise can lessen the possibility of the progressive exacerbation of the patient's condition, exerting an active role in improving their lung function and the quality of the patients' life. Therefore, researcher have designed a lung function exercise bottle, which is capable of adjusting the pressure according to the patient's needs. The blowpipe can be inserted into the bottle body and the patient can blow the air through the tube. the air pressure in the bottle can be adjusted, with the advantage of wider range of application, lower cost and more convenient.

Secretion production and retention is top most complication of chronic obstructive pulmonary disease. First step of its management is removal of secretion as soon as possible to prevent infection and development of further complications. ACBT is one of most commonly used technique used in all times. But blow bottle is not only economic but also provide direct visual stimulus during performance to enhance patient interest. So it is necessity to find out the comparison of these two technique which will help to get the better quality of life, reduce the severity of disease and improve the pulmonary function.

Eligibility Criteria:
Inclusion Criteria:

* Moderate COPD
* Hx of chronic sputum production
* Regular expectoration
* After 48 hours of admission in hospital
* Patient of 45 to 65 years
* Both genders (male and female)

Exclusion Criteria:

* Pulmonary disease like, Bronchiectasis, pneumothorax, TB, atelectasis
* Lung Abscess
* Lung cancer
* Any post-surgical (pneumectomy, lobectomy)
* Hemoptysis