Resistive Breathing Versus Inspiratory Hold Technique in Patients With Chronic Bronchitis

Study Overview
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Brief Summary
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The aim of the study is to determine the importance and impact of resistive breathing techniques versus inspiratory hold techniques in patients with chronic bronchitis and specially to find out if there are any changes seen in results measured via the incentive spirometer.

Detailed Description
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Chronic Bronchitis (CB) is defined as a chronic cough and sputum production for at least 3 months a year for 2 consecutive years. It is covered under the umbrella term of Chronic Obstructive Pulmonary Disease (COPD). Chronic bronchitis is thought to be caused by overproduction and hypersecretion of mucus by goblet cells. Epithelial cells lining the airway response to toxic, infectious stimuli by releasing inflammatory mediators and e.g. pro-inflammatory cytokines. During an acute exacerbation of chronic bronchitis, the bronchial mucous membrane becomes hyperemic and edematous with diminished bronchial mucociliary function. This, in turn, leads to airflow impediment because of luminal obstruction to small airways. The airways become clogged by debris and this further increases the irritation. The characteristic cough of bronchitis is caused by the copious secretion of mucus in chronic bronchitis. Pseudostratified epithelium, highlighting the pseudostratified epithelial cells, goblets cells (shown in blue), then underlying connective tissue.(3) To determine the importance and impact of resistive breathing techniques versus inspiratory hold techniques in patients with chronic bronchitis and specially to find out if there are any changes seen in results measured via incentive spirometer. There are few studies done over it whereas purpose of this research work is to compare these techniques to get better results.

Official Title
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Comparison of Resistive Breathing Versus Inspiratory Hold Technique in Patients With Chronic Bronchitis

Conditions
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Chronic Bronchitis

Intervention / Treatment
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* Other: Resistive Breathing Training group
* Other: inspiratory hold technique


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: • Diagnosed with chronic bronchitis Clinically stable patients. Both genders. Age 45 to 60 years. Pink puffers included in this study Clients that are involved in research are not allowed for other interventional therapies. They can take their regular medications. Patients diagnosed at least 2 years ago with bronchitis. Exclusion Criteria: • Presence of any genetic disorders (cystic fibrosis). Recent spinal / chest surgery Cardiac issues Fractures of vertebra caused by osteoporosis.

Ages Eligible for Study
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Minimum Age: 45 Years
Maximum Age: 60 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Resistive Breathing Training group<br>The patients performed two sessions each of 15 minutes session of resistive breathing for four days a week for six weeks using an inspiratory resistive device. Ask patient to take long slow inspirations while breathing through the resistive device | Other: Resistive Breathing Training group<br>* The patients performed two sessions each of 15 minutes session of resistive breathing for four days a week for six weeks using an inspiratory resistive device. Ask patient to take long slow inspirations while breathing through the resistive device<br>|
| Active Comparator: inspiratory hold technique<br>With the patient in a comfortable position such as side lying or reclined, the therapist may assist the patient by placing both hands on abdominal area to provide proprioceptive feedback. Then in a relaxed tone of voice therapist instructs the patient to sniff quickly through the nose three times with slow, relaxed exhalations | Other: inspiratory hold technique<br>* With the patient in a comfortable position such as side lying or reclined, the therapist may assist the patient by placing both hands on abdominal area to provide proprioceptive feedback. Then in a relaxed tone of voice therapist instructs the patient to sniff quickly through the nose three times with slow, relaxed exhalations<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| oxygen saturation | amount of oxygen traveling through your body with your red blood cells. Changes will be assessed at baseline, 3rd week and 6th weeks measured | Changes will be assessed at baseline, 3rd week and 6th weeks measured | 
| Forced expiratory volume in one second | amount of air expired in first one second. Changes will be assessed at baseline, 3rd week and 6th weeks measured | Changes will be assessed at baseline, 3rd week and 6th weeks measured | 
| Forced vital capacity | the total amount of air exhaled during the FEV test. Changes will be assessed at baseline, 3rd week and 6th weeks measured | Changes will be assessed at baseline, 3rd week and 6th weeks measured | 
| FEV1/FVC ratio | the amount of air exhaled in the first second divided by all of the air exhaled during a maximal exhalation. | 6 weeks | 
| shortness of breath measured through borge scale of dyspnea | shortness of breath. Changes will be assessed at baseline, 3rd week and 6th weeks measured | Changes will be assessed at baseline, 3rd week and 6th weeks measured | 
| SGRQ questionnaire | how breathing problems effects quality of life . Changes will be assessed at baseline, 3rd week and 6th weeks measured | Changes will be assessed at baseline, 3rd week and 6th weeks measured | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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lung infection, resistive breathing, inspiratory hold technique