A comparison of the effect of "postural drainage" and "flutter VRP1" on secretion clearance and pulmonary functions in patients suffering from acute exacerbation of bronchiectasis

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A comparison of the effect of "postural drainage" and "flutter VRP1" on secretion clearance and pulmonary functions in patients suffering from acute exacerbation of bronchiectasis

 

Author: Tsang, Man-ha Sharon
Title: A comparison of the effect of "postural drainage" and "flutter VRP1" on secretion clearance and pulmonary functions in patients suffering from acute exacerbation of bronchiectasis
Degree: M.Sc.
Year: 2002
Subject: Hong Kong Polytechnic University -- Dissertations
Bronchiectasis -- Physical therapy
Secretion -- Regulation
Chest -- Diseases -- Physical therapy
Department: Multi-disciplinary Studies
Dept. of Rehabilitation Sciences
Pages: xii, 105 leaves : ill. ; 30 cm
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b1659011
URI: http://theses.lib.polyu.edu.hk/handle/200/3299
Abstract: Bronchiectasis is a respiratory condition characterized with hypersecretory problem, chronic and repeated chest infections, which frequently require hospital care upon acute exacerbations. With reference to the holistic approach in management of this type of respiratory condition, chest physiotherapy remains the mainstay and involve actively for both the acute and rehabilitation phases. This study aimed to examine one of the commonest used techniques, Postural Drainage (PD); and a small assistant device named Flutter VRP1(r) (FD) in comparison to a standardized breathing and coughing exercise programme (BC) alone on secretion clearance and effects on the pulmonary functions in patients with diagnosed Bronchiectasis during the acute exacerbation phase. Fifteen patients (eight males and seven females) diagnosed with bronchiectasis with aged between 48 and 84 were recruited and completed for this study. The patients were randomly divided into three treatment groups. Group one received PD and B&C for 15 minutes daily until the day of discharge. Group two received FD and B&C and group three received B&C alone. Variables including sputum produced during the 15 minute treatment, for the 15 minutes after treatment and amount produced in 24 hours, Forced Vital Capacity (FVC), Forced Expiratory Volume in one second (FEV1) and Peak Expiratory Flow Rate (PEFR) were recorded in Day 2, Day 4 after admission to hospital and in the day of discharge. Patients were also asked to complete a subjective score of the ease of application of each treatment methods and their effectiveness. Results showed that all three treatments were safe and well tolerated by patients. Both the Postural Drainage and Flutter VRP 1 (r) combined with breathing and coughing exercise promoted more secretion than breathing and coughing exercise alone during the assigned treatment period of 15 minutes. Sputum produced during the 15 minutes after PD and FD) also played a role in mobilizing the secretion from the peripheral region of the lung as secretion was continuously cleared from the lung after the treatment had been stopped. Clinically, the pulmonary functions of all three groups patients did improve gradually over the period of hospitalization but not immediately after treatment. However, the extent of such improvements did not reach statistical significance (p > 0.05). Meanwhile, there was a statistically higher score for the degree of effectiveness reported by the subjects received Flutter VRP1(r) when compared to BC group (p = 0.01 1). The possible explanation for these phenomenon and their clinical implications were discussed accordingly. Finally, the limitations of this study and recommendation for further studies were also presented.

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