Abstract
<i>Background:</i> A major decline in pulmonary function is observed on the first day after upper abdominal surgery. This decline can reduce vital and inspiratory capacity and can culminate in restrictive lung diseases that cause atelectasis, reduced diaphragm movement, and respiratory insufficiency. <i>The aim</i> was to compare the effect of Acapella device and breathing exercises with traditional chest physiotherapy program on forced expiratory volume/ forced vital capacity ratio after upper abdominal surgeries. <i>Subjects and methods:</i> Thirty patients underwent upper abdominal surgery were assigned randomly into two equal groups; their ages ranged from 20-50 years. The study group received breathing exercises, Acapella device and traditional chest physical therapy program (postural drainage. percussion, vibration, cough training and early ambulation). Control group received traditional chest physical therapy program (postural drainage. percussion, vibration, cough training and early ambulation). All groups received three sessions per week for four successful weeks. The data were collected before and after the same period of treatment for both groups. Evaluation procedures were carried out to measure forced expiratory volume/ forced vital capacity ratio (FEV1/ FVC ratio) using electronic spirometer. <i>Results:</i> Post treatment results showed that there was a significant difference in FEV1/ FVC ratio in both groups in favor of the study group. Percentage of improvement of FEV1/ FVC ratio in the study group was 10.17%, while it was 2.96% in the control group. <i>Conclusion:</i> Acapella device and breathing exercises were more effective in improvement of FEV1/FVC % than traditional chest physical therapy after upper abdominal surgeries.
Highlights
Patients undergoing upper abdominal and thoracic surgery have a decreased postoperative vital capacity (VC), which contributes to development of hypoxemia
Forced expiratory volume/ forced vital capacity ratio is the relationship between forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) is expressed as FEV1/FVC ratio or FEV1 % which is a simple screening test that will assist in the diagnosis of any respiratory impairment
The findings of this study indicated that there was a significant difference in FEV1/FVC % after application of Acapella device with breathing exercises after upper abdominal surgeries
Summary
Patients undergoing upper abdominal and thoracic surgery have a decreased postoperative vital capacity (VC), which contributes to development of hypoxemia. Methods of sputum clearance have over time developed from standard physiotherapy to include; percussion, vibration and cough in varying postural drainage positions to active cycle of breathing techniques (ACBT), Autogenic drainage (AD), positive expiratory pressure devices (PEP) and oscillating positive expiratory pressure devices; the Flutter and Acapella. These more recent techniques rely on the principles of getting air behind the secretions to move from distal to proximal along the muco-cilliary escalator. The aim of this study was to compare the effect of Acapella device and breathing exercises with traditional chest physiotherapy program on forced expiratory volume/forced vital capacity ratio after upper abdominal surgeries. The total treatment 20-30 minutes 3 days/week for 4 weeks
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