Pneumonia is a major cause of illness and death in children, leading to breathing difficulties and reduced oxygen levels due to impaired gas exchange. Non-pharmacological techniques like balloon blowing and Bubble PEP are simple, engaging methods used to improve respiratory function.

This randomized clinical trial will compare the effects of Balloon Blowing Therapy and Bubble PEP on oxygen saturation, dyspnea, and enjoyment in 40 children with pediatric pneumonia over one week.

Pneumonia is one of the main causes of morbidity and mortality in children worldwide and serious pediatric health concern. Symptoms including hypoxia, tachypnea, and dyspnea are brought on by inflammation and fluid buildup in the alveoli, which hinders gas exchange.Supportive oxygen therapy and antibiotics are usually used in conventional treatment, nonpharmacological therapies have become more prevalent to improve respiratory outcomes.Breathing techniques, such as bubble positive expiratory pressure (PEP) therapy and balloon blowing, are being used extensively to assist gas exchange, enhance lung function, and encourage airway clearing. These techniques are useful in children because these are easy to use, entertaining, and cost-effective.

This randomized clinical trial aims to compare the effects of Balloon Blowing Therapy (BBTG) and Bubble PEP Therapy (BPTG) on oxygen saturation, dyspnea, and perceived enjoyment in children with Pneumonia. Forty children aged 6-12 years diagnosed with pneumonia, fulfilling the eligibility criteria will be recruited through non-probability purposive sampling. Participants will be randomly assigned to two groups. Group A will receive Balloon Blowing Therapy along with baseline breathing techniques. Group B will receive Bubble PEP Therapy with the same baseline breathing techniques. Interventions will be administered twice daily in 5 consecutive days for 1 week. Outcome measures include oxygen saturation assessed via pulse oximeter, dyspnea assessed via Modified Borg Dyspnea Scale, and perceived enjoyment measured by a 5-point smiley Likert scale. Data will be analyzed using SPSS software.

Inclusion Criteria:

• Children aged 6 to 12 years
• Medically stable and cleared to perform breathing exercises
• Both genders will be included
• Presence of dyspnea according to the patient's statement
• Peripheral oxygen saturation (SpO2) <94%

Exclusion Criteria:

• Children who are critically ill patients on bi-pep or a ventilator, as well as patients who were intubated and uncooperative
• Children with any oral surgery
• Participants were excluded from the study, if they had any contraindication to the use PEP therapy (severe haemoptysis)
• Refusal to participate or inability to complete full sessions

Participants will get separate treatment protocols and possible efforts will be put to mask both groups about treatment