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This randomized clinical trial aims to compare the effectiveness of Active Cycle of Breathing Techniques combined with Incentive Spirometry (ACBT + IS) versus High-Frequency Chest Wall Oscillation (HFCWO) in patients undergoing thoracic surgery. Postoperative pulmonary complications such as reduced lung function, ineffective cough, and sputum retention are common after thoracic procedures and can delay recovery. A total of 42 participants will be randomly allocated into two groups: one receiving ACBT with Incentive Spirometry and the other receiving HFCWO, along with standard postoperative care. Outcomes including cough effectiveness, sputum clearance, pulmonary function tests, and patient satisfaction will be assessed at baseline, postoperative day 3, and day 5. The study aims to determine the more effective airway clearance technique to improve respiratory outcomes and enhance patient recovery following thoracic surgery.
Postoperative pulmonary complications are common after thoracic surgery due to reduced lung function and impaired secretion clearance. Effective respiratory physiotherapy is essential to improve recovery and prevent complications such as atelectasis and pneumonia.
This randomized clinical trial aims to compare the effectiveness of Active Cycle of Breathing Techniques combined with Incentive Spirometry (ACBT + IS) and High-Frequency Chest Wall Oscillation (HFCWO) in improving respiratory outcomes. A total of 42 patients undergoing elective thoracic surgery will be randomly assigned to either ACBT + IS or HFCWO, along with standard postoperative care.
Outcomes including cough effectiveness, sputum clearance, pulmonary function (FEV₁, FVC), and patient satisfaction will be assessed at baseline, postoperative day 3, and day 5. The study seeks to identify the more effective airway clearance technique to enhance recovery and reduce postoperative complications.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| ACBT with Incentive Spirometry | Active Comparator | Participants in this group will receive Active Cycle of Breathing Techniques (ACBT) combined with Incentive Spirometry along with standard postoperative care. The ACBT protocol will include breathing control, thoracic expansion exercises, and forced expiratory techniques (huffing), performed multiple times daily. Incentive spirometry will be used to promote deep breathing and lung expansion. The intervention will begin in the early postoperative period and continue for 5 days. |
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| High-Frequency Chest Wall Oscillation (HFCWO) | Experimental | Participants in this group will receive High-Frequency Chest Wall Oscillation therapy using an oscillatory vest device along with standard postoperative care. The device delivers external chest wall oscillations to mobilize pulmonary secretions. The intervention will start on postoperative day 3 and will be administered twice daily for 5 days. |
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Active Cycle of Breathing Techniques with Incentive Spirometry | Procedure | A structured breathing intervention combining Active Cycle of Breathing Techniques (breathing control, thoracic expansion exercises, and forced expiratory technique) with incentive spirometry to promote lung expansion and secretion clearance. Performed multiple times daily during the early postoperative period. |
| Measure | Description | Time Frame |
|---|---|---|
| Forced Expiratory Volume in 1 second (FEV₁) | Assessment of pulmonary function using spirometry parameters including Forced Expiratory Volume in 1 second (FEV₁) to evaluate respiratory recovery after thoracic surgery. | Baseline (preoperative), Postoperative Day 3, and Day 5 |
| Forced Vital Capacity (FVC) | Assessment of pulmonary function using spirometry parameters including Forced Vital Capacity (FVC) to evaluate respiratory recovery after thoracic surgery. | Baseline (preoperative), Postoperative Day 3, and Day 5 |
| Cough Effectiveness | Evaluation of cough effectiveness using the Leicester Cough Questionnaire (LCQ), measuring physical, psychological, and social impact of cough. | Baseline, Postoperative Day 3, and Day 5 |
| Measure | Description | Time Frame |
|---|---|---|
| Sputum Clearance | Measurement of sputum volume to assess effectiveness of airway clearance techniques. | Postoperative Day 3 and Day 5 |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Muhammad Iqbal Tariq, Phd* | Contact | 03338236752 | iqbal.tariq@riphah.edu.pk |
| Name | Affiliation | Role |
|---|---|---|
| Arjumand Bano, MSPT | Riphah International University | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Gulab Devi Hospital or General Hospital Lahore. | Lahore | Punjab Province | 40100 | Pakistan |
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Participants will be randomly assigned into two parallel groups. Group A will receive Active Cycle of Breathing Techniques combined with Incentive Spirometry, while Group B will receive High-Frequency Chest Wall Oscillation. Both groups will receive standard postoperative care and outcomes will be compared between groups.
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Outcome assessors will be blinded to group allocation to reduce assessment bias, while participants and care providers will not be blinded due to the nature of the interventions.
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| High-Frequency Chest Wall Oscillation | Device | A mechanical airway clearance technique delivered using an oscillatory vest that produces high-frequency chest wall vibrations to help mobilize and remove pulmonary secretions. The intervention is administered twice daily beginning on postoperative day 3. |
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| ID | Term |
|---|---|
| D035641 | Chest Wall Oscillation |
| ID | Term |
|---|---|
| D012138 | Respiratory Therapy |
| D013812 | Therapeutics |
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