The participants in this group will be instructed to sit comfortably with the neck slightly extended and clear the upper airways by huffing or blowing the nose. Autogenic drainage begins with slow diaphragmatic breathing at low lung volumes, followed by a 3-second pause and gentle high-velocity expiration with an open glottis. As secretions move upward, breathing gradually shifts to medium and high lung volumes until mucus reaches the trachea for expectoration. The cycle of breathing exercises is repeated for 15-20 minutes while suppressing unnecessary coughing.

The participant in this group will be instructed to sit comfortably while leaning forward with elbows supported and the neck slightly extended to open the airway. The flutter device is held horizontally with a slight upward tilt and placed in the mouth. The patient inhales slowly through the nose, holds the breath for 3-5 seconds, and exhales through the flutter device slightly faster than normal. After 4-8 breaths, a deep inhalation followed by forced expiration through the device helps mobilize secretions. Breathing control is maintained, followed by coughing or huffing if needed. The procedure is repeated for 10-15 minutes.