Effects of Acapella versus Blow Bottle Positive Expiratory Pressure on Airway Clearance and Peak Expiratory Flow Rate in Post-Covid-19 Patients
Main Article Content
Abstract
Background: The COVID-19 pandemic has led to significant respiratory complications in affected individuals. Positive Expiratory Pressure (PEP) devices, specifically Acapella and blow bottle devices, have been widely used in respiratory rehabilitation, particularly in patients with pulmonary diseases and post-surgical respiratory complications. However, their efficacy in post COVID-19 patients has been less explored.
Objective: This study aimed to compare the effectiveness of Acapella and blow bottle devices in improving oxygen saturation, peak expiratory flow rate, shortness of breath, and six-minute walk distance in post COVID-19 patients.
Methods: This randomized clinical trial was conducted at Tehsil hospital Kot Addu over six months. Forty-eight post COVID-19 patients were divided equally into two groups: one group received treatment with the Acapella device, and the other with a blow bottle device. Baseline and post-treatment measurements of oxygen saturation, peak expiratory flow rate, and six-minute walk distance were recorded using a pulse oximeter, peak expiratory flow meter, and six-minute walk test, respectively.
Results: On day 1, the Acapella group showed a mean oxygen saturation rank of 20.98 with a sum of ranks of 503.50 (p=0.79), while the Blow Bottle group had a mean rank of 28.02 and a sum of ranks of 672.50. By day 7, the Acapella group's mean rank was 17.31 (sum of ranks = 415.50, p=0.000) compared to the Blow Bottle group's 31.69 (sum of ranks = 760.50). For peak expiratory flow rate, no significant differences were found between the groups at day 1 (Acapella: mean rank = 28.06, sum of ranks = 673.50, p=0.078; Blow Bottle: mean rank = 20.94, sum of ranks = 502.50) and day 7 (Acapella: mean rank = 23.77, sum of ranks = 570.50, p=0.717; Blow Bottle: mean rank = 25.23, sum of ranks = 605.50). Similar trends were observed in the six-minute walk test results.
Conclusion: The study found that both Acapella and blow bottle devices effectively improve oxygen saturation in post COVID-19 patients, but do not significantly affect peak expiratory flow rate, shortness of breath, and six-minute walk distance. These findings suggest that while these devices are beneficial for enhancing oxygenation, a more comprehensive respiratory rehabilitation approach is necessary for addressing the full spectrum of respiratory complications in post COVID-19 patients.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
Velavan TP, Meyer CG. The COVID‐19 epidemic. Tropical medicine & international health. 2020;25(3):278.
Yuki K, Fujiogi M, Koutsogiannaki S. COVID-19 pathophysiology: A review. Clinical immunology. 2020;215:108427.
Daniel SJ. Education and the COVID-19 pandemic. Prospects. 2020;49(1):91-6.
Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus–infected pneumonia in Wuhan, China. Jama. 2020;323(11):1061-9.
Saqlain M, Munir MM, Ahmed A, Tahir AH, Kamran S. Is Pakistan prepared to tackle the coronavirus epidemic? Drugs & Therapy Perspectives. 2020;36(5):213-4.
Raza S, Rasheed MA, Rashid MK. Transmission potential and severity of COVID-19 in Pakistan. 2020.
Apriliana D. Peranan Incentive Spirometry Terhadap Kapasitas Exercise, Gejala Sesak Napas, Tingkat Depresi, dan Kualitas Hidup pada Penderita Kanker Paru Karsinoma Bukan Sel Kecil Dengan Pengobatan Kemoterapi: UNS (Sebelas Maret University); 2020.
Ciotti M, Ciccozzi M, Terrinoni A, Jiang W-C, Wang C-B, Bernardini S. The COVID-19 pandemic. Critical reviews in clinical laboratory sciences. 2020;57(6):365-88.
Watkins J. Preventing a covid-19 pandemic. British Medical Journal Publishing Group; 2020.
Shi Y, Wang G, Cai X-p, Deng J-w, Zheng L, Zhu H-h, et al. An overview of COVID-19. Journal of Zhejiang University-SCIENCE B. 2020;21(5):343-60.
Zaim S, Chong JH, Sankaranarayanan V, Harky A. COVID-19 and multiorgan response. Current problems in cardiology. 2020;45(8):100618.
Sousa G, Garces T, Cestari V, Florêncio R, Moreira T, Pereira M. Mortality and survival of COVID-19. Epidemiology & Infection. 2020;148.
Esendağli D, Yilmaz A, AKÇAY MŞ, Özlü T. Post-COVID syndrome: pulmonary complications. Turkish journal of medical sciences. 2021;51(7):3359-71.
Kilinc E, BARANOĞLU Y. Mast cell stabilizers as a supportive therapy can contribute to alleviate fatal inflammatory responses and severity of pulmonary complications in COVID-19 infection. Anatolian Clinic the Journal of Medical Sciences. 2020;25(Special Issue on COVID 19):111-8.
Silverman DA, Lin C, Tamaki A, Puram SV, Carrau RL, Seim NB, et al. Respiratory and pulmonary complications in head and neck cancer patients: Evidence‐based review for the COVID‐19 era. Head & Neck. 2020;42(6):1218-26.
Ahmed OF, Amin BJH, Abdullah BA, Hassan MN, Salih RQ, Mohammed SH, et al. Post COVID-19 pulmonary complications; a single center experience. Annals of Medicine and Surgery. 2021;72:103052.
Mahadik AS, Das AK, Diwate AD, Nagargoje AK. The comparison between blow bottle positive expiratory pressure (BBPEP) device versus acapella on oxygenation and peak expiratory flow rate (PEFR) among patients with open heart surgery-a comparative study. 2021.
Mahadik AS. IMMEDIATE EFFECT OF BLOW BOTTLE POS OXYGEN SATURATION IN PATIENTS W. Age.49(66.8):47.8-65.3.
Liverani B, Nava S, Polastri M. An integrative review on the positive expiratory pressure (PEP)‐bottle therapy for patients with pulmonary diseases. Physiotherapy Research International. 2020;25(1):e1823.
Shamakh M, Badr N, El-Batanouny M, Shendy M. Acapella versus hand-held positive expiratory pressure on Pulmonary functions in management of chronic obstructive Pulmonary diseases. Journal of Advanced Pharmacy Education & Research| Apr–Jun. 2020;10(2).
Jage B, Thakur A. Effectiveness of Acapella along with institutional based chest physiotherapy techniques on pulmonary functions and airway clearance in post-operative CABG patients. Hong Kong Physiotherapy Journal. 2022:1-9.
Hichkad S, Ganesh B. Effect of blow bottle device and flutter on functional capacity, dyspnea, fatigue, and peak expiratory flow rate in mild-to-moderate COPD patients: A comparative study. Indian Journal of Respiratory Care. 2021;10(3):294.
Olsén MF, Olofsson P, Frejd P, Lannefors L, Westerdahl E. Technical aspects of devices and equipment for positive expiratory pressure with and without oscillation. Respiratory care. 2021;66(5):862-77.
Badgujar KC, Badgujar AB, Dhangar DV, Badgujar VC. Importance and use of pulse oximeter in COVID-19 pandemic: general factors affecting the sensitivity of pulse oximeter. Indian Chemical Engineer. 2020;62(4):374-84.
Shilpa N, Veena H. Peak flow meter and digital spirometer: A comparative study of peak expiratory flow rate values. National Journal of Physiology, Pharmacy and Pharmacology. 2020;10(6):508-.
Noormohammadpour P, Abolhasani M. Besides other signs, can a 6-min walk test be applied as a criterion for going to the hospital with a diagnosis of COVID-19? Frontiers in Emergency Medicine. 2020;4(2s):e42-e.
Banerjee D, Kamuren J, Baird GL, Palmisciano A, Krishnan I, Whittenhall M, et al. The Modified Borg Dyspnea Scale does not predict hospitalization in pulmonary arterial hypertension. Pulmonary Circulation. 2017;7(2):384-90.
Chaudhary S, Chaudhary NI, Ghewade B, Mahajan G. The Immediate Effects of Breathing Exercises with Acapella and Incentive Spirometer on Preventing Early Pulmonary Complications Following Cabg.-A Comparitive Study. International Journal of Current Research and Review. 2020;12(17):51-8.