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Autogenic 1 PDF
Autogenic 1 PDF
ISSN 1818-4952
IDOSI Publications, 2012
DOI: 10.5829/idosi.wasj.2012.20.06.71125
1
College of Applied Medical Sciences,
Departmant of Rehabilitation Sciences,
King Saud University, Riyadh, 11433, Saudi Arabia
2
Clinical Therapist, Department of Physical Therapy, Mohali, India
Abstract: Airway clearance is integral to the management of COPD, yet there is no evidence as to the optimal
modality. This study was conducted to compare the efficacy of two chest clearance techniques, autogenic
drainage and active cycle breathing in COPD patients.Thirty subjects who were 40 - 60 years of age and had
moderate chronic obstructive pulmonary disorder were allocated randomly into three groups, each consisting
of 10 subjects. Group A received autogenic drainage, group B was givenactive cycle breathing technique and
group C received medications. The treatment duration was 5 days per week for 4 weeks. The outcome measure
used was computerized spirometer to evaluate pre& post test values of forced expiratory volume (FEV1), forced
vital capacity (FVC) and peak expiratory flow rate (PEFR). There was significant improvement in FVC, FEV 1&
PEFR values in both A and B groups when compared to group C patients who received only medications with
no additional breathing techniques. But there was no statistical significant difference in FVC, FEV1& PEFR
values between the groups A and B.The results of this study revealed that both autogenic drainage and active
cycle breathing technique are effective in clearance of secretions, which is one of the causes of airway
obstruction in patients with COPD.
Key words: Chronic Obstructive Pulmonary Disease Chest Clearance Pulmonary Rehabilitation Airway
Clearance
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World Appl. Sci. J., 20 (6): 818-822, 2012
unsticking, collecting and evacuating phases. At the end Table 1: Demographic characteristics of groups A, B and C
of the session the mucus was evacuated by a stronger Group A Group B Group C
expiration or a high volume huff. The duration of the (n=10) (n=10) (n=10) F value
session depends on the amount and viscosity of the Age (Yrs) 50.45.52 50.95.5 50.65.7 .0153*
secretions. Height (mts) 162.16.0 162.26.08 163.36.12 .1201*
Weight (Kgs) 57.55.58 57.45.71 57.65.56 .0025*
Group B (ACBT): The active cycle of breathing includes *there was no significant difference at the 0.05 level
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World Appl. Sci. J., 20 (6): 818-822, 2012
in the values of FVC, FEV1& PEFR in group A, that The present study undertaken included patients
received autogenic drainage technique and group B that who had moderate chronic obstructive pulmonary
received active cycle of breathing as compared to group disease especially the age group between 40-60 years
C subjects who were only on medications. But there is and who didnt have any other pulmonary or cardiac
no statistical significant difference in the values of FVC, complications, hence this study can be generalized only
FEV1& PEFR between group A and B. to moderate chronic obstructive pulmonary disease
In the present study, AD was given including a patients. Although many treatment methods are
three-phase breathing exercise. The gradually increasing currently in vogue in order to deal these kind of
inspiratory and expiratory reserve volumes from patients, there is an emergent need of applying the
functional residual capacity and a 2 to 3 second right technique which suits the patients need .The
breath-holding period may have resulted in collateral growing demand for meeting various problems associated
filling among the alveoli and improved ventilation and with pulmonary complications are indeed worth
mobilized secretions [14]. considering.
Researchers had done a systemic review on evidence Although the AD technique was more difficult
for Airway clearance physical therapy training in Cystic for patients to learn, once patients used the technique
fibrosis. They concluded that there was some evidence to correctly it was found to be effective. The ACBT
support the physical therapy technique like ACBT, AD application was quite simpler than AD. However, no
etc and no evidence to discourage their inclusion [14]. single technique may be best for every patient.
Previous studies done to compare the effect of AD and Each patient should be assessed to determine the
ACBT on SaO2, PaO2 and dyspnoea in COPD patients most appropriate and effective technique. The
concluded that AD is as effective as ACBT in clearing implications of present study can be important in
secretions and improving lung function. A number of designing a training program for COPD patients to
randomized, controlled trials have demonstrated improve the lung volumes mainly FEV1, FVC & PEFR
consistently that Autogenic drainage & Active cycle and removal of the secretions. Both the techniques are
breathing technique improves the lung volumes but safe and equally effective in chest clearance and easy to
there is no significant difference between the techniques use by the patients.
[15-18]. This study used only three tools in detecting the
Previous studies showed that the improvement in improvement in moderate chronic obstructive pulmonary
oxygenation with AD is unlikely related to mucus clearing, patients, studies can be done with other parameters like
although improved matching of ventilation to perfusion rate of perceived exertion and arterial blood gas analysis.
may occur because of redistribution of airway secretions. The comparison between active cycle of breathing
In addition, thoracic expansion exercises used in the technique and autogenic drainage and other training
ACBT provide communication among the alveoli, improve modes like incentive spirometry can be studied, as the
ventilation and allow air to flow behind the bronchial latter is also concerned with the better outcome in recent
secretions. The underlying mechanism may be that AD studies. As this study was done only with age group
and ACBT used in present study improved lung function between 40-60years, study of all age groups can be
by ensuring collateral ventilation in segments of lungs undertaken for a better knowledge of treatment outcome
which were not previously involved in ventilation [19]. in the future research.
airway clearance techniques reported clinical benefits like
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