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A Randomized Control Trial of Treatment of Bronchial Asthma with Inhaled Salbutamol Combined with Pursed Lip Breathing


Affiliations
1 Department of Cardiovascular Rehabilitation and Preventive Cardiology, Noble Hospital, Pune, India
2 M.A. Rangoonwala College of Physiotherapy and Research, Pune, India
3 Pulmonology Department, Military Hospital, Cardio-Thoracic Centre, Pune, India
4 Department of Cardiovascular Rehabilitation and Preventive Cardiology, Noble Hospital Pune, India
     

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Purpose of the study: To compare immediate and sustained effect of Pursed Lip Breathing (PLB) and Inhaled Salbutamol with Salbutamol alone on Peak Expiratory Flow Rate (PEFR) and Asthma Control Questionnaire (ACQ) in Controlled Asthmatics. Methodology: 60 Asthmatics (30 in interventional group, 30 in control group) were selected for the randomized control trial. On the first day, Pre PEFR was measured and four puffs of Salbutamol were administered using Metered Dose Inhaler (MDI) and Spacer device in both the groups. For 20 minutes, Interventional group was instructed to perform PLB and post PEFR was measured in both the groups. For 1 week, interventional group performed PLB and entire procedure performed on day 1 was repeated. ACQ scores were calculated on day 1 and day 8 in both the groups. Results: The mean increase in PEFR after treatment with Salbutamol and PLB was greater than Salbutalmol alone on day 1 and 8. The Pre PEFR value on Day 8 significantly increased compared to day 1 in the interventional group whereas Control group did not have improvement in Pre PEFR value. ACQ score significantly improved on day 8 in both the groups however on comparing improvement in both the groups, interventional group had a more significant improvement in the score. On comparing improvement in Pre and Post PEFR on day1 and Day 8, it did not differ significantly in individual groups. Conclusion: Performing PLB following inhalation of Salbutamol enhances bronchodilation in Asthmatics. Also PLB has a sustained bronchodilatory effect and resulted in a better control of symptoms of Asthma.

Keywords

Bronchial Asthma, Pursed Lip Breathing, Bronchodilation, Salbutamol, Peak Expiratory Flow Rate
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  • S K Chhabra, Bronchial Asthma; API Textbook for Medicine; Edition 8; volume 1; Section 8; Chapter 5; Pg. no. 355
  • E F Christensen, T Nedergaard and R Dahl; “Long-term treatment of chronic bronchitis with positive expiratory pressure mask and chest physiotherapy”; Chest 1990;97;645-650
  • Christensen EF, Dahl R. ;”Treatment of chronic bronchitis with terbutaline inhaled from a cone spacer with and without positive expiratory pressure”; Lung. 1991;169(6):325-33
  • E Frischknecht-Christensen, O Norregaard and R Dahl; “Treatment of Bronchial Asthma with Terbutaline Inhaled by Conespacer Combined with Positive Expiratory Pressure Mask”; Chest 1991; 100; 317-3221
  • E H Breslin; “The pattern of respiratory muscle recruitment during pursed lip breathing”; Chest 1992;101;75-78
  • E Frischknecht-Christensen, O Norregaard, L W Jensen, R Dahl; “The effects of Inhaled beta 2- agonist and positive expiratory pressure in bronchial asthma. Influences on airway resistance and functional residual capacity”;Chest 1993; 104;1108-1113
  • Nicola Scichilone, Roberto Marchese et al; “Bronchodilatory Effect of deep inspiration is absent in subjects with Mild COPD”; Chest 2004;125;2029-2035
  • Maria Tzoufi, Spyros D. Mentzelopoulos et al, “Effects of Nebulised Salbutamol, External Positive End Expiratory Pressure, and Their Combination on Respiratory Mechanics, Hemodynamics, and Gas Exchange in Mechanically Ventilated Chronic Obstructive Pulmonary Disease Patients”; Anesth Analg 2005;101:843–5
  • Nigro CA, Prieto JE, Kleinert MM, Rhodius EE.; “Effects of inhaled salbutamol on dynamic intrinsic positive end-expiratory pressure in spontaneously breathing patients with stable severe chronic obstructive pulmonary disease”; Med Sci Monit. 2005 Nov;11(11):PI81-5
  • Jadranka Spahija, Michel de Marchie et al; “The effects of imposed pursed lips Brething on respiratory mechanics and Dyspnea at Rest and during Exercise in COPD”; Chest 2005;128; 640-650
  • Annelies M. Slats, Jacob K. Sont et al; “Improvement in Bronchodilation following deep inspiration after a course of high dose oral Prednisone in Asthma”; Chest 2006;130;58-65
  • Gail Dechman, Christine Wilson; “Evidence underlying breathing Retraining in people with stable Chronic Obstructive Pulmonary Disease”; PHYS THER. 2004;84;1189-1197
  • Jennifer Pryor, S Ammani Prasad; Patients’ problem, Physiotherapy management and outcome Measures; Physiotherapy for Respiratory and Cardiac Problems- Adults and Pardiatrics; Fourth Edition; chapter 6; pg. no. 230
  • Jennifer Pryor, S Ammani Prasad;Pulmonary Rehabilitation in Chronic Respiratory disease; Physiotherapy for Respiratory and Cardiac Problems- Adults and Pardiatrics; Fourth Edition; Chapter 13; pg no 453
  • Van der Schans et al; 1995; Mouth pressures during pursed lip breathing. Physiotherapy theory and Practice 11: 29- 34
  • Mueller RE et al, 1970; Ventilation and arterial Blood gas changes induced by Pursed lip breathing. Journal of Applied Physiology28(6):784-789
  • Ingram RH et al; Effect of Pursed lip expiration on the pulmonary pressure flow relationship in obstructive lung diseases; Am Rev Respir Dis 1967; 96:381-88
  • Martin JG et al; Effect of continuous positive airway pressure on respiratory mechanics and pattern of breathing in induced asthma; Am Rev Respir Dis 1982; 126: 812-17
  • Wilson BA et al; Effects of positive end expiratory pressure breathing on exercise induced asthma; Int J Sports Med 1981;2:27-30
  • Groth S et al; Positive expiratory pressure(PEP mask) physiotherapy improves ventilation and reduces volume of trapped gas in cystic fibrosis; Bull Eur Physiopathol Respir 1985; 21:339-43

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  • A Randomized Control Trial of Treatment of Bronchial Asthma with Inhaled Salbutamol Combined with Pursed Lip Breathing

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Authors

Saee Khandagale
Department of Cardiovascular Rehabilitation and Preventive Cardiology, Noble Hospital, Pune, India
Ronika Agrawal
M.A. Rangoonwala College of Physiotherapy and Research, Pune, India
M. S. Barthwal
Pulmonology Department, Military Hospital, Cardio-Thoracic Centre, Pune, India
Devashri Salvi
Department of Cardiovascular Rehabilitation and Preventive Cardiology, Noble Hospital Pune, India

Abstract


Purpose of the study: To compare immediate and sustained effect of Pursed Lip Breathing (PLB) and Inhaled Salbutamol with Salbutamol alone on Peak Expiratory Flow Rate (PEFR) and Asthma Control Questionnaire (ACQ) in Controlled Asthmatics. Methodology: 60 Asthmatics (30 in interventional group, 30 in control group) were selected for the randomized control trial. On the first day, Pre PEFR was measured and four puffs of Salbutamol were administered using Metered Dose Inhaler (MDI) and Spacer device in both the groups. For 20 minutes, Interventional group was instructed to perform PLB and post PEFR was measured in both the groups. For 1 week, interventional group performed PLB and entire procedure performed on day 1 was repeated. ACQ scores were calculated on day 1 and day 8 in both the groups. Results: The mean increase in PEFR after treatment with Salbutamol and PLB was greater than Salbutalmol alone on day 1 and 8. The Pre PEFR value on Day 8 significantly increased compared to day 1 in the interventional group whereas Control group did not have improvement in Pre PEFR value. ACQ score significantly improved on day 8 in both the groups however on comparing improvement in both the groups, interventional group had a more significant improvement in the score. On comparing improvement in Pre and Post PEFR on day1 and Day 8, it did not differ significantly in individual groups. Conclusion: Performing PLB following inhalation of Salbutamol enhances bronchodilation in Asthmatics. Also PLB has a sustained bronchodilatory effect and resulted in a better control of symptoms of Asthma.

Keywords


Bronchial Asthma, Pursed Lip Breathing, Bronchodilation, Salbutamol, Peak Expiratory Flow Rate

References