CHEST PROPRIOCEPTIVE NEUROMUSCULAR FACILITATION WITH OSCILLATORY POSITIVE EXPIRATORY PRESSURE THERAPY VERSUS POSTURAL DRAINAGE WITH OSCILLATORY POSITIVE EXPIRATORY PRESSURE THERAPY FOR FUNCTIONAL CAPACITY, DYSPNEA, AND PEAK EXPIRATORY FLOW RATE IN ST

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is a progressive, largely preventable respiratory condition marked by persistent airflow limitation, chronic dyspnea, impaired secretion clearance, and reduced exercise capacity. Airway clearance strategies such as chest proprioceptive neuromuscular facilitation (PNF), postural drainage, and oscillatory positive expiratory pressure (OPEP) devices such as the Acapella are widely used in pulmonary rehabilitation, yet direct comparative evidence for combining chest PNF or postural drainage with an OPEP device remains limited. Objective: To compare the effectiveness of chest PNF combined with an Acapella device against postural drainage combined with an Acapella device on functional capacity, dyspnea, peak expiratory flow rate (PEFR), and arterial oxygen saturation (SpO₂) in patients with stable COPD. Methods: In this randomized, comparative, pre-post interventional trial, 60 patients with stable, moderate COPD were allocated by simple random (chit) sampling to two equal groups. Group A (n = 30) received chest PNF six days a week (twice daily) together with Acapella therapy five days a week, while Group B (n = 30) received postural drainage six days a week (twice daily) with the same Acapella regimen, over a one-week intervention period. Functional capacity (six minute walk test, 6MWT), dyspnea (modified Medical Research Council [mMRC] scale), PEFR, and SpO₂ were recorded before and after intervention. Between-group differences were analyzed using the independent-samples t-test and within group change using repeated-measures ANOVA; gender distribution was compared using the chi-square test (α = 0.05). Results: The two groups were comparable at baseline for age and gender (p > 0.05). Both groups improved significantly from pre- to post-intervention across all four outcomes (p < 0.001). On between-group comparison, Group A showed significantly greater post-treatment gains than Group B in PEFR (209.00 ± 37.91 vs 189.00 ± 31.44 L/min; improvement 82.67 ± 25.18 vs 69.67 ± 21.09 L/min, p = 0.034), SpO₂ (96.70 ± 1.74% vs 95.83 ± 1.49%, p = 0.043), and mMRC dyspnea score (0.80 ± 0.71 vs 1.47 ± 0.63, p < 0.001). Improvement in 6MWT distance was significant within both groups but did not differ significantly between them (p = 0.398). Conclusion: Both chest PNF with Acapella and postural drainage with Acapella produced clinically meaningful improvement in pulmonary and functional outcomes in stable COPD. Chest PNF combined with Acapella conferred an additional advantage over postural drainage with Acapella in reducing dyspnea and improving expiratory flow and oxygen saturation, suggesting it may be the preferable adjunct in short-term pulmonary rehabilitation protocols.