The Combined effect of Chest Physiotherapy and Respiratory Exercises on Activities of Daily Living on The Patients With Chronic Obstructive Pulmonary Disease

Pulmonary rehabilitation is an important part of the care of patients with respiratory diseases. Although there is enough evidences indicated that the various pulmonary rehabilitation techniques are useful, but less comparative studies about the effectiveness of these techniques has been conducted. The purpose of this study was to compare the effect of chest physiotherapy with and without respiratory exercises on the patients′ ability with chronic obstructive pulmonary disease to perform activities of daily living (ADL). This study is a randomized clinical trial. The study population included patients with COPD who admitted to the internal wards of hospitals affiliated to Yasuj University of Medical Sciences, 2015. Fifty one patients were selected through convenience sampling method, but randomly assigned among three groups of chest physiotherapy, respiratory exercises training and chest physiotherapy with respiratory exercises training. Interventions were performed for fourteen days, three times a day for patients. Data were gathered through questionnaire of the activities daily of life at three times before intervention, one and two weeks after the intervention. The collected data were analyzed using SPSS software using descriptive and inferential statistics such as Kruskal Wallis and Friedman with 95% confidence interval and significance level less than 0.05. The total mean of ADL in chest physiotherapy group before intervention was 43.6 ± 10.1, which increased to 57.1 ± 11.3 and 66.8 ± 8.8, one and two weeks after the intervention, respectively. The average total score of ADL for patients in respiratory exercises training group was 41.1 ± 7.7, 55.1 ± 6.9, and 65 ± 5.9 at three measuring times, respectively. In the group of chest physiotherapy combined with breathing exercises, the mean of ADL increased from 36.6 ± 4.5 (before intervention) to 54.3 ± 4.2 (second time) and to 65.7 ± 3.5 (third time). Although within group comparison for the mean difference in three measurement times indicated an increased ADL after interventions compared with before the intervention in three groups (P = 0.001), however, no statistical significant difference was observed in the effect of three interventions (P = 0.3). The effect of chest physiotherapy combined with respiratory exercises training was the same on the patients′ ability with COPD for performing ADL in comparison with the effect of each one.