Effects of Positive Expiratory Pressure Breathing on Functional Outcomes in patients with Chronic Obstructive Pulmonary Disease after Major Abdominal Surgeries: Randomized Controlled Trial

Introduction: Disturbances in pulmonary function (PF), blood gases and functional capacity (FC) are most common postoperative complications in patients with chronic obstructive pulmonary disease (COPD). Methods: 44 COPD patients with major abdominal surgeries were randomly assigned into group-A received Positive Expiratory Pressure Breathing (PEPB) plus Traditional Physical Therapy program (TPTP) or group-B received TPTP only. Results: Forced vital capacity (FVC), forced expiratory volume in one second (FEV1), arterial oxygen pressure (PaO2), carbon dioxide pressure (PaCO2) and six minute walk test (6MWT) were evaluated pre-operative (baseline), one week post-surgical (midpoint) and after 4 weeks. At the end of the study; FVC and percentage of improvement (%) for the groups A and B were 2.55 ± 0.5 L, (30.97 %) and 2.03 ± 0.34 L, (10.65 %) respectively. FEV1 and (%) for the groups A and B were 1.56 ± 0.34 L, (18.82 %) and 1.36 ± 0.25 L, (9.13 %) respectively. PaO2 and (%) for the groups A and B were 69.58 ± 3.38 mmHg, (12.12 %) and 64.86 ± 2.88 mmHg, (4.07 %) respectively. PaCO2 and (%) for the group A and B were 41.61 ± 2.76 mmHg, (6.63 %) and 43.19 ± 2.16 mmHg, (2.7 %) respectively. 6MWT and (%) for the group A and B were 352.13 ± 43.82 m, (41.92 %) and 312.62 ± 44.58 m, (25.99 %) respectively. Conclusions: PEPB program is effective in improving PF, arterial blood gases and FC in COPD patients with major abdominal surgeries.