Methods
Patients meeting the diagnostic criteria of bronchiectasis and undergoing medical treatment were selected by convenience. A sample size of 16 is required to detect a difference of at least 3.8 g (4.23), with 90% power, using a-value of 0.05 and a two-tailed test (6). All participants gave written informed consent and were evaluated for their cardiopulmonary status. Patients between 20 and 60 years who were diagnosed to have non-cystic bronchiectasis by a certified chest physician, and those presenting with mild to moderate degree of obstructive or restrictive pattern on PFTwere included in the study. Both the procedures the patients would be undergoing were explained to them in detail in their own language. Patients were instructed to take their medications like sympathomimetics, short-and long-acting bronchodilators, and steroids, where applicable, at least 1 h before treatment and at the same hour on both study days. Patients were also refrained from taking any hot fluids or food materials that can affect the airway clearance for at least 2 h prior to either of the treatment arms. Patients with history of hemoptysis in the past 24 h, surgical treatment for bronchiectasis, cardiovascular instability or symptoms that are acute in nature and contraindicate either of the techniques used were excluded from the study. Patients who could not understand the given instructions were also kept under exclusion criteria. After screening for inclusion and exclusion criteria, the patients included into the study were put to a pre-therapy PFT using Schiller SP1 Portable Spirometer, Germany. Patients were given clear instructions and demonstration of the PFT technique in a sitting position. Instructions given were as per the American Thoracic Society guidelines and were given 1 h prior to the procedure. Patients were allowed to practice for six to eight times during the training for PFT. Baseline data of PFT measures was collected before administration of therapy. Three efforts were allowed and the best of the three values was considered. The sequence of therapy (conventional/ACBT) was randomized using a simple lottery method. Patients acted as their own controls and undertook both treatments. Patients were exposed for both conventional therapy and ACBT with a minimum rest period of 12 h between the exposures. Patients underwent conventional chest physical therapy as the first intervention on day 1 followed by the postural drainage plus ACBTs on the second day. Patients were crossed over for the first therapy. Patients were positioned for 1015 min in postural drainage positions as per the evaluation before each therapy. Treatment duration for either therapy was set as 2030 min every 3 h during the waking hours. Approximately 1 h was allocated per session. Both the therapies were administered by the same physiotherapist.
วิธี Patients meeting the diagnostic criteria of bronchiectasis and undergoing medical treatment were selected by convenience. A sample size of 16 is required to detect a difference of at least 3.8 g (4.23), with 90% power, using a-value of 0.05 and a two-tailed test (6). All participants gave written informed consent and were evaluated for their cardiopulmonary status. Patients between 20 and 60 years who were diagnosed to have non-cystic bronchiectasis by a certified chest physician, and those presenting with mild to moderate degree of obstructive or restrictive pattern on PFTwere included in the study. Both the procedures the patients would be undergoing were explained to them in detail in their own language. Patients were instructed to take their medications like sympathomimetics, short-and long-acting bronchodilators, and steroids, where applicable, at least 1 h before treatment and at the same hour on both study days. Patients were also refrained from taking any hot fluids or food materials that can affect the airway clearance for at least 2 h prior to either of the treatment arms. Patients with history of hemoptysis in the past 24 h, surgical treatment for bronchiectasis, cardiovascular instability or symptoms that are acute in nature and contraindicate either of the techniques used were excluded from the study. Patients who could not understand the given instructions were also kept under exclusion criteria. After screening for inclusion and exclusion criteria, the patients included into the study were put to a pre-therapy PFT using Schiller SP1 Portable Spirometer, Germany. Patients were given clear instructions and demonstration of the PFT technique in a sitting position. Instructions given were as per the American Thoracic Society guidelines and were given 1 h prior to the procedure. Patients were allowed to practice for six to eight times during the training for PFT. Baseline data of PFT measures was collected before administration of therapy. Three efforts were allowed and the best of the three values was considered. The sequence of therapy (conventional/ACBT) was randomized using a simple lottery method. Patients acted as their own controls and undertook both treatments. Patients were exposed for both conventional therapy and ACBT with a minimum rest period of 12 h between the exposures. Patients underwent conventional chest physical therapy as the first intervention on day 1 followed by the postural drainage plus ACBTs on the second day. Patients were crossed over for the first therapy. Patients were positioned for 1015 min in postural drainage positions as per the evaluation before each therapy. Treatment duration for either therapy was set as 2030 min every 3 h during the waking hours. Approximately 1 h was allocated per session. Both the therapies were administered by the same physiotherapist.
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