EFFECTIVENESS OF THORACIC EXPANSION EXERCISE OVER RESPIRATORY MUSCLE ENERGY TECHNIQUE IN IMPROVING PEAK EXPIRATORY FLOW RATE IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE PATIENTS

Abstract

Background: Airflow obstruction is the defining physiological abnormality of chronic obstructive
pulmonary disease (COPD) and peak expiratory flow rate (PEFR) is a simple, reproducible
bedside measure of airflow obstruction. Whether an active chest-mobility exercise or a manual
muscle-energy technique better restores expiratory flow has not been well established.
Objective: To compare the effect of thoracic expansion exercise (TEE) and respiratory muscle
energy technique (RMET) on peak expiratory flow rate in patients with COPD.
Methods: Eighty COPD patients were randomly allocated by chit method into Group A (n=40,
TEE) and Group B (n=40, RMET). Both groups received a 30-minute session daily, five days a
week, for 12 weeks. PEFR was measured at week 0, 4, 8 and 12 with a peak flow meter.
Results: Both groups showed a highly significant week-wise rise in PEFR (Group A: F=92.43,
p<0.001; Group B: F=143.59, p<0.001). Between-group comparison was significant at every time
point, including baseline (week 0: t=6.158, p<0.001; week 4: t=9.962, p<0.001; week 8: t=14.079,
p<0.001; week 12: t=13.529, p<0.001; overall: t=12.124, p<0.001), with Group B consistently
outperforming Group A.
Conclusions: TEE and RMET both result in significant improvements in PEF over 12 weeks in
COPD patients, with a consistently, and significantly larger, improvement in PEF seen with
RMET during the treatment period.