Effect of Intercostal Stretch on Respiratory Function in Mechanically Ventilated Patients: A Randomized Controlled Trial

Authors

1 Cairo university

2 PhD and professor Internal Medicine Department, Faculty of Medicine, Al-Azhar University

3 PhD and Associate professor Department of Cardiovascular Disorder and Geriatrics, Physical Therapy Faculty, Cairo University

Abstract

Background: As an adjuvant treatment to help clear the airways and encourage 
productive coughing, chest physical therapy, or CPT, has been used extensively. 
Proprioceptive neuromuscular facilitation (PNF) techniques use large-scale, three dimensional spiral resistive exercises to increase the strength of the respiratory muscles.
Purpose: This study aimed to look into how diaphragmatic proprioceptive neuromuscular 
facilitation (DPNF) of the intercostal stretch type affected the respiratory function of 
patients on mechanical ventilation. Methods: Forty male patients, aged 50–60, with acute 
exacerbation of chronic obstructive pulmonary disease (AECOPD) were included in this 
randomized controlled trial. They were placed in pressure support mode on a mechanical 
ventilator and divided into two equal groups (n = 20) at random. The study group (A) 
received the DPNF technique in addition to regular medical care and chest physical 
therapy (percussion, shaking, and mobilization), while the control group (B) only received 
regular medical care and chest physical therapy, which includes percussion, shaking, and 
mobilization. Study variables included arterial blood gases (ABGs), such as PaO2 and 
PaCO2, which were measured before and after treatment over a period of five to seven 
days. Results: Within-group statistical analysis, both groups (A) and (B) showed 
significant increase of PaO2 and significant decrease of PaCO2 post-treatment compared 
to pretreatment mean values. While, between-group statistical analysis showed a 
significant difference in posttreatment mean values of PaCO2 only between groups (A) 
and (B) in favor of group (A). with a post-study confidence interval for PaO2 of -2.7 (-
8.1, 2.7) and an effect size of 0.026, and for the post-study confidence interval for PaCO2 
of -3.4 (-6.1, -0.7) and an effect size of 0.146. Conclusion: In mechanically ventilated 
patients experiencing an AECOPD, intercostal stretch-type diaphragmatic proprioceptive 
neuromuscular facilitation (DPNF) was an effective strategy to improve respiratory 
function as an adjunctive technique to routine medical treatment and chest physiotherapy.

Keywords

Benha International Journal of Physical Therapy
Volume 2, Issue 2
December 2024
Pages 63-70

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