Role Of Physiotherapy In Pulmonary Diseases

Dr Sulbha Chawla, MPT (CP & IC)

2018-02-04 10:24:09



Pulmonary diseases account for 10% hospitalization and 16% deaths in developed countries and rate is high in developing countries, diseases can be in any form mild that is cold or in severe form. Pulmonary diseases are further divided depending upon the pattern of symptoms or cause of disease they are divided into obstructive lung diseases; restrictive lung diseases.

The Global initiative for chronic obstructive lung disease (GOLD 2009) classified chronic obstructive pulmonary disease as “preventable and treatable disease with some significant extra pulmonary effects that may contribute to the severity in individual patients. Its pulmonary component is characterized by airflow a limitation that is not fully reversible. The airflow limitations are usually progressive and associated with an abnormal inflammatory response to noxious particles or gases.

Restrictive lung diseases (or restrictive ventilator defects) are a category of extra pulmonary, pleural, or parenchyma respiratory diseases that restrict lung expansion resulting in a decreased lung volume, an increased work of breathing, and inadequate ventilation and/or oxygenation.

In India, it is recognized as a major health problem. As per the WHO/World Bank Global Burden of Disease Study, the Indian prevalence was 4.4 and 3.4 per 1000 against the world prevalence of 9.3/1000 and 7.3/1000 men and women respectively it is said to be men dominated disease According to recent guidelines, the prevalence of pulmonary diseases nowadays is considerably higher than reported earlier in ages of over 45 years.

Symptoms of pulmonary disease include cough, sputum production, and shortness of breath, especially with exercise, wheezing when subject breathe in, and tightness in the chest, dyspnoea and productive cough, variable or increased heart rate due to impaired cardiac autonomic control of heart due to weakness of inspiratory muscles causing impaired vagal tone, it is therefore necessary to strengthen inspiratory muscles to regulate the vagal tone therefore  inspiratory muscle trainer that is spring loaded is used for strengthening of inspiratory muscles.

To relieve the symptoms and physical limitations of patients with pulmonary disease, physical therapists teaches breathing exercises in the form of diaphragmatic breathing (DB), pursed-lip breathing (PLB), thoracic expansion technique and postural drainage a combination of these patterns.

There is lack of dearth of literature regarding outcome given in form of   Inspiratory muscle training, rib raising/springing and other. That’s why this study is design to find a better tool or pulmonary rehab program for management of pulmonary diseases.

Epidemiological data shows that the pulmonary diseases are going to be leading cause of morbidity and mortality. During coarse of disease it shows complication with Reduced thoracic mobility, manipulative techniques such as Rib raising technique and Muscle strengthening techniques are minimally used in patients with pulmonary disease, due to lack of research work done, so this research study may help in providing the better protocol and benefits to patients in providing thoracic mobility and improving quality of life and for the better health management. Comparative effect of Inspiratory muscle training with conventional therapy would be better than rib raising with conventional physiotherapy in pulmonary diseases.