Positive expiratory pressure devices training versus the active cycle of breathing techniques in dyspnoeic patients

Abstract

Background: Dyspnoea, commonly referred to as shortness of breath, is the subjective sensation of uncomfortable breathing comprised of varying intensity. The human body cannot function or sustain life without the process of breathing. If this process is not as efficient as it should be, complications which may arise will surely cause damage and trauma to the body, eventually diminishing one’s quality of life. Therefore, effective treatment options are of major importance and considered to be a priority. Research question: Does PEP training show improvement in symptoms when compared to ACBTs with dyspnoeic patients? PICO elements: Population (P): Adult patients suffering from various respiratory conditions that ultimately lead to dyspnoea, Intervention (I): PEP devices, Comparison (C): ACBTs, Outcome (O): Reduced perceived dyspnoeic levels. Keywords were extracted from the PICO elements, which were used in conjunction with Boolean operators and limiters as search tools. Inclusion and Exclusion Criteria: Studies which focused on recording changes in perceived level of dyspnoea in respiratory patients, with ACBTs and PEP devices as interventions, were included in the study. Studies which focused on patients suffering from other medical issues, where dyspnoea was not measured, and neither ACBT nor PEP devices used as interventions, were excluded from this study. Results: Five randomised control trials (RCTs) were critically appraised through the use of the CASP tool (2020) for RCTs. Three out of five RCTs concluded that PEP devices (Acapella and Flutter) were more significantly effective in reducing dyspnoeic level in respiratory patients. Conclusion: Two out of five key articles showed that PEP devices were more significantly effective, demonstrating that there is no significant difference in perceived dyspnoea when using either PEP devices or ACBTs, with dyspnoea patients. Recommendations and Implications: Further local research must be conducted, along with other implications including study design, recruitment and follow up, as well as the local documentation of statistics, education and local public awareness.