Blow Bottle Technique Along With Percussion and Diaphragmatic Breathing in Patients With Community Acquired Pneumonia
Main Article Content
Abstract
Background: Community-acquired pneumonia may impair ventilation, airway clearance, pulmonary function, and respiratory symptoms. Positive expiratory pressure generated through blow bottle breathing may provide additional benefit when combined with conventional respiratory physiotherapy. Objective: To compare the effects of blow bottle technique added to percussion and diaphragmatic breathing with percussion and diaphragmatic breathing alone in patients with community-acquired pneumonia. Methods: This randomized clinical trial included 28 patients at The University of Lahore Teaching Hospital, Lahore, allocated equally to Group A (percussion plus diaphragmatic breathing) or Group B (blow bottle technique plus percussion and diaphragmatic breathing). Treatment was administered twice daily for one week. FVC, FEV1, FEV1/FVC ratio, PEF, and Breathlessness, Cough and Sputum Scale (BCSS) scores were assessed at baseline and post-treatment. Data were analyzed using IBM SPSS Statistics version 26.0, with p<0.05 considered statistically significant. Results: Baseline outcomes were comparable between groups. Group B demonstrated greater changes in pre-bronchodilator FVC (between-group difference 0.281 L; 95% CI 0.243–0.318; p<0.001), FEV1 (0.297 L; 95% CI 0.256–0.338; p<0.001), and PEF (56.786 L/min; 95% CI 50.423–63.148; p<0.001). Total BCSS reduction was also greater in Group B by 1.786 points (95% CI 0.863–2.708; p<0.001). Conclusion: Adding blow bottle therapy to percussion and diaphragmatic breathing produced greater short-term improvements in pulmonary function and respiratory symptoms than percussion and diaphragmatic breathing alone
Article Details
Issue
Section
This work is licensed under a Creative Commons Attribution 4.0 International License.
How to Cite
References
1. Waterer G. What is pneumonia? Breathe. 2021;17(3).
2. Lim WS. Pneumonia—overview. Encyclopedia of Respiratory Medicine. 2021:185.
3. Chen X, Jiang J, Wang R, Fu H, Lu J, Yang M. Chest physiotherapy for pneumonia in adults. Cochrane Database Syst Rev. 2022;(9).
4. Mohamed NR, Ahmed SM, Mohammed MH, Sayed YM. Effect of chest percussion post nebulizer on respiratory status among infants with pneumonia. Minia Sci Nurs J. 2023;14(1):13-22.
5. Wibowo DA, Pramusinta L. Effectiveness of chest physiotherapy with thoracic expansion exercise (TEE) in pneumonia patients. Physiother Phys Rehabil J. 2022;1(1):15-20.
6. Kubo T, Osuka A, Kabata D, Kimura M, Tabira K, Ogura H. Chest physical therapy reduces pneumonia following inhalation injury. Burns. 2021;47(1):198-205.
7. Liverani B, Nava S, Polastri M. An integrative review on the positive expiratory pressure (PEP)-bottle therapy for patients with pulmonary diseases. Physiother Res Int. 2020;25(1).
8. Cadorin TH, Cardoso J, Castilho T, Ducati GC, Wamosy RMG, Schivinski CIS. Blowing devices, resources and incentive screens during respiratory physiotherapy: a systematic review. BMC Pulm Med. 2025;25(1):459.
9. Khar MN, Kausar R, Akbar R, Khan MRI, Huda NU, Yousaf G, et al. Effects of Acapella versus blow bottle positive expiratory pressure on airway clearance and peak expiratory flow rate in post-COVID-19 patients. J Health Rehabil Res. 2024;4(1):161-6.
10. Afzal S, Shahzad J, Majeed R. Blow bottle and percussion techniques in patients with chronic obstructive pulmonary disease. Link Med J Health Community Res. 2024;2(1):37-43.
11. Anjum H, Farooq N, Sheraz S, Saqulain G, Adnan H. Post-laparotomy pulmonary complications in blow bottle versus interdigital breathing technique: a quasi-experimental study. Pak Armed Forces Med J. 2024;74(4):1088.
12. Liu H, Wiedman CM, Lovelace-Chandler V, Gong S, Salem Y. Deep diaphragmatic breathing—anatomical and biomechanical consideration. J Holist Nurs. 2024;42(1):90-103.
13. Yoon JM, Im SC, Kim K. Effects of diaphragmatic breathing and pursed lip breathing exercises on the pulmonary function and walking endurance in patients with chronic stroke: a randomised controlled trial. Int J Ther Rehabil. 2022;29(8):1-11.
14. Fargaly AAEA, Bahgat RSY, Shrshor SMES. Effect of Buteyko breathing technique versus diaphragmatic breathing on clinical outcomes for children with lower respiratory tract infection. Tanta Sci Nurs J. 2023;28(1):109-23.
15. Ahmad M, Afzal S, Amjad N, Batool M, Kausar R, Fatima N. Comparison effects of postural drainage and positive expiratory pressure technique in community acquired pneumonia. J Health Rehabil Res. 2023;3(2):370-5.
16. Rutkauskienė L, Kubilius R, Tamošuitis T. Early mobilization, breathing exercises and chest wall oscillation in patients with bilateral pneumonia disease in the intensive care unit: a randomized clinical trial. BMC Pulm Med. 2025;25(1):20.
17. Sun J, Chen J, Wang L, Lu A. The effect of vibrating positive expiratory pressure therapy on refractory Mycoplasma pneumoniae pneumonia prognosis in children. Transl Pediatr. 2021;10(2):315-22.
18. Hassan AK, Elnahas NG, Soliman YM, Ghaleb HA. Effect of lung breather on hospital stay in patients with acquired pneumonia: a randomized clinical study. Bull Rehabil Med. 2024;23(2):17-24.
19. Saleh MM, Said MT, Elsawy SB, Adawy ZR, Shehata AI, AbdElkareem TS, et al. A randomized controlled trial of the diaphragmatic manual therapy on respiratory and cardiovascular functions in severe pneumonia patients. J Angiother. 2024;8(5):1-18.