Combined Effects of Balloon Blowing Therapy with Percussion on Pulmonary Functions in Patients with Pneumonia
DOI:
https://doi.org/10.61919/nkedvv30Keywords:
Balloon Blowing Therapy, Percussion, Pneumonia, Pulmonary Function Tests, CASA-Q,Abstract
Background: Pneumonia is a leading cause of morbidity and mortality globally, especially in low-resource settings where access to advanced diagnostic and therapeutic modalities is limited. Chest physiotherapy techniques, such as percussion and active cycle of breathing techniques (ACBT), are widely used to facilitate airway clearance. Balloon blowing therapy (BBT), a low-cost, non-invasive intervention, has shown promise in enhancing respiratory muscle strength and pulmonary function, but its combined effect with percussion in pneumonia has not been adequately studied. Objective: To evaluate the combined effects of balloon blowing therapy with percussion on pulmonary functions in patients with pneumonia. Methods: A single-blinded, randomized clinical trial was conducted at Services Hospital, Lahore, involving 40 adult pneumonia patients randomized into two groups. Group A received ACBT, BBT, and percussion; Group B received ACBT and percussion alone. Interventions were administered daily over 7 days. Primary outcomes included forced vital capacity (FVC), forced expiratory volume in one second (FEV₁), and FEV₁/FVC ratio, assessed by spirometry. Secondary outcomes were CASA-Q scores and breath sound evaluation via auscultation. Statistical analysis was performed using SPSS version 25 with significance set at p < 0.05. Results: Group A showed significantly greater improvement in FVC (mean difference: 2.01 L vs. 1.49 L; p < 0.001) and CASA-Q scores (p < 0.001). Both groups improved in FEV₁, but only Group A exhibited a notable reduction in FEV₁/FVC ratio due to disproportionate FVC gain. Conclusion: The combination of balloon blowing therapy with percussion significantly enhances pulmonary function and symptom resolution in pneumonia patients compared to standard physiotherapy, supporting its integration into respiratory rehabilitation protocols.
References
1. Mani CS. Acute Pneumonia and Its Complications. In: Long SS, Prober CG, Fischer M, editors. Principles and Practice of Pediatric Infectious Diseases. 5th ed. Philadelphia: Elsevier; 2018. p. 238–49.e4.
2. Hilta J, Mary AJK. Effectiveness of Breathing Exercises as a Play Way Method in Terms of Improving Clinical Parameters of Pneumonia Among Children. RGUHS J Nurs Sci. 2018;8(1):1–7.
3. de Benedictis FM, Kerem E, Chang AB, Colin AA, Zar HJ, Bush A. Complicated Pneumonia in Children. Lancet. 2020;396(10253):786–98.
4. Quinton LJ, Walkey AJ, Mizgerd JP. Integrative Physiology of Pneumonia. Physiol Rev. 2018;98(3):1417–64.
5. Rao A, Ruiz J, Bao C, Roy S. Tabla: A Proof-of-Concept Auscultatory Percussion Device for Low-Cost Pneumonia Detection. Sensors (Basel). 2018;18(8):1–16.
6. Prina E, Ranzani OT, Torres A. Community-Acquired Pneumonia. Lancet. 2015;386(9998):1097–108.
7. Stokes K, Castaldo R, Federici C, Pagliara S, Maccaro A, Cappuccio F, et al. The Use of Artificial Intelligence Systems in Diagnosis of Pneumonia via Signs and Symptoms: A Systematic Review. Biomed Signal Process Control. 2022;72:103325.
8. Woodhead M, Blasi F, Ewig S, Garau J, Huchon G, Ieven M, et al. Guidelines for the Management of Adult Lower Respiratory Tract Infections—Full Version. Clin Microbiol Infect. 2011;17(Suppl 6):E1–59.
9. Chaudhry R, Bordoni B. Anatomy, Thorax, Lungs. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2017.
10. Haddad M, Sharma S. Physiology, Lung. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019.
11. Delgado BJ, Bajaj T. Physiology, Lung Capacity. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019.
12. Ponce MC, Sankari A, Sharma S. Pulmonary Function Tests. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023.
13. Stanojevic S, Kaminsky DA, Miller MR, Thompson B, Aliverti A, Barjaktarevic I, et al. ERS/ATS Technical Standard on Interpretive Strategies for Routine Lung Function Tests. Eur Respir J. 2022;60(1):2101499.
14. DeCato TW, Hegewald MJ. Strategies for the Management of a Pulmonary Function Laboratory. Clin Pulm Med. 2024;31(1):100055.
15. Lamb K, Theodore D, Bhutta BS. Spirometry. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020.
16. Sylvester KP, Clayton N, Cliff I, Hepple M, Kendrick A, Kirkby J, et al. ARTP Statement on Pulmonary Function Testing 2020. BMJ Open Respir Res. 2020;7(1):e000575.
17. Patalano F, Hache C, Pethe A, Kaur H, Leidy NK, Arsiwala T, et al. Performance of the Cough and Sputum Assessment Questionnaire (CASA-Q) in COPD: Evidence from Clinical and Online Patient Interaction Studies. Int J Chron Obstruct Pulmon Dis. 2022;17:3087–96.
18. Charon L, Launois C, Perotin JM, Ravoninjatovo B, Mulette P, Ancel J, et al. Current Cough and Sputum Assessed by the CASA-Q Is Associated with Quality of Life Impairment in Cystic Fibrosis. BMC Pulm Med. 2023;23(1):457.
19. Ningsih AD. Literature Review: Benefits of Balloon Blowing Breathing Exercises on Lung Function in Asthma Patients. J Sci Res Educ Technol. 2023;2(2):725–34.
20. Suwaryo PAW, Yunita S, Waladani B. Application of Blowing Balloon Therapy in Asthma Patients to Stabilize Breathing Frequency. AIP Conf Proc. 2023;2883:020004.
21. Hassan EAF, Amer HW. Impact of Regular Chest Percussion on Outcome Measures for Infants with Pneumonia. J Nurs Educ Pract. 2020;10(4):42–50.
22. Roqué-Figuls M, Gine-Garriga M, Rugeles CG, Perrotta C, Vilaró J. Chest Physiotherapy for Acute Bronchiolitis in Paediatric Patients Between 0 and 24 Months Old. Cochrane Database Syst Rev. 2023;(4):CD004873.
23. Bargahi M, Rastgoo N, Aryanejad F, Esmaielzade S, Nemati R, Ghaebi M, et al. Effect of Balloon-Blowing on Dyspnea and Oxygenation in Hospitalized COVID-19 Patients: A Pilot Study. Acta Med Iran. 2022;60(6):338–44.
24. Misra A, Pawar R, Pal A. Effect of Balloon-Blowing Exercise on Oxygen Saturation in COVID-19 Patients. Cureus. 2023;15(6):e38891.
25. Seo K, Cho M. The Effects of a Balloon-Blowing Exercise in a 90/90 Bridge Position Using a Ball on the Pulmonary Function of Females in Their Twenties. J Phys Ther Sci. 2018;30(10):1267–70.
26. Pandey S. Basic Principles of Sample Size Calculation. J Pract Cardiovasc Sci. 2020;6(2):123–6.
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Copyright (c) 2025 Humayun Ali, Kaynat Saleem, Neelum Mehmood, Arida Mushtaq, Anum Shehzadi (Author)
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