Thesis (M.Sc.) - Cairo University - Faculty of Physical Therapy - Department of Physical Therapy for Cardiopulmonary and Geriatrics Disorders

Introduction: Although expiratory muscles have been little studied it is known that expiratory muscle strength is impaired in most patients with significant chronic obstructive pulmonary disease (COPD), the expiratory muscles partake in the generalized muscle weakness that is observed in those patients. The decreased expiratory muscle strength was associated with reduced patient{u2019}s exercise capacity. There is need to find an alternate cost effective, easy technique which can help strength the expiratory muscles and improve the exercise capacity. An intervention like applying positive end expiratory pressure (PEEP) training could help in strengthening of expiratory muscles and improving the exercise capacity in patient with COPD. Procedure: Forty COPD men patients their age 45 to 65 years old from kasr Al Einy hospital were assigned into two equal groups: Group A consisted of 20 men whom received PEEP (10-20 cm H2o,15 minutes session,once daily for 4 weeks) plus standard chest physiotherapy. Group B consisted of 20 men received standard chest physiotherapy only. Maximum Expiratory Pressure (MEP) and Six-minute walk distance (6MWD) were measured for each patient before and after treatment. Results: There was a significant difference (p= 0.041) between study and control group patients in MEP post treatment (84.35 ± 9.73 vs 77 ± 12.11 cm H2o) the percentage of improvement is 20.59% after applying Positive End Expiratory Pressure (PEEP).There was significant difference (p= 0.045) between study and control group patients in 6MWT post treatment (339.7 meter ± 54.126 vs 301.65 meter± 61.78).The percentage of improvement is 17.73% after applying Positive End Expiratory Pressure (PEEP). Conclusion: Positive expiratory pressure therapy is efficient in improving the expiratory muscle strength and exercises capacity and helps COPD patients to improve their active life style

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