ACBT With Incentive Spirometry Versus High-Frequency Chest Wall Oscillation After Thoracic Surgery

Effects of Active Cycle of Breathing Techniques With Incentive Spirometry Versus High-Frequency Chest Wall Oscillation on Cough, Sputum, Pulmonary Function Test and Patient Satisfaction After Thoracic Surgery

This randomized clinical trial aims to compare the effectiveness of Active Cycle of Breathing Techniques combined with Incentive Spirometry (ACBT + IS) versus High-Frequency Chest Wall Oscillation (HFCWO) in patients undergoing thoracic surgery. Postoperative pulmonary complications such as reduced lung function, ineffective cough, and sputum retention are common after thoracic procedures and can delay recovery. A total of 42 participants will be randomly allocated into two groups: one receiving ACBT with Incentive Spirometry and the other receiving HFCWO, along with standard postoperative care. Outcomes including cough effectiveness, sputum clearance, pulmonary function tests, and patient satisfaction will be assessed at baseline, postoperative day 3, and day 5. The study aims to determine the more effective airway clearance technique to improve respiratory outcomes and enhance patient recovery following thoracic surgery.

Study Overview

• Status: Not yet recruiting
• Conditions: Thoracic Surgery
• Intervention / Treatment: Procedure: Active Cycle of Breathing Techniques with Incentive Spirometry; Device: High-Frequency Chest Wall Oscillation

Detailed Description

Postoperative pulmonary complications are common after thoracic surgery due to reduced lung function and impaired secretion clearance. Effective respiratory physiotherapy is essential to improve recovery and prevent complications such as atelectasis and pneumonia.

This randomized clinical trial aims to compare the effectiveness of Active Cycle of Breathing Techniques combined with Incentive Spirometry (ACBT + IS) and High-Frequency Chest Wall Oscillation (HFCWO) in improving respiratory outcomes. A total of 42 patients undergoing elective thoracic surgery will be randomly assigned to either ACBT + IS or HFCWO, along with standard postoperative care.

Outcomes including cough effectiveness, sputum clearance, pulmonary function (FEV₁, FVC), and patient satisfaction will be assessed at baseline, postoperative day 3, and day 5. The study seeks to identify the more effective airway clearance technique to enhance recovery and reduce postoperative complications.

• Study Type: Interventional
• Enrollment (Estimated): 42
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Muhammad Iqbal Tariq, Phd*; Phone Number: 03338236752; Email: iqbal.tariq@riphah.edu.pk

Study Locations

• Pakistan
  • Punjab Province
    • Lahore, Punjab Province, Pakistan, 40100
      • Gulab Devi Hospital or General Hospital Lahore.
      • Contact: Arjumand Bano, MS-CPPT; Phone Number: 03059551883; Email: arjumand.bano@riphah.edu.pk
      • Principal Investigator: Sarah Nasir, MS-CPPT

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Adults aged 18-40 years
• Patients scheduled for elective thoracic surgery (e.g., lobectomy, pneumonectomy, thoracotomy, or VATS)
• Hemodynamically stable in the postoperative period
• Cognitively and physically able to perform breathing exercises and use devices (incentive spirometer/HFCWO vest)
• Willing to participate and provide informed consent

Exclusion Criteria:

• Pre-existing severe pulmonary diseases (e.g., COPD, cystic fibrosis, bronchiectasis)
• Contraindications to HFCWO (e.g., recent rib fractures, chest wall trauma, unstable cardiovascular status)
• Cognitive, neuromuscular, or musculoskeletal impairments limiting participation in interventions
• Prolonged mechanical ventilation (>24 hours postoperatively)
• Active pulmonary infection or hemoptysis within one week after surgery

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: ACBT with Incentive Spirometry; Participants in this group will receive Active Cycle of Breathing Techniques (ACBT) combined with Incentive Spirometry along with standard postoperative care. The ACBT protocol will include breathing control, thoracic expansion exercises, and forced expiratory techniques (huffing), performed multiple times daily. Incentive spirometry will be used to promote deep breathing and lung expansion. The intervention will begin in the early postoperative period and continue for 5 days.	Procedure: Active Cycle of Breathing Techniques with Incentive Spirometry; A structured breathing intervention combining Active Cycle of Breathing Techniques (breathing control, thoracic expansion exercises, and forced expiratory technique) with incentive spirometry to promote lung expansion and secretion clearance. Performed multiple times daily during the early postoperative period.; Other Names: ACBT + IS
Experimental: High-Frequency Chest Wall Oscillation (HFCWO); Participants in this group will receive High-Frequency Chest Wall Oscillation therapy using an oscillatory vest device along with standard postoperative care. The device delivers external chest wall oscillations to mobilize pulmonary secretions. The intervention will start on postoperative day 3 and will be administered twice daily for 5 days.	Device: High-Frequency Chest Wall Oscillation; A mechanical airway clearance technique delivered using an oscillatory vest that produces high-frequency chest wall vibrations to help mobilize and remove pulmonary secretions. The intervention is administered twice daily beginning on postoperative day 3.; Other Names: HFCWO, Oscillatory Vest Therapy

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Forced Expiratory Volume in 1 second (FEV₁)	Assessment of pulmonary function using spirometry parameters including Forced Expiratory Volume in 1 second (FEV₁) to evaluate respiratory recovery after thoracic surgery.	Baseline (preoperative), Postoperative Day 3, and Day 5
Forced Vital Capacity (FVC)	Assessment of pulmonary function using spirometry parameters including Forced Vital Capacity (FVC) to evaluate respiratory recovery after thoracic surgery.	Baseline (preoperative), Postoperative Day 3, and Day 5
Cough Effectiveness	Evaluation of cough effectiveness using the Leicester Cough Questionnaire (LCQ), measuring physical, psychological, and social impact of cough.	Baseline, Postoperative Day 3, and Day 5

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Sputum Clearance	Measurement of sputum volume to assess effectiveness of airway clearance techniques.	Postoperative Day 3 and Day 5

Collaborators and Investigators

• Sponsor: Riphah International University
• Investigators: Principal Investigator: Arjumand Bano, MSPT, Riphah International University

Study record dates

Study Major Dates

• Study Start (Estimated): June 1, 2026
• Primary Completion (Estimated): August 28, 2026
• Study Completion (Estimated): August 29, 2026

Study Registration Dates

• First Submitted: April 2, 2026
• First Submitted That Met QC Criteria: June 1, 2026
• First Posted (Actual): June 2, 2026

Study Record Updates

• Last Update Posted (Actual): June 2, 2026
• Last Update Submitted That Met QC Criteria: June 1, 2026
• Last Verified: June 1, 2026

More Information

Terms related to this study

• Keywords: Thoracic Surgery Postoperative,ACBT
• Additional Relevant MeSH Terms: Therapeutics; Respiratory Therapy; Chest Wall Oscillation
• Other Study ID Numbers: REC/RCR & AHS/25/0323

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No