Effect of Intercostal Stretch on Respiratory Function in Mechanically Ventilated Patients: A Randomized Controlled Trial

Background: As an adjuvant treatment to help clear the airways and encourage productive coughing, chest physical therapy, or CPT, has been used extensively. Proprioceptive neuromuscular facilitation (PNF) techniques use large-scale, three dimensional spiral resistive exercises to increase the strength of the respiratory muscles.Purpose: This study aimed to look into how diaphragmatic proprioceptive neuromuscular facilitation (DPNF) of the intercostal stretch type affected the respiratory function of patients on mechanical ventilation. Methods: Forty male patients, aged 50–60, with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) were included in this randomized controlled trial. They were placed in pressure support mode on a mechanical ventilator and divided into two equal groups (n = 20) at random. The study group (A) received the DPNF technique in addition to regular medical care and chest physical therapy (percussion, shaking, and mobilization), while the control group (B) only received regular medical care and chest physical therapy, which includes percussion, shaking, and mobilization. Study variables included arterial blood gases (ABGs), such as PaO2 and PaCO2, which were measured before and after treatment over a period of five to seven days. Results: Within-group statistical analysis, both groups (A) and (B) showed significant increase of PaO2 and significant decrease of PaCO2 post-treatment compared to pretreatment mean values. While, between-group statistical analysis showed a significant difference in posttreatment mean values of PaCO2 only between groups (A) and (B) in favor of group (A). with a post-study confidence interval for PaO2 of -2.7 (-8.1, 2.7) and an effect size of 0.026, and for the post-study confidence interval for PaCO2 of -3.4 (-6.1, -0.7) and an effect size of 0.146. Conclusion: In mechanically ventilated patients experiencing an AECOPD, intercostal stretch-type diaphragmatic proprioceptive neuromuscular facilitation (DPNF) was an effective strategy to improve respiratory function as an adjunctive technique to routine medical treatment and chest physiotherapy.