Effect Of Acapella Versus Lung Flute On Pulmonary Function, Exercise Capacity, And Quality Of Life In Chronic Obstructive Pulmonary Disease Patients: A Randomised Clinical Trial

Background and Purpose: Chronic obstructive pulmonary disease (COPD) is a treatable condition often complicated by excess mucus, which impairs lung function and lowers quality of life (QoL). Positive expiratory pressure (PEP) devices, such as Acapella and Lung Flute, are non-pharmacological physiotherapy options for managing COPD symptoms. Our objective is to compare the effects of Acapella versus Lung Flute on pulmonary function, exercise capacity and QoL in patients with COPD. Methods: A randomized clinical trial was conducted involving 70 male COPD patients aged 40–60 years, divided into two groups: Acapella and Lung Flute. Both groups received conventional chest physiotherapy along with their respective devices over eight weeks. Primary outcomes included forced expiratory volume in one second (FEV₁), forced vital capacity (FVC), and FEV₁/FVC ratio. Secondary outcomes were the six-minute walk test (6MWT), VO₂ max (mL/kg/min), modified Medical Research Council (mMRC) dyspnoea scale, and the VQ11 QoL questionnaire. Results: Both groups showed significant improvements in FEV₁ (Acapella: p = 0.021; Lung Flute: p = 0.035), FVC (Acapella: p = 0.015; Lung Flute: p = 0.042), 6MWT (p< 0.001 for both), and VQ11 scores (p< 0.001). The Acapella group showed significantly greater improvements in FEV₁ (p = 0.007), FVC (p = 0.047), 6MWT (p = 0.035), and mMRC scores (p = 0.010) compared to the Lung Flute group. No significant changes were found in the FEV₁/FVC ratio or VO₂ max (p> 0.05). Discussion: Acapella is more effective than Lung Flute in enhancing pulmonary function, exercise capacity, and QoL in COPD patients.