Effectiveness of lung flute and acapella devices in pulmonary tuberculosis rehabilitation: a randomized controlled trial

Abstract Background Pulmonary tuberculosis (PTB) is a major worldwide health concern, particularly in environments with limited resources, even while pharmaceutical therapies for active tuberculosis have improved outcomes, pulmonary function impairment and a lower quality of life are common post-treatment side effects. Though their relative effectiveness in PTB rehabilitation is yet unknown, devices like the Lung Flute and Acapella have demonstrated potential in enhancing pulmonary rehabilitation, especially in conditions like COPD and asthma. Objectives This study aims to evaluate and compare the efficacy of the Lung Flute and Acapella devices in improving cardiorespiratory function and quality of life in PTB patients. Methodology A Randomized Controlled Trial (RCT) was conducted with 180 PTB patients, divided into three groups: Lung Flute ( n = 60), Acapella ( n = 60), and Control ( n = 60). Participants were allocated to the three groups using the simple lottery (chit) method, ensuring equal probability of assignment to each intervention group. The interventions were administered for one month, with pre- and post-assessments of Peak Expiratory Flow Rate (PEFR), VO₂ max (Queens College Step Test), Modified Medical Research Council (MmRC) dyspnoea score, and SF-12 quality of life scores. Patient adherence was monitored throughout the intervention period and reinforced through regular follow-up visits by the supervising physiotherapist. Results Both the Lung Flute and Acapella groups showed significant improvements in PEFR and MmRC scores. The Acapella group demonstrated superior improvement in VO₂ max and SF-12 scores, indicating its broader impact on pulmonary function and quality of life. Exact p-values and effect sizes are reported in the Results section. The ANOVA revealed significant between-group differences for VO₂ max [F (2,177) = 69.25, p < 0.001], PEFR [F (2,177) = 23.24, p < 0.001], and MmRC grade [F (2,177) = 59.23, p < 0.001]. Conclusion Both devices, Lung Flute device and Acapella are effective adjuncts in pulmonary rehabilitation for PTB patients. The Acapella device offers more comprehensive improvements in aerobic capacity and quality of life, while the Lung Flute provides targeted symptom relief and dyspnoea management. These findings are preliminary and based on a single-centre, short-duration trial; therefore, clinical generalisation should be undertaken with caution. Further multi-centre studies with longer follow-up are warranted before definitively integrating these devices into routine PTB rehabilitation protocols.