Year: 2025 | Month: October-December | Volume: 10 | Issue: 4 | Pages: 170-180
DOI: https://doi.org/10.52403/ijshr.20250425
Combined Effect of Expiratory Rib Cage Compression Technique and Intercostal Stretch Technique on Static Lung Compliance and Hemodynamic Parameters in Mechanically Ventilated Patients
Shristi Das1, Gitanjali Sikka2, Prashant Kumar3
1MPT Student, College of Physiotherapy, 2MPT Cardiopulmonary, PhD, Associate Professor, College of Physiotherapy, 3M.D. Anaesthesia, Professor, Deptt. of, Anaesthesia,
Pt. B.D. Sharma, University of Health Sciences, Rohtak, Haryana, India
Corresponding Author: Shristi Das
ABSTRACT
Background: Expiratory Rib Cage Compression (ERCC) and Intercostal Stretch Technique (ICT) are commonly used in chest physiotherapy to clear secretions in mechanically ventilated patients but there is scarcity of evidence supporting combined effects of these techniques. The present study tested hypothesis that whether there is a significant difference between combined effects of ERCC and ICT compared to ERCC alone on static lung compliance and hemodynamic parameters in mechanically ventilated patients.
Methods: Prospective crossover study conducted on fifty mechanically ventilated patients with mean days of mechanical ventilation= 14.2 ± 3.14 and mean age 46.66 ± 15.7 years. All participants were given both interventions- ERCC+ICT (Group-A) and ERCC (Group-B) on same day with a 3-hour washout period. Outcome measures included static lung compliance (CST), oxygen saturation (SpO2), hemodynamic (SBP, DBP, HR) and ABG parameters (pH, pCO2, paO2 and P/F ratio) recorded at time intervals: - before (PRE), POST-1 (after 0 min), POST-2 (after 30 min.) and POST-3 (after 60 min.).
Results: One-way ANOVA and Cohen’s D effect size showed that CST and SpO2 mean values improved in both treatment groups (p<0.01) with significantly higher (p< 0.05) increase in CST and SpO2 mean values in Group-A as compared to Group-B using t-test. ICC recorded at various time intervals for hemodynamic and ABG parameters was found to be highly statistically significant for both groups (p<0.01), with higher ICC coefficients for Group-A than Group-B.
Conclusion: ERCC+ICT improves CST and SpO2 in mechanically ventilated patients with stabilizing effect on hemodynamic and ABG parameters compared to ERCC alone.
Keywords: Expiratory rib cage compression, intercostal stretch, ICU physiotherapy, lung compliance, mechanical ventilation.