A study to analyse the effect of various positions along with coughing and huffing techniques on respiratory parameters in smokers

INTRODUCTION: Smoking is the inhalation of the smoke of the burning tobacco. If smoking is directly related to a decrease in pulmonary function, then people who smoke more than one pack a week or heavy smokers will show a dramatic difference in pulmonary measurements such as vital capacity, forced expired volume, Forced Vital Capacity and the ratio of Forced Expired Volume in one second to Forced Vital Capacity compared to mild smokers or nonsmokers. Nicotine the active ingredient in tobacco, is inhaled into the lungs, where most of it stays. The rest passes into the blood stream, reaching the brain in about 10seconds and dispersing throughout the body in about a20 seconds. OBJECTIVES: 1. To find out the effect of sitting position along with the interventions of coughing and huffing on FEV1, FEV1/FVC and FEV1/FEV6 in smokers. 2. To find out the effect of supine position along with the interventions of coughing and huffing on FEV1, FEV1/FVC and FEV1/FEV6 in smokers. 3. To find out the effect of 45° prone position along with the interventions of coughing and huffing on FEV1, FEV1/FVC and FEV1/FEV6 in smokers. METHODOLOGY: Study Design: One group pretest and post test experimental study design. Study Setting: Study was conducted at physiotherapy outpatient department, K.G. College of Physiotherapy, Saravanampatti, Coimbatore-35. Study Duration: Study was conducted for a period of 6 month. Study Subjects: Based on selection criteria, 20 subjects were selected for the study. CRITERIA FOR SELECTION: INCLUSION CRITERIA: Age group between 30 and 40 years, Male subjects, Smokers, Subjects with BMI from 20-29.9 kg/m, Subjects who are willing to participate. EXCLUSION CRITERIA: Subjects with cardio vascular disease, Subjects with neuro muscular disease, Subjects with acute respiratory disease within the previous 6 weeks, Uncooperative subjects, Subjects unwilling to participate. RESULTS: The results of this study are similar to the findings of Atsuhiro [et. al.], 2009. The reason for increased FEV1, FEV1/FVC and FEV1/FEV6 in 45°rotative prone and sitting position might be due to rectus abdominus muscle and its force production ability with respect to hip joint status. During forced expiration the rectus abdominus muscle is mainly working. In the sitting and 45°rotative prone position, both the hip joints are in flexion. It gives an advantage for excessive force production to rectus muscle by increasing its efficiency. But, in case of supine position both the hip joints are in extension where the rectus muscle cannot work efficiently and thereby the forced expiration cannot be achieved adequately. Moreover, the effectiveness of coughing and huffing techniques has been proved by many researchers like Pryor et al, 1999. This study has also got the similar improvement on respiratory parameters following four weeks of coughing and huffing interventions in smokers. CONCLUSION: This study concludes that there is a significant improvement on FEV1, FEV1/FVC and FEV1/FEV6 following the interventions of coughing and huffing techniques in smokers. While considering three different positions, 45° rotative prone position is the most effective position for the transfer of the intrabronchial secretions to the proximal airway. Thus this study also concludes that 45° rotative prone position is effective for coughing up secretions especially in smoker population