Pulmonary Function Responses to Active Cycle Breathing Techniques in Heart Failure Patients at the University Teaching Hospital (UTH), Lusaka, Zambia

Abstract

Chronic heart failure patients experience restrictive respiratory dysfunction, resulting in alterations of FEV1, FVC and FEV /FVC as demonstrated in exercise 1 intolerance, dyspnoea and poor quality of life (QoL). Active Cycle of Breathing Techniques (ACBT) is traditionally used by Physiotherapists in the management of respiratory conditions. The aim of this study was to investigate the physiological effects of ACBT on pulmonary function in stable heart failure (HF) patients (New York Heart Association Functional class II and III) at the University Teaching Hospital (UTH) in Lusaka, Zambia.
Methods: This prospective cohort study investigated the pulmonary function response to ACBT in heart failure patients at UTH Lusaka, Zambia. A Minnesota questionnaire was used to collect anthropometric and QoL data; respiratory function tests were done by a handheld spirometer at baseline, 6 weeks and 12 weeks. ACBT were conducted on 3 days of the week for a total of 12 weeks. STATA version 11.2 was used for data analysis.
Results: A total of 23 patients, mean age 54.0 years (range 25-77), participated in the study. The lung function volumes were reduced at baseline as expected (FVC = 2.9L, FEV₁ = 2.0L and FEV₁ /FVC = 70.1%). There was   hardly any change at 6 weeks (FVC = 2.7 L, FEV₁ = 1.9 L  and FEV₁ /FVC = 70.2 %). There was a slight increase in the means at 12 weeks (FVC = 2.8L, FEV₁  = 2.0 L and  FEV₁ /FVC = 73.0%) which was statistically insignificant (p= 0.73). However there was a statistically significant improvement in quality of life at both 6 and 12 weeks of intervention ((p< 0.0001).

Conclusion: ACBT exercises facilitate modest increases in ventilatory function but significantly improve HF related symptoms, greatly improving the quality of life in heart failure patients.

Key Words: Heart Failure, Active Cycle of Breathing Techniques, Spirometry, Pulmonary Function and Quality of Life