This randomized clinical trial aims to compare the effectiveness of Active Cycle of Breathing Techniques combined with Incentive Spirometry (ACBT + IS) versus High-Frequency Chest Wall Oscillation (HFCWO) in patients undergoing thoracic surgery. Postoperative pulmonary complications such as reduced lung function, ineffective cough, and sputum retention are common after thoracic procedures and can delay recovery. A total of 42 participants will be randomly allocated into two groups: one receiving ACBT with Incentive Spirometry and the other receiving HFCWO, along with standard postoperative care. Outcomes including cough effectiveness, sputum clearance, pulmonary function tests, and patient satisfaction will be assessed at baseline, postoperative day 3, and day 5. The study aims to determine the more effective airway clearance technique to improve respiratory outcomes and enhance patient recovery following thoracic surgery.
Adults aged 18-40 years
Patients scheduled for elective thoracic surgery (e.g., lobectomy, pneumonectomy, thoracotomy, or VATS)
Hemodynamically stable in the postoperative period
Cognitively and physically able to perform breathing exercises and use devices (incentive spirometer/HFCWO vest)
Pre-existing severe pulmonary diseases (e.g., COPD, cystic fibrosis, bronchiectasis)
Contraindications to HFCWO (e.g., recent rib fractures, chest wall trauma, unstable cardiovascular status)
Cognitive, neuromuscular, or musculoskeletal impairments limiting participation in interventions
Prolonged mechanical ventilation (>24 hours postoperatively)
Parallel
Active Cycle of Breathing Techniques with Incentive Spirometry
Procedure/SurgeryA structured breathing intervention combining Active Cycle of Breathing Techniques (breathing control, thoracic expansion exercises, and forced expiratory technique) with incentive spirometry to promote lung expansion and secretion clearance. Performed multiple times daily during the early postoperative period.
High-Frequency Chest Wall Oscillation
DeviceA mechanical airway clearance technique delivered using an oscillatory vest that produces high-frequency chest wall vibrations to help mobilize and remove pulmonary secretions. The intervention is administered twice daily beginning on postoperative day 3.
Forced Expiratory Volume in 1 second (FEV₁)
Assessment of pulmonary function using spirometry parameters including Forced Expiratory Volume in 1 second (FEV₁) to evaluate respiratory recovery after thoracic surgery.
Forced Vital Capacity (FVC)
Assessment of pulmonary function using spirometry parameters including Forced Vital Capacity (FVC) to evaluate respiratory recovery after thoracic surgery.
Cough Effectiveness
Evaluation of cough effectiveness using the Leicester Cough Questionnaire (LCQ), measuring physical, psychological, and social impact of cough.
Sputum Clearance
Measurement of sputum volume to assess effectiveness of airway clearance techniques.
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