ACBT With Incentive Spirometry Versus High-Frequency Chest Wall Oscillation After Thoracic Surgery

Postoperative pulmonary complications are common after thoracic surgery due to reduced lung function and impaired secretion clearance. Effective respiratory physiotherapy is essential to improve recovery and prevent complications such as atelectasis and pneumonia.

This randomized clinical trial aims to compare the effectiveness of Active Cycle of Breathing Techniques combined with Incentive Spirometry (ACBT + IS) and High-Frequency Chest Wall Oscillation (HFCWO) in improving respiratory outcomes. A total of 42 patients undergoing elective thoracic surgery will be randomly assigned to either ACBT + IS or HFCWO, along with standard postoperative care.

Outcomes including cough effectiveness, sputum clearance, pulmonary function (FEV₁, FVC), and patient satisfaction will be assessed at baseline, postoperative day 3, and day 5. The study seeks to identify the more effective airway clearance technique to enhance recovery and reduce postoperative complications.

Inclusion criteria

• 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)
• Willing to participate and provide informed consent

Exclusion criteria

• 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)
• Active pulmonary infection or hemoptysis within one week after surgery