High Frequency Chest Wall Oscillations Versus ACBT With Percussion in COPD Patients

Background: Chronic obstructive pulmonary disease is characterized by persistent airflow limitation and impaired mucociliary clearance, and airway clearance strategies are commonly used in physiotherapy-based COPD management to reduce secretion burden and improve functional status. Objective: To compare the effects of High-Frequency Chest Wall Oscillation (HFCWO) versus Active Cycle of Breathing Technique (ACBT) with percussion on pulmonary function and functional capacity in adults with advanced COPD. Methods: A randomized clinical trial was conducted at the Pulmonary Department, DHQ Hospital Narowal. Eligible adults with GOLD stage III–IV COPD were randomized to ACBT with percussion (n=19) or HFCWO via vest therapy (n=19). Both groups received 12 sessions over 4 weeks (3 sessions/week). Outcomes were assessed at baseline and week 4, including FEV1% predicted, 6-minute walk distance (6MWD), modified Medical Research Council dyspnea scale (mMRC), and BMI. Parametric tests were applied following normality checks. Results: At week 4, HFCWO showed superior outcomes versus ACBT for FEV1% predicted (67.79±12.73 vs 53.89±9.30; mean difference +13.90, 95% CI 6.56 to 21.24; p