Effects of Acapella versus Postural Drainage along with Diaphragmatic Breathing on Airway Clearance, Pulmonary Function and Dyspnea in Post-Operative CABG Patients

Background: Despite surgical advances, bronchopulmonary complications remain a leading cause of morbidity and mortality after coronary artery bypass grafting, delaying recovery and impairing pulmonary function. Effective airway clearance strategies are therefore critical for improving postoperative outcomes. Objective: To compare the effects of acapella versus postural drainage combined with diaphragmatic breathing on airway clearance, pulmonary function, and dyspnea in patients undergoing coronary artery bypass grafting. Methodology: In this randomised clinical trial, the sample was selected from Jinnah Hospital, Lahore, for seven months. Participants aged between 45-65 years, both genders, post-CABG patients, and cardiac rehab phase-1 patients were included in the study. Existing pulmonary complications, infection, or sepsis, unstable cardiovascular status, uncontrolled diabetes or other metabolic issues, impaired cognition, and required long-term intubation post-surgery were excluded. Digital spirometer measures pulmonary function tests, including FEV1, FVC, and FEV1/FVC ratios. The breathlessness, cough and sputum scale and MBDS are used to assess cough, dyspnea, ranging from 0 (no shortness of breath) to 10 (worst shortness of breath). Frequency tables, histograms, and bar charts were used, along with the chi-square test, to analyse demographic data. Independent sample t-test and Mann-Whitney U test were used to compare baseline characteristics and differences between the two groups. Paired sample t-test and Wilcoxon signed rank test were employed to assess pre- and post-intervention data within the same group. Results: At baseline, no significant differences were noted between groups for FVC (p=0.862), FEV1 (p=0.652), FEV1/FVC ratio (p=0.760), BCSS (p=1.000), and MBDS (p=0.807). After treatment, significant improvements were found in all parameters, with p=0.000. Conclusion: Acapella therapy, when combined with diaphragmatic breathing, proved more effective than postural drainage in optimising respiratory recovery among post-CABG patients.