1.A Pilot Randomized Control Cross over Study Evaluating the Effectiveness and Safety of Mechanical Percussor Compared with Conventional Chest Physiotherapy in Adults with Productive Cough
Punithavathi Narayanan ; Ong Loke Meng ; Irfhan Ali Hyder Ali ; Mohd Izmi @ Ibrahim Ahmad ; Dharminy Thurairatnam ; Ang Ah Heong ; Hadzlinda Zainal ; Sivasangari Subramaniam
The Medical Journal of Malaysia 2014;69(1):16-20
Introduction: Conventional Chest Physiotherapy (CCPT)
remains the mainstay of treatment for sputum mobilization
in patients with productive cough such as bronchiectasis
and “Chronic Obstructive Airway Disease” (COPD). However
CCPT is time consuming requires the assistance of a
physiotherapist and limits the independence of the patient.
Mechanical percussors which are electrical devices used to
provide percussion to the external chest wall might provide
autonomy and greater compliance. We compared safety and
efficacy of a mechanical chest percusser devised by
Formedic Technology with conventional chest percussion.
Methods: Twenty patients (mean age 64years) were
randomly assigned to receive either CCPT or mechanical
percussor on the first day and crossed over by “Latin square
randomisation” to alternative treatment for 6 consecutive
days and the amount of sputum expectorated was compared
by dry and wet weight. Adverse events and willingness to
use was assessed by a home diary and a questionnaire.
Results: There were 13 males and 7 females, eight
diagnosed as bronchiectasis and 12 COPD. The mean dry
weight of sputum induced by CCPT (0.54g + 0.32) was
significantly more compared with MP (0.40g + 0.11); p-value
= 0.002. The mean wet weight of sputum with CCPT (10.71g
+ 8.70) was also significantly more compared with MP (5.99g
+ 4.5); p-value < 0.001. There were no significant difference
in adverse events and majority of patients were willing to
use the device by themselves.
Conclusion: The mechanical percussor although produces
less sputum is well tolerated and can be a useful adjunct to
CCPT
2.The impact of music guided deep breathing exercise on blood pressure control - A participant blinded randomized controlled study
Kow Fei PING ; Adlina BAKAR ; Sivasangari SUBRAMANIAM ; Punithavathi NARAYANAN ; Ng Kum KEONG ; Ang Ah HEONG ; Ong Loke MENG
The Medical Journal of Malaysia 2018;73(4):233-238
Introduction: As pharmacological treatment of hypertensionhas become a burden worldwide, the study looked into nonpharmacological ways of reducing blood pressure. Theobjective was to determine if music guided, slow and deepbreathing will reduce the blood pressure among patientswith hypertension in eight weeks.Methods: A participant blinded, multi-centre, randomisedcontrolled trial was conducted in which the participants inthe intervention group (IG) practiced deep breathingexercise guided by sound cues and those in the controlgroup (CG) listened to the music. The primary end point wasreduction in blood pressure at eight weeks.Results: 87 patients, 46 males and 41 females with mean ageof 61.1 years were recruited and 93.1% of them successfullycompleted the study. There was significant reduction insystolic and diastolic Blood Pressure from baseline by 8weeks in both groups. The reduction in Mean systolic bloodpressure (SBP) in the control arm was 10.5mmHg comparedto 8.3mmHg (p<0.001) in intervention group. Diastolic bloodpressure (DBP) reduction in control and intervention groupswere 5.2 mmHg (p<0.001) and 5.6 mmHg (p<0.001)respectively. The absolute difference in SBP reduction frombaseline in IG & CG was -2.2 (95%CI: -7.8 to 3.5) and DBPwas -0.4 (95%CI: -2.9 to 3.6). However, blood pressurereduction between the two groups was not significant.Conclusions: Both listening to music and deep breathingexercise were associated with a clinically significantreduction in SBP and DBP. However, deep breathingexercise did not augment the benefit of music in reducingBP.