REVIEW OF LITERATURE:

¹⁾          Vidhi D. Thakkar et al (2023):  This study suggests that individuals may benefit from performing non respiratory activities such as upper and lower abdominal muscle exercise that can be clinically implied to improve respiratory parameters, cough mechanism and in cardiovascular rehabilitation program.  The study concludes that, there is statistically improvement in PEFR and abdominal muscle endurance after four weeks of abdominal muscle exercises in healthy females. The Improvement was also clinically significant. Thus, the present study accepts the experimental hypothesis and reject the null hypothesis

2)     Shweta Modi et al (2021):  The study was carried out to know the effect of abdominal muscle exercises on Peak Expiratory Flow Rate in middle age females. The result from the statistical analysis of the present study found that there is a beneficial effect of peak expiratory flow rate on the subjects treated with abdominal muscle strengthening exercises. The mean values of data from present study indicates that subjects showed better peak expiratory flow rate after 15 days of abdominal strengthening exercises. The increase in peak expiratory flow rate is most likely due to the abdominal muscles’ facilitator function, which improves the diaphragm’s ability to produce pressure during respiration. This study concludes that abdominal muscle exercises are beneficial in improving peak expiratory flow rate in middle age females. Hence, regular abdominal muscle strengthening exercises can be done to improve strength of abdominal muscles which in turn help in forceful expiration which can be beneficial in clearing cough out of airways, enhancing cough reflex thereby improving quality of life of individuals.

3)     Ishida H et al (2014):  The purpose of this study was to determine whether forced expiration is correlated with abdominal muscle thickness. Twenty-three healthy male volunteers participated in this study. The peak expiratory flow (PEF) was obtained using a peak flow meter with subjects in the sitting position. The thicknesses of the right rectus abdominis, external oblique, internal oblique, and transverse abdominis muscles were measured using B-mode ultrasonography at the end of a relaxed expiration in the supine position. The results show that among the abdominal muscles, only the thickness of the external oblique muscle displayed a significant correlation with PEF. The study concludes that  the thickness of the external oblique muscle might be associated with PEF during forced expiration^[3]

4)     Bijal pasad et al (2020):  The purpose of this study was to find the effect of abdominal muscle exercises on peak expiratory flow rate in obese individuals. 4 weeks of abdominal strengthening protocol was given to obese subjects who had a decrease in peak expiratory flow rate. The sample consisted of 20 obese individuals. Prior to the abdominal muscle exercises the peak expiratory flow rate was noted and then after 4 weeks again the peak expiratory flow rate was recorded. The study concluded that there is significant effect of abdominal muscle exercises on peak expiratory flow rate in obese individuals.^[4]

5)     Kedar KV et al (2017):   This a study on the effect of menopause on pulmonary functions. It concludes that as menopause sets in, decrease in hormonal levels leads to decreased lung capacity as evident by pulmonary function tests. Decreased pulmonary function test can be attributed to lower levels of sex hormones estrogen and progesterone in postmenopausal women. The predicted values of PEFR were lower in postmenopausal women compared with premenopausal women.^[5]

METHODOLOGY:

SOURCE OF DATA: Samples will be collected from Pravara Rural Hospital , Loni.

STUDY SETTING: Study will be conducted in the in -patient department of cardiorespiratory physiotherapy at Dr. APJ Abdul Kalam College of Physiotherapy.

STUDY TYPE: Interventional study.  

DURATION OF THE STUDY: 1 Year

SAMPLE SIZE: 30

STUDY POPULATION: COPD patients in rural setup

MATERIAL TO BE USED: 1) Peak expiratory flow meter

Inclusion criteria:

1.     Both Males and Females.

2.     participants diagnosed with COPD

3.     mild and moderate COPD according to gold criteria.

4.     Ability to perform abdominal exercises

5.     Patients between 30-60 years of age group.

   Exclusion criteria :                          

1)     recent abdominal or thoracic surgery

2)     Severe cognitive impairment

3)     Inability to understand

4)     Presence of any musculoskeletal or neurological condition

Outcome Measures:  Peak Expiratory Flow Rate.