Active cycle of breathing technique versus oscillating positive expiratory pressure therapy: Effect on lung function in children with primary ciliary dyskinesia; A feasibility study

Background: Primary Ciliary Dyskinesia (PCD) is a rare genetic disorder requiring airway clearance techniques for mucus removal. We aimed to evaluate the feasibility and the effect of the active cycle of breathing technique (ACBT) versus oscillating positive expiratory pressure therapy (OPEP) in improving lung function and functional exercise capacity among children with PCD in Palestine. Methods: 32 PCD children (6-18 years) were included in a 12-week home-based feasibility study. They were assigned randomly into two groups: ACBT and OPEP. Data collection included spirometry measurements, and the six-minute walk test (6MWT). Results: After 12 weeks of regular airway clearance techniques (ACT), the FEV1, MEF25-75%, and the 6MWT demonstrated statistically significant differences (p = .02, p = .04, and p = .05 respectively) between the two groups, in favor of the OPEP group with the effect size of Cohen's d (0.86, 0.76, and 0.71) respectively. However, there was no significant difference (p > .05) between the two groups in FVC and FEV1/FVC. Additionally, only in the OPEP group, significant differences were recorded between pre and post-tests for FEV1 and 6MWT (p < .05). Conclusion: The randomized study design comparing ACBT and OPEP was feasible and acceptable to patients. OPEP demonstrates potential for managing respiratory health; however, treatments should be individualized to address each patient's specific needs. Further research with larger cohorts is needed to assess the effectiveness of both methods.