ABSTRACT

Background: Chronic bronchitis, a primary manifestation of chronic obstructive pulmonary disease (COPD) in occupational settings, is highly prevalent among brick kiln workers. This population faces continuous exposure to biomass fuel smoke, coal dust, and respirable crystalline silica, which induce persistent airway inflammation, mucus hypersecretion, and impaired mucociliary clearance. Non- pharmacological interventions, including breathing exercises and airway clearance techniques, are essential adjuncts to standard care. Objective: This study evaluated the effectiveness of combined diaphragmatic breathing exercises (DBE) and oscillating positive expiratory pressure (OPEP) therapy using a Flutter device in improving respiratory function, dyspnea, and subjective discomfort in brick kiln workers with chronic bronchitis. Methods: A randomized controlled trial was conducted with 150 brick kiln workers (75 intervention, 75 control) over 8 weeks. The intervention group practiced DBE (twice daily) and Flutter therapy (once daily). Outcome measures included Peak Expiratory Flow Rate (PEFR), Modified Borg Dyspnoea Scale (MBS), and Visual Analogue Scale (VAS). Results: Post-intervention, the experimental group showed highly significant improvements in PEFR (t=28.16, p < 0.001, Cohen’s d=2.30), MBS (t=–20.82, p < 0.001), and VAS (t=–20.21, p < 0.001). Sub- group analysis indicated that females (p=0.006) and non-smokers (p < 0.001) achieved greater physiological gains. Correlation analysis revealed a disconnect between objective lung function and subjective symptom relief. Conclusion: The combined intervention of DBE and Flutter therapy is an effective, non-invasive, and cost- efficient strategy for pulmonary rehabilitation in occupational chronic bronchitis. Keywords: Chronic Bronchitis; Brick Kiln Workers; Diaphragmatic Breathing Exercises; Oscillating Positive Expiratory Pressure; Flutter Device; Pulmonary Rehabilitation
Publication date: 01/09/2026

https://www.ijbpas.com/pdf/2026/September/MS_IJBPAS_2026_10726.pdf

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https://doi.org/10.31032/IJBPAS/2026/15.9.10726