Incorporating RC-Cornet PLUS and POWERbreathe Medic Plus Device Along With Pulmonary Rehabilitation on Functional Capacity and Quality of Life in Bronchiectasis: A Case Report

Abstract

This case report discusses the physiotherapy management of an adult patient with chief complaints of breathlessness and difficulty expelling out mucus for the past month, with a history of multiple hospitalizations due to recurrent respiratory infections, who was diagnosed as bronchiectasis. In this study, the patient was treated with a combination of the RC-Cornet PLUS (CEGLA Medizintechnik, Montabaur, Germany), an oscillatory positive expiratory pressure (OPEP) device used for airway clearance, and the POWERbreathe Medic Plus (POWERbreathe, England, UK), an inspiratory muscle training (IMT) device, along with tailored pulmonary rehabilitation. Pulmonary rehabilitation focused on patient education, breathing exercises, airway clearance techniques (ACTs), endurance training, strengthening, and energy conservation techniques. The RC-Cornet PLUS device further complemented these interventions and facilitated effective mucus clearance, while the POWERbreathe Medic Plus device aided in improving respiratory muscle strength and endurance. Through this comprehensive approach, significant improvement in dyspnea was observed from grade 3 to grade 1 on the Modified Medical Research Council (MMRC) scale, improvement in inspiratory muscle strength was observed from 9 cmH2O to 12 cmH2O, there was an increase in functional capacity using a six-minute walk test distance from 60 meters to 190 meters, and improvement in the quality of life was observed on the WHO Quality of Life scale from 50% to 52.5% just after two weeks. The study concludes that adding the RC-Cornet PLUS device and POWERbreathe Medic Plus device to the standard pulmonary rehabilitation protocol improves functional capacity and quality of life in bronchiectasis patients.

Keywords: breathlessness; bronchiectasis; chronic cough; pulmonary rehabilitation; rc-cornet plus.

Figure 1. A: Baseline chest X-ray showing marked bronchovascular and hilar markings and the presence of heterogenous opacities bilaterally. B: Post-intervention X-ray after six weeks showing recovery compared to baseline X-ray.

A: The right and left side arrows show marked bronchovascular and hilar markings and the presence of heterogenous opacities bilaterally. B: The right and left side arrows signify the markedly reduced bronchovascular and hilar markings.

Figure 2. HRCT of the thorax suggesting multiple patchy areas of consolidation and tree-in-bud appearance scattered in bilateral lung fields. Bronchiectatic changes were noted in bilateral lung fields. The right arrow shows the tracheal diverticulum, and the left arrow shows the bronchial diverticulum.

HRCT: high-resolution computed tomography