Postural drainage effect after bronchodilator inhalation in patients with chronic airway obstruction

To determine the effect of postural drainage (PD) on pulmonary functions and sputum volume in patients with partially reversible chronic obstructive pulmonary disease, comparisons were made between days with and without PD in 13 such patients. Pulmonary function tests were done 3 times a day over a 12-day period. Medications remained unchanged during this time. PD had no significant effect on either individual pulmonary function tests or 24-hour spectrum volumes. The function tests done at 9:30 AM showed some improvement over those obtained at 8:00 AM without regard to PD, indicating the beneficial effects of bronchodilators inhaled 15 to 20 minutes before PD. Patients were classified as PD responders, nonresponders and negative responders on the basis of concurrent consideration of forced expiratory volume in 1 second, mid-forced expiratory flow and airway resistance. Although the 24-hour sputum volumes did not change, the amount associated with PD was greater. It is suggested that PD is helpful for some patients but detrimental to others. Single pulmonary function tests and single day measurements are insufficient to determine the effects of PD.