Effect Of Vagus Nerve Stimulation Technique On Ventilatory Function In Acute Exacerbation Of Bronchial Asthma

Background: Asthma when uncontrolled, can severely limit the patientu0027s daily life.Little, no, or excess delivery of the active drug substance will place patients with asthma at substantial risk. As physical therapist it is our responsibility to find physical techniques as substitutions or complementary for medications to reduce its use, dose and/or side effects. Purpose: to measure the efficacy of bilateral non invasive cervical vagus nerve stimulation technique on ventilatory function in acute exacerbation of patient diagnosed with bronchial asthma. Subjects and procedures: 30 patients aged between 21-70 years were assigned randomly into two groups 2/1ratio:vagus nerve stimulation group (A) and placebo group (B) both groups underwent pulmonary function test (flow-volume curve)to measure parameters of pulmonary function test (FVC,FEV1,PEF and FEF25-75%) as a percentage of predicted ,after that the vagus nerve stimulation group underwent positioning of four adhesive electrodes for bilateral non invasive cervical vagus nerve stimulation for 20 minutes and the placebo group underwent positioning of four adhesive electrodes without vagus nerve stimulation for 20 minutes after that spirometry was repeated to measure any changes in both groups. Results: for vagus nerve stimulation group (FVC,FEV1,PEF and FEF25-75%) as a percentage of predicted showed significant increase and reversibility of 10.76% ,10.19% ,10.43% and 10.40% respectively . For sham vagus nerve stimulation group FVC, FEV1 and PEF as a percentage of predicted showed insignificant differences and decline of 0.4%, 1.7% and 5.5% respectively and FEF25-75% showed significant decline of 6.8% . Comparing between the two groups in relative changes %;FVC as % of predicted was indicative of insignificant difference ,for FEV1, PEF and FEF25-75% as % of predicted relative changes % were indicative of statistically significant difference conclusion: a technique bilateral vagus nerve electrical stimulation in patients diagnosed with bronchial asthma in acute exacerbation is an effective technique in reversibility of FVC ,FEV1,PEF and FEF25-75% the improvement may be attributed to stimulation of afferent vagus with central desensitization.