Tomahayu.
Norlita.
, & Yani.
Fisiomu.
2025,Vol 6.
: 152-160 DOI: https://10.
23917/fisiomu.
Combination of Nebulizer and Active Cycle of Breathing Technique (ACBT) to Reduce Shortness of Breath in Asthma Patients Siti Ayulia Tomayahu1*.
Siti Nadhir Ollin Norlinta2.
Fitri Yani3
1,2,3
Physiotherapy Undergraduate Programme.
Faculty of Health.
Universitas 'Aisyiyah Yogyakarta.
Indonesia Email : ayutomayahu6@gmail.
Submition : 2025-03-05.
Accepted : 2025-03-12.
Published :2025-06-01 ABSTRACT Introduction: Asthma is a chronic inflammatory disorder of the airways that experiences continuous inflammation, causing increased airway hyperresponsiveness that causes symptoms of shortness of breath, chest heaviness, wheezing especially at night or during the day.
The Word Health Organisation says there are currently 235 million asthma sufferers in the world.
The Riskesdas survey results showed the highest prevalence of asthma in 2018 at 4.
DIY 3.
5% and data from the Bantul district health office in 2018, asthma in Bantul district as many as 5,572 people.
Methods: quantitative research with quasi-experimental using pre test and post test one group design with a combination of Nebulizer and Active Cycle of Breathing Technique (ACBT).
before and after treatment, the sample measured shortness of breath using the Borg Scale to determine the level of shortness of breath.
Sampling using total sampling technique with sampling that uses all the population as a sample on the condition that it meets the inclusion and exclusion Results: based on the test results of the Wilxocon signed rank test obtained a sig value of p=0.
namely the combination of Nebulizer and Active Cycle of Breathing Technique can reduce shortness of breath in asthmatics.
Conclusion: data analysis shows a value of p=0.
<0.
indicating that there is an effect of the combination of Nebulizer and Active Cycle of Breathing Technique on reducing shortness of breath in asthmatics.
Keywords: Nebulizer.
Active Cycle of Breathing Technique.
Asthma
ISSN 2722 Ae 9610
E AeISSN 2722 - 9629
INTRODUCTION
Asthma is a condition in which people with overactive airways experience coughing, shortness of breath and reversible airway Asthma is also a common disease that varies in severity, ranging from mild wheezing to acute airway closure that can be life-threatening.
It usually appears in childhood and is associated with other features of atopy, such as eczema and hay fever.
Asthma is a chronic inflammatory disorder of the airways that involves many cells and elements.
Persistent inflammation causes increased hyperresponsiveness in the airways, causing symptoms such as shortness of breath, chest heaviness, wheezing, especially at night or during the day (Rahmah & Pratiwi, 2.
Asthma is an urgent disease that must be treated quickly, asthma that often recurs will fatal if not treated quickly and immediately.
There are FISIO MU: Physiotherapy Evidences ISSN 2722 - 9610
E-ISSN 2722-9629
several types of namely childhood asthma where this type of asthma attacks children and the main risk factors are genetic predisposition, history of allergies, respiratory viral infections, bacteria and tobacco exposure.
One of the main factors that increase the likelihood of developing asthma in early childhood tends to be genetic (Resti et al.
, 2.
Allergic Asthma which is caused by allergies which are sensitised to allergens causing asthma symptoms and respiratory tract inflammation.
Allergic asthma is a common asthma phenotype.
This type of asthma is usually accompanied by other comorbidities including atopic dermatitis and allergic rhinitis and a history of eczema (Akar-Ghibril et al.
, 2.
Occupational Asthma, which is asthma caused by work, can usually develop after a single, very high exposure to irritating chemicals.
It causes a direct burning This work is licensed under a Creative Commons Attribution-NonCommercial 4.
0 International License.
Tomahayu.
Norlita.
, & Yani.
Fisiomu.
2025,Vol 6.
: 152-160 DOI: https://10.
23917/fisiomu.
effect on the airways and is not related to the immune system.
This type of asthma can also be caused by sensitisation or can become allergic to certain chemical agents.
This sensitisation process occurs after a single exposure but can develop over time (Nabila et al.
, 2.
The negative impact of asthma that is not treated quickly can be a decrease in productivity, a decrease in quality of life, and can even experience respiratory failure which will cause Asthma can be caused by environmental factors where these factors will cause asthma exacerbations, such as allergens, respiratory infections, exercise, hyperventilation, weather changes, food, air pollution, drugs, cigarette smoke, and excessive emotional expression (Ramadhani, 2.
Heavy smokers who have asthma disease will affect a faster decline in lung function and will experience irreversible airflow limitations (Vanesa Bellou et al.
, 2.
Asthma recurrence can also be caused by a lack of knowledge and education related to health so that patients are not willing to immediately prevent asthma recurrence and lack of support from the family in preventing asthma recurrence.
According to the Word Health Organisation (WHO) there are currently 235 million asthma sufferers in the world.
Every year there are 80% of deaths that occur due to asthma attacks, mostly affecting low and middle income The prevalence of asthma continues to increase, especially in developing countries due to lifestyle changes and increasing air pollution (Sulistiyawati et al.
, 2.
Indonesia, asthma is among the ten most common diseases and deaths.
Of Indonesia's total population of 265 million in 2018, the Riskesdas survey results showed the highest prevalence of asthma in 2018 at 4.
8% with the highest number of women at 2.
5% and 2.
3% of men (Rahman et , 2019 in Syafriningrum et al.
, 2.
Over the past five years, the number of asthma patients in Indonesia has decreased.
Judging from the results of Riskesdas data in 2013, the prevalence of asthma decreased from 4.
5% in 2018 to 2.
Based on data from the Ministry of Health, the prevalence of asthma in Yogyakarta Special Region Province in 2023 reached 3.
5% and FISIO MU: Physiotherapy Evidences ISSN 2722 - 9610
E-ISSN 2722-9629
according to data from the Bantul Health Office in 2018, there were 5,572 people with asthma in Bantul.
Health education can influence a person by providing information directly about things that are still not understood, providing information about health education to patients can increase patients' understanding of asthma so that patients can immediately prevent asthma recurrence itself (Arvida.
Bar et al.
, 2.
Based on the results of previous studies, it was stated that respondents with asthma were more often female than male with an average age of 47 years (Hanna Hisinger et al.
, 2.
A nebulizer is a device used as a treatment for patients with respiratory tract disorders using liquid vapour that has been mixed with medicine.
Inhalation therapy is beneficial for patients suffering from respiratory tract diseases, the main advantage of inhalation therapy is that the drug can be delivered directly into the respiratory tract and then the vapour is mixed with the drug.
directly into the lungs, resulting in higher local concentrations with a much lower risk of systemic side effects (Sondakh et al.
, 2.
Furthermore, there is an Active Cycle of Breathing Technique (ACBT) intervention to reduce shortness of breath and help release secretions from the lungs so that gradually breathing patterns in asthma patients will be more Active Cycle of Breathing Technique (ACBT) is an airway technique for patients with lung disease using breath control, chest expansion and strong expiratory techniques .
lowing and coughin.
in a mechanism designed to reduce shortness of breath, help release secretions from the lungs and maximise oxygen access into the lungs, and restore respiratory muscle activity (Suryati et al.
, 2.
METHODS
This type of research is quasi-experimental research where it does not control respondents in their free activities (Dicky Hastjarjo, 2.
While the research design was carried out during the pre test and post test one group design by giving a combination of Nebulizer and Active Cycle of Breathing Technique (ACBT).
Before This work is licensed under a Creative Commons Attribution-NonCommercial 4.
0 International License.
Tomahayu.
Norlita.
, & Yani.
Fisiomu.
2025,Vol 6.
: 152-160 DOI: https://10.
23917/fisiomu.
being given treatment, the sample was measured for shortness of breath first using the Borg Scale measuring instrument to determine the level of shortness of breath.
Then after undergoing treatment the patient is immediately measured again for the level of breathlessness using the Borg scale measuring instrument.
Sampling in this study using total sampling the samples that researchers use are samples selected through a series of assessment processes so that they represent the population.
The sample that the researcher used was asthma patients at Respira Yogyakarta Hospital, this exercise was carried out 1y in one meeting with the duration of the study for 3 weeks with the number of samples obtained as many as 30.
With the following inclusion criteria: Patients suffering from asthma who experience increased shortness of breath, male and female patients, aged 20-65 years, willing to be a sample as evidenced by signing a letter of consent, a borg scale value of 5 .
evere shortness of breat.
Exclusion criteria are as follows: have a history of heart disease, have a history of hypertension, patients who are not willing to be research subjects.
Drop out criteria are patients who do not participate in the study in full until the research time is completed.
The independent variables in this study are Nebulizer and Active Cycle of Breathing Technique (ACBT).
The dependent variable in this study is a decrease in shortness of breath in The data processing method in this study was univariate analysis in the form of age, gender, family history and borg scale scores.
Data analysis using statistical tests based on the results of the sample normality test.
The normality test uses the Shapiro-Wilk test to determine whether the data is normally distributed .
>0.
or not normally distributed .
<0.
If the results are obtained normally distributed, then to test the hypothesis using a parametric statistical test, namely the Paired Sample t-test, if the data is not normally distributed using a non-parametric test, namely the Shaphiro Wilk Test.
Hypothesis testing to determine whether the effect of giving Nebulizer and Active Cycle of Breathing Technique (ACBT).
This research was conducted after the issuance of an Ethical Certificate from Respira Lung Hospital Yogyakarta Number:
036/KEPK/XII/2024.
RESULTS
The results of this study regarding the characteristics of respondents including age, gender, height and weight can be seen in table 4.
as follows:
Table1.
Respondent Characteristics Respondents Rent
MeanASD
Age
07A12,25
Height
03A7,74
Body weight
57A13,75
Description n = Number of Respondents Based on the results of research and SPSS calculations, the table above shows the characteristics of respondents in this study in the form of age with a mean of 47.
In the characteristics of respondents based on height, the mean is 159.
In the characteristics of respondents based on body weight with a mean of In the characteristics of respondents based on the borg pre scale value with a mean of 4.
the characteristics of respondents based on the borg post scale value with a mean of 1.
Figure 1.
Nebuliser and Active Cycle of Breathing Technique (ACBT) administration FISIO MU: Physiotherapy Evidences ISSN 2722 - 9610
E-ISSN 2722-9629
This work is licensed under a Creative Commons Attribution-NonCommercial 4.
0 International License.
Tomahayu.
Norlita.
, & Yani.
Fisiomu.
2025,Vol 6.
: 152-160 DOI: https://10.
23917/fisiomu.
Table 2.
Characteristics of Respondents Based on Gender Gender Male Women Total Table 5.
Characteristics Based on Frequency of Shortness of Breath Rent Group n Pre Mean Post Mean Nebu and 30 4-5 4,97 1-3 1,67 ACBT Based on the results of research and SPSS calculations, it is known that the percentage of gender is mostly female, 16 respondents each .
3%) while the fewest are 14 respondents .
7%).
Description Nebu and ACBT= Nebuliser and Active Cycle of Breathing Technique (ACBT Pre test= before Post test= after n= number of Based on the table above, it is known that the average shortness of breath in asthma patients before being given a nebulizer and active cycle of breathing technique (ACBT) with a mean of 4.
and after being given a nebulizer and active cycle of breathing technique (ACBT) obtained a mean value of 1.
Table 3.
Characteristics by Age Age (Year.
29,8% 33,3% 36,6% Total Table 6.
Shapiro Wilk Test
Frequency of Shapiro wilk test
Shortness of Breath
Pre test
0,000
Post test
0,000
Based on the table above, the samples given Nebulizer and Active Cycle of Breathing Technique (ACBT) had an age of 24-43 years as many as 9 respondents .
8%), age 44-52 as many as 10 respondents .
3%) and age 53-65 as many as 11 respondents .
6%).
Table 4.
Characteristics Based on Family History Family History Yes
56,7%
43,3%
Total Based on the calculations and results from SPSS from Shapiro Wilk above, it is found that the pre-test Shapiro Wilk value has a p-value of 000, while the post-test has a p-value of 0.
From these results it can be seen that both pvalues are 0.
From these results it can be seen that both P values <0.
05, it can be concluded that the borg scale data is not normally distributed.
Based on the table above, it can be seen that those given Nebulizer and Active Cycle of Breathing Technique (ACBT) who gave yes answers were 17 respondents .
7%) while those who answered no were 13 respondents .
3%).
Table 7.
Hypothesis Test Using Wilxocon Signed Rank Test Effect of Nebulizer and ACBT Group Sig .
Nebu and ACBT
0,000
FISIO MU: Physiotherapy Evidences ISSN 2722 - 9610
E-ISSN 2722-9629
This work is licensed under a Creative Commons Attribution-NonCommercial 4.
0 International License.
Tomahayu.
Norlita.
, & Yani.
Fisiomu.
2025,Vol 6.
: 152-160 DOI: https://10.
23917/fisiomu.
Based on the calculation and SPSS results of the Wilxocon test above, it is known that the respondents who were given a nebulizer and active cycle of breathing technique with a p-value of p <0.
05 so it can be concluded that there is a very significant effect of giving a nebulizer and active cycle of breathing technique in reducing shortness of breath in asthmatics.
accordance with research by Hisinger-mylkynen & Honkamyki .
that asthma diagnosed in adults is more often associated with environmental and lifestyle factors than asthma diagnosed in children which again is often associated with atopy and genetic factors.
Based on the results of the study of 30 respondents, the average body weight was 57kg who experienced asthma.
This is in line with research by Caroline et al.
, .
which states that obesity is recognised as an important risk factor for being diagnosed with asthma.
There may be a common genetic basis for obesity and Obesity is also recognised as a potential risk factor for more severe asthma.
Therefore, obesity is a potentially modifiable risk factor for asthma patients.
Being overweight not only leads to the development of asthma, but also negatively affects the clinical manifestations of asthma including symptoms and response to asthma.
Weight loss is expected to have the opposite effect which might improve the clinical status of individuals with asthma.
From the results of the auscultation examination, 25 respondents experienced shortness of breath accompanied by wheezing and 5 respondents experienced shortness of breath but not wheezing.
One of the symptoms that indicates the narrowing of the respiratory tract in asthma patients is the additional sound of wheezing.
Wheezing describes the sound produced by the turbulence of gas flow through a narrow airway.
When obstruction is more severe, wheezing sounds are more prominent and can be heard in the early phase of expiration.
Wheezing sounds that occur repeatedly and persist can be expected due to focal airway obstruction, such as bronchial narrowing due to foreign body aspiration or due to neoplasm (Aini et al.
, 2.
From the results of interviews with respondents who have been conducted, it is found that more patients experience shortness of breath at night than in the morning.
On average, patients experience shortness of breath more often in cold weather and patients who experience shortness of breath due to exposure to cigarette smoke are more than patients who do not experience recurrence when exposed to cigarette smoke.
DISCUSSION