Effect of Active Prolonged Inspiration Technique on Intractable Hiccups in Hemodialysis Patients

Wadea, Madonna Magy; Elnahas, Nesreen Gharib Mohamed; Sharabash, Asmaa Mohammed Mohammed; Ismael, Ismael Mohammed

doi:10.21608/iptccu.2025.440764

	Effect of Active Prolonged Inspiration Technique on Intractable Hiccups in Hemodialysis Patients
International Physical Therapy Conference - Cairo University
Volume 4, Issue 1 - Serial Number 20251, 2025, Page 241-255 PDF (847.76 K)
Document Type: Original Article
DOI: 10.21608/iptccu.2025.440764
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Authors
Madonna Magy Wadea ¹; Nesreen Gharib Mohamed Elnahas²; Asmaa Mohammed Mohammed Sharabash³; Ismael Mohammed Ismael⁴
¹Demonstrator, Department of Cardiovascular/ Respiratory Disorder and Geriatrics Physical Therapy, Faculty of Physical Therapy, Cairo University, Egypt
²Professor in Department of Physical Therapy for Cardiovascular / Respiratory Disorder and Geriatrics, Vice Dean Of Community Service and Environmental Development Affairs, Faculty of Physical Therapy, Cairo University, Egypt
³Lecturer of Physical Therapy for Cardiovascular/Respiratory Disorder and Geriatrics Faculty of Physical Therapy, Cairo University, Egypt
⁴Consultant of Internal Medicine and Nephrology at El Sahel Hospital
Abstract
Background: Non-pharmacological interventions like the Active Prolonged Inspiration technique, which combines sustained inspiratory effort and hypercapnia induction, offer a potential solution. Intractable hiccups, a distressing symptom in hemodialysis patients, significantly impair quality of life by disrupting eating, sleeping, and daily activities. This study determined the efficacy of active prolonged inspiration technique in relieving hiccups and its physiological effects in hemodialysis patients. Methods: thirty two hemodialysis patients (19 men and 13 women) were suffering from intractable hiccups with their age ranged from (45-64) years old recruited from El Sahel Teaching Hospital were randomized into two groups: Group A (9 men &7 women) received active prolonged inspiration training (3 sessions/week for 12 weeks) alongside conventional physical therapy training, while Group B (10 men &6 women) received conventional physical therapy training. Hiccups severity was assessed using a 0–10 scale, and arterial blood gases (PCO₂, PO₂, pH) were measured pre- and post-intervention, the duration of the study: from October 2024 to February 2025 Results: Group A exhibited a 67% reduction in hiccup scores, alongside a significant increase in PCO₂ (16%) and decrease in PO₂ (11.5%), indicating hypercapnia. Group B showed no significant changes. Between-group comparisons revealed statistically significant differences in post-intervention hiccup scores and PCO₂ levels (p=0.001), favoring active prolonged inspiration technique. No significant changes in pH were observed in either group. Conclusion: The active prolonged inspiration technique effectively reduces hiccup severity in hemodialysis patients, likely through hypercapnia and reflex arc modulation. Its simplicity, safety, and non-pharmacological nature make it a promising intervention for improving patient quality of life. Further research is warranted to optimize protocols and explore long-term efficacy.
Keywords
active prolonged inspiration technique; intractable hiccups; hemodialysis; hypercapnia; non-pharmacological intervention


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