A clinical trial to study the effects of emergency physiotherapy in persons with a breathing difficulty as a result of an exacerbation of chronic obstructive pulmonary disease

INTERVENTION: Intervention1: Emergency physiotherapy: relaxation, positioning, breathing exercises, sputum clearance techniques, humidification,reassurance all given 4th hourly as indicated Intervention2: Chest physical therapy: incentive spirometry, breathing exercises, breathing control, ambulation, thoracic expansion exercises, humidification and nebulisation. All given when called upon by medical staff Control Intervention1: Chest physical therapy: incentive spirometry, breathing exercises, breathing control, ambulation, thoracic expansion exercises all given twice a day. humidification and nebulisation as indicated. CONDITION: COPD exacerbation PRIMARY OUTCOME: Borgs dyspnea grading‐‐‐‐‐‐Timepoint: Admission,discharge and follow up SECONDARY OUTCOME: Karnofsky grading‐‐‐‐‐‐Timepoint: Admission and discharge Length of stay in hospital‐‐‐‐‐‐Timepoint: Admission to discharge from hospital Length of stay in ICU in hours‐‐‐‐‐‐Timepoint: admission to discharge from ICU Mortality‐‐‐‐‐‐Timepoint: Admission, discharge and follow up Six minute walk test‐‐‐‐‐‐Timepoint: discharge and follow up INCLUSION CRITERIA: Acute exacerbation of COPD