1
|
Huang H, Da J, Watson R, Hayter M, Huang M. Development and Validation of an Evidence-Based Home Pursed Lip Breathing Protocol for Improving Health Outcomes in Patients With Chronic Obstructive Pulmonary Disease. Int J Older People Nurs 2024; 19:e12627. [PMID: 38946215 DOI: 10.1111/opn.12627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 06/04/2024] [Accepted: 06/09/2024] [Indexed: 07/02/2024]
Abstract
AIM To develop and validate an evidence-based home pursed lip breathing (PLB) intervention protocol for improving related health outcomes (e.g., dyspnea and exercise capability) in patients with chronic obstructive pulmonary disease (COPD) and to present a detailed intervention development process. METHODS This home PLB intervention protocol employed phase one of the Medical Research Council (MRC) Framework for Developing and Evaluating Complex Interventions to guide the development process of the PLB intervention. We searched for research evidence on 5 July 2023 from several databases, including PubMed, Embase (via Ovid), Cochrane Library, Google Scholar and China Biology Medicine Disk (CBM). Using the content validity index, a panel of experts assessed the appropriateness of the PLB protocol. RESULTS We developed the preliminary home PLB intervention protocol on the basis of several underlying rationales, which encompass the extension of expiration time, enhancement of respiratory muscle strength, augmentation of tidal volume and integration of the most reliable research evidence obtained from four systematic reviews, five RCTs, five clinical trials, and 10 recommendations. We structured the PLB intervention with a designated time ratio of inspiration to expiration, set at 1:2. Additionally, this study recommends that the training parameters of the PLB intervention were as follows: three sessions per day, each lasting for 10 min, over 8 weeks. Individualised PLB training intensity adjusted the inhalation component according to each participant's tolerance level while emphasising the exhalation phase to ensure the complete expulsion of air from the lungs. The home PLB intervention protocol established strong content validity through consensus, which was reached among all panel experts. The item-level and scale-level content validity indices (CVIs) reached a maximum score of 1.0, indicating a high level of agreement and credibility in the protocol's content as evaluated by the expert panel. CONCLUSION An optimal evidence-based home PLB protocol has been adapted and developed to manage health-related outcomes of patients with COPD. The protocol is transparent and fully supported by relevant mechanisms, concrete evidence, recommendations and experts' consensus. IMPLICATIONS FOR PRACTICE In this study, we consulted patients with COPD about the 'Prepared Conditions Before PLB Practice', to ensure appropriate measures to prevent patients with COPD from potential risks. In addition, patients with COPD also contributed to the PLB exercise frequency distribution.
Collapse
Affiliation(s)
- Houqiang Huang
- Nursing Department, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, People's Republic of China
| | - Jun Da
- Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, People's Republic of China
| | - Roger Watson
- Nursing Faculty, Southwest Medical University, Luzhou, Sichuan, People's Republic of China
| | - Mark Hayter
- Nursing Faculty, Manchester Metropolitan University, Manchester, UK
| | - Min Huang
- Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Southwest Medical University, Luzhou, Sichuan, People's Republic of China
| |
Collapse
|
2
|
Yang L, Gao Z, Cao X, Wang C, Wang H, Dai J, Liu Y, Qin Y, Dai M, Zhang B, Zhao K, Zhao Z. Visualizing pursed lips breathing of patients with chronic obstructive pulmonary disease through evaluation of global and regional ventilation using electrical impedance tomography. Physiol Meas 2024; 45:045005. [PMID: 38479002 DOI: 10.1088/1361-6579/ad33a1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 03/13/2024] [Indexed: 04/17/2024]
Abstract
Objective. This study aims to explore the possibility of using electrical impedance tomography (EIT) to assess pursed lips breathing (PLB) performance of patients with chronic obstructive pulmonary disease (COPD).Methods. 32 patients with COPD were assigned equally to either the conventional group or the EIT guided group. All patients were taught to perform PLB by a physiotherapist without EIT in the conventional group or with EIT in the EIT guided group for 10 min. The ventilation of all patients in the final test were continuously monitored using EIT and the PLB performances were rated by another physiotherapist before and after reviewing EIT. The global and regional ventilation between two groups as well as between quite breathing (QB) and PLB were compared and rating scores with and without EIT were also compared.Results.For global ventilation, the inspiratory depth and the ratio of expiratory-to-inspiratory time during PLB was significantly larger than those during QB for both group (P< 0.001). The inspiratory depth and the ratio of expiratory-to-inspiratory time during PLB in the EIT guided group were higher compared to those in the conventional group (P< 0.001), as well as expiratory flow expiratory uniformity and respiratory stability were better (P< 0.001). For regional ventilation, center of ventilation significantly decreased during PLB (P< 0.05). The expiratory time constant during PLB in the EIT guided group was greater than that in the conventional group (P< 0.001). Additionally, Bland-Altman plots analysis suggested a high concordance between subjective rating and rating with the help of EIT, but the score rated after EIT observation significantly lower than that rated subjectively in both groups (score drop of -2.68 ± 1.1 in the conventional group and -1.19 ± 0.72 in the EIT guided group,P< 0.01).Conclusion.EIT could capture the details of PLB maneuver, which might be a potential tool to quantitatively evaluate PLB performance and thus assist physiotherapists to teach PLB maneuver to patients.
Collapse
Affiliation(s)
- Lin Yang
- Department of Aerospace Medicine, Air Force Medical University, Xi'an, People's Republic of China
| | - Zhijun Gao
- Department of Aerospace Medicine, Air Force Medical University, Xi'an, People's Republic of China
| | - Xinsheng Cao
- Department of Aerospace Medicine, Air Force Medical University, Xi'an, People's Republic of China
| | - Chunchen Wang
- Department of Aerospace Medicine, Air Force Medical University, Xi'an, People's Republic of China
| | - Hang Wang
- Department of Aerospace Medicine, Air Force Medical University, Xi'an, People's Republic of China
| | - Jing Dai
- Department of Aerospace Medicine, Air Force Medical University, Xi'an, People's Republic of China
| | - Yang Liu
- Department of Aerospace Medicine, Air Force Medical University, Xi'an, People's Republic of China
| | - Yilong Qin
- Department of Aerospace Medicine, Air Force Medical University, Xi'an, People's Republic of China
| | - Meng Dai
- Department of Biomedical Engineering, Air Force Medical University, Xi'an, People's Republic of China
| | - Binghua Zhang
- Department of Pulmonary and Critical Care Medicine, 986th Hospital of Air Force, Air Force Medical University, Xi'an, People's Republic of China
| | - Ke Zhao
- Department of Pulmonary and Critical Care Medicine, 986th Hospital of Air Force, Air Force Medical University, Xi'an, People's Republic of China
| | - Zhanqi Zhao
- School of Biomedical Engineering, Guangzhou Medical University, Guangzhou, People's Republic of China
- Department of Critical Care Medicine, Peking Union Medical College Hospital, Beijing, People's Republic of China
| |
Collapse
|
3
|
Nangliya R, Yadav V, Nandanwar SP. Novelty of Physiotherapy Management in a Classic Case of Chronic Obstructive Pulmonary Disease in an 84-Year-Old Male Patient with Hypertension and Well-Controlled Hypothyroidism: A Case Report. Cureus 2024; 16:e57318. [PMID: 38690482 PMCID: PMC11060019 DOI: 10.7759/cureus.57318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 03/31/2024] [Indexed: 05/02/2024] Open
Abstract
Chronic obstructive pulmonary disease (COPD) often coexists with hypertension and hypothyroidism, posing challenges in management. Physiotherapy is crucial for improving respiratory function and quality of life in COPD patients. This case report details the physiotherapy management of an 84-year-old male with COPD, hypertension, and well-controlled hypothyroidism. The patient presented with worsening cough, breathlessness, and barrel chest. Diagnostic investigations confirmed COPD with respiratory alkalosis, hypoxemia, and well-controlled hypothyroidism. Pharmaceutical management was initiated alongside intensive physiotherapy interventions. A two-week rehabilitation program was tailored to the patient's COPD condition. It included deep breathing exercises, relaxation techniques, and aerobic activities to improve respiratory function and exercise tolerance. Physiotherapy sessions focused on patient education with medical treatment. Significant improvements were noted in dyspnea grading, perceived exertion rate, and thoracic excursion post-rehabilitation. Follow-up assessments showed sustained benefits with improved daily activities and reduced dyspnea. This case underscores the efficacy of multidisciplinary management, highlighting the essential role of physiotherapy in optimizing outcomes for COPD patients with comorbidities.
Collapse
Affiliation(s)
- Radha Nangliya
- Department of Cardiovascular and Respiratory Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Vaishnavi Yadav
- Department of Cardiovascular and Respiratory Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Sojwal P Nandanwar
- Department of Cardiovascular and Respiratory Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| |
Collapse
|
4
|
Potočnik MM, Edwards I, Potočnik N. Locomotor-Respiratory Entrainment upon Phonated Compared to Spontaneous Breathing during Submaximal Exercise. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2838. [PMID: 36833534 PMCID: PMC9957459 DOI: 10.3390/ijerph20042838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 01/24/2023] [Accepted: 01/27/2023] [Indexed: 06/18/2023]
Abstract
Recently, increased attention to breathing techniques during exercise has addressed the need for more in-depth study of the ergogenic effects of breathing manipulation. The physiological effects of phonation, as a potential breathing tool, have not yet been studied. Thus, the aim of this study was to investigate the respiratory, metabolic and hemodynamic responses of phonated exhalation and its impact on locomotor-respiratory entrainment in young healthy adults during moderate exercise. Twenty-six young, healthy participants were subjected to peak expiratory flow (PEF) measurements and a moderate steady cycling protocol based on three different breathing patterns (BrP): spontaneous breathing (BrP1), phonated breathing pronouncing "h" (BrP2) and phonated breathing pronouncing "ss" (BrP3). The heart rate, arterial blood pressure, oxygen consumption, CO2 production, respiratory rate (RR), tidal volume (VT), respiratory exchange ratio and ventilatory equivalents for both important respiratory gasses (eqO2 and eqCO2) were measured (Cosmed, Italy) simultaneously during a short period of moderate stationary cycling at a predefined cadence. To evaluate the psychological outcomes, the rate of perceived exertion (RPE) was recorded after each cycling protocol. The locomotor-respiratory frequency coupling was calculated at each BrP, and dominant coupling was determined. Phonation gradually decreased the PEF (388 ± 54 L/min at BrP2 and 234 ± 54 L/min at BrP3 compared to 455 ± 42 L/min upon spontaneous breathing) and affected the RR (18.8 ± 5.0 min-1 at BrP2 compared to 22.6 ± 5.5 min-1 at BrP1 and 21.3 ± 7.2 min-1 at BrP3), VT (2.33 ± 0.53 L at BrP2 compared to 1.86 ± 0.46 L at BrP1 and 2.00 ± 0.45 L at BrP3), dominant locomotor-respiratory coupling (1:4 at BrP2 compared to 1:3 at BrP1 and BrP2) and RPE (10.27 ± 2.00 at BrP1 compared to 11.95 ± 1.79 at BrP1 and 11.95 ± 1.01 at BrP3) but not any other respiratory, metabolic or hemodynamic measures of the healthy adults during moderate cycling. The ventilatory efficiency was shown to improve upon dominant locomotor-respiratory coupling, regardless of BrP (eqO2 = 21.8 ± 2.2 and eqCO2 = 24.0 ± 1.9), compared to the other entrainment coupling regimes (25.3 ± 1.9, 27.3 ± 1.7) and no entrainment (24.8 ± 1.5, 26.5 ± 1.3), respectively. No interaction between phonated breathing and entrainment was observed during moderate cycling. We showed, for the first time, that phonation can be used as a simple tool to manipulate expiratory flow. Furthermore, our results indicated that in young healthy adults, entrainment, rather than expiratory resistance, preferentially affected ergogenic enhancement upon moderate stationary cycling. It can only be speculated that phonation would be a good strategy to increase exercise tolerance among COPD patients or to boost the respiratory efficiency of healthy people at higher exercise loads.
Collapse
Affiliation(s)
- Maja Marija Potočnik
- Departmenet of Anasthesiology and Intensive Therapy, University Medical Center, 1000 Ljubljana, Slovenia
| | - Ian Edwards
- Centre for Cardiovascular and Metabolic Neuroscience, Department of Neuroscience, Physiology & Pharmacology, University College London, London WC1E 6BT, UK
| | - Nejka Potočnik
- Institute of Physiology, Medical Faculty, University of Ljubljana, 1000 Ljubljana, Slovenia
| |
Collapse
|
5
|
Neşe A, Samancıoğlu Bağlama S. The Effect of Progressive Muscle Relaxation and Deep Breathing Exercises on Dyspnea and Fatigue Symptoms of COPD Patients: A Randomized Controlled Study. Holist Nurs Pract 2022; 36:E18-E26. [PMID: 35708562 DOI: 10.1097/hnp.0000000000000531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This study was conducted to examine the effect of progressive muscle relaxation and deep breathing exercises applied to patients diagnosed with chronic obstructive pulmonary disease (COPD) on their dyspnea and fatigue symptoms. The study was a randomized controlled experimental trial and comprised 116 COPD patients who applied to a chest diseases follow-up outpatient clinic hospital located in Gaziantep, Turkey. The data were collected using the "Patient Information Form" including sociodemographic and disease-related characteristics of the patients, COPD and Asthma Fatigue Scale (CAFS), and Dyspnea-12 Scale. Dyspnea-12 Scale and CAFS total scores of the patients in the intervention group showed a statistically significant difference before and after the Progressive Relaxation Exercise and Deep Breathing Exercise applications (P < .05). Although the Dyspnea-12 Scale and CAFS total mean scores showed an increase in the intervention group, they remained the same in the control group. In the present study, it was found that the Progressive Muscle Relaxation Exercise and Deep Breathing Exercise applied to COPD patients were effective in decreasing their dyspnea and fatigue symptoms.
Collapse
Affiliation(s)
- Adile Neşe
- Gaziantep University Vocational School of Health Services, Gaziantep, Turkey (Dr Neşe); and Faculty of Health Sciences, Nursing Department, Muğla Sıtkı Kocaman University, Muğla, Turkey (Dr Samancıoğlu Bağlama)
| | | |
Collapse
|
6
|
Sharpe E, Lacombe A, Sadowski A, Phipps J, Heer R, Rajurkar S, Hanes D, Jindal RD, Bradley R. Investigating components of pranayama for effects on heart rate variability. J Psychosom Res 2021; 148:110569. [PMID: 34271528 PMCID: PMC8568305 DOI: 10.1016/j.jpsychores.2021.110569] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 07/02/2021] [Accepted: 07/04/2021] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Traditional Indian breath control practices of Pranayama have been shown to increase indices of heart rate variability (HRV) that are generally held to reflect parasympathetic nervous system (PNS) tone. To our knowledge, individual components of pranayama have not been separately evaluated for impact on HRV. The objective of this study was to isolate five components of a pranayama practice and evaluate their impact on HRV. METHODS In a crossover clinical trial, 46 healthy adults were allocated to complete five activities in random order, over five separate visits: 1) sitting quietly; 2) self-paced deep breathing; 3) externally-paced deep breathing; 4) self-paced Sheetali/Sheetkari pranayama; and 5) externally paced Sheetali/Sheetkari pranayama RESULTS: Our final sample included 25 participants. There was a significant increase in a time-domain index of HRV, the root mean square successive differences between RR intervals (RMSSD), during the five interventions. The change in logRMSSD ranged from 0.2 to 0.5 (p < .01 in all conditions by paired t-test). Greater increases were evident during externally-paced breathing than during self-paced breathing (mean pre-during logRMSSD change of 0.50 vs. 0.36, p = .02) or sitting quietly (mean, 0.17 ms; p = .005 and 0.02 when comparing Activities 3 and 5 to Activity 1 by random intercept model with Tukey correction for multiple comparisons). Lastly, pre-during increase in RMSSD was greater for Sheetali/Sheetkari vs. deep breathing, when controlling for respiration rate, though not significantly different (p = .07 in random intercept model) CONCLUSIONS: RMSSD increased with paced breathing, deep breathing, and Sheetali/Sheetkari pranayama, reinforcing evidence of a physiologic mechanism of pranayama. TRIAL REGISTRATION NCT03280589 https://www.clinicaltrials.gov/ct2/show/NCT03280589?term=sheetali&draw=2&rank=1.
Collapse
Affiliation(s)
- Erica Sharpe
- National University of Natural Medicine, Portland, OR, United States of America; State University of New York at Canton, Canton, NY, United States of America.
| | - Alison Lacombe
- National University of Natural Medicine, Portland, OR,United States Department of Agriculture, Produce Safety Microbiology Research Unit, Albany, CA
| | - Adam Sadowski
- National University of Natural Medicine, Portland, OR, United States of America.
| | - John Phipps
- National University of Natural Medicine, Portland, OR, United States of America.
| | - Ryan Heer
- National University of Natural Medicine, Portland, OR
| | - Savita Rajurkar
- National University of Natural Medicine, Portland, OR, United States of America.
| | - Douglas Hanes
- National University of Natural Medicine, Portland, OR, United States of America.
| | - Ripu D Jindal
- Birmingham VA Medical Center, University of Alabama at Birmingham, Birmingham, AL, United States of America.
| | - Ryan Bradley
- National University of Natural Medicine, Portland, OR, United States of America; University of California, San Diego, La Jolla, CA, United States of America; Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia.
| |
Collapse
|
7
|
Ubolnuar N, Tantisuwat A, Thaveeratitham P, Lertmaharit S, Kruapanich C, Chimpalee J, Mathiyakom W. Effects of pursed-lip breathing and forward trunk lean postures on total and compartmental lung volumes and ventilation in patients with mild to moderate chronic obstructive pulmonary disease: An observational study. Medicine (Baltimore) 2020; 99:e23646. [PMID: 33371099 PMCID: PMC7748318 DOI: 10.1097/md.0000000000023646] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 11/09/2020] [Accepted: 11/11/2020] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT This study identified the effects of pursed-lip breathing (PLB), forward trunk lean posture (FTLP), and combined PLB and FTLP on total and compartmental lung volumes, and ventilation in patients with chronic obstructive pulmonary disease (COPD). Sixteen patients with mild to moderate COPD performed 2 breathing patterns of quiet breathing (QB) and PLB during FTLP and upright posture (UP). The total and compartmental lung volumes and ventilation of these 4 tasks (QB-UP, PLB-UP, QB-FTLP, PLB-FTLP) were evaluated using optoelectronic plethysmography. Two-way repeated measures ANOVA was used to identify the effect of PLB, FTLP, and combined strategies on total and compartmental lung volumes and ventilation. End-expiratory lung volume of ribcage compartment was significantly lower in PLB-UP than QB-UP and those with FTLP (P < .05). End-inspiratory lung volume (EILV) and end-inspiratory lung volume of ribcage compartment were significantly greater during PLB-FTLP and PLB-UP than those of QB (P < .05). PLB significantly and positively changed end-expiratory lung volume of abdominal compartment (EELVAB ) end-expiratory lung volume, EILVAB, tidal volume of pulmonary ribcage, tidal volume of abdomen, and ventilation than QB (P < .05). UP significantly increased tidal volume of pulmonary ribcage, tidal volume of abdomen, and ventilation and decreased EELVAB, end-expiratory lung volume, and EILVAB than FTLP (P < .05). In conclusion, combined PLB with UP or FTLP demonstrates a positive change in total and compartmental lung volumes in patients with mild to moderate COPD.
Collapse
Affiliation(s)
- Nutsupa Ubolnuar
- Department of Physical Therapy, Faculty of Allied Health Sciences
| | - Anong Tantisuwat
- Department of Physical Therapy, Faculty of Allied Health Sciences
| | | | - Somrat Lertmaharit
- Department of Preventive and Social Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok
| | | | - Jaturong Chimpalee
- Department of Physical Therapy and Rehabilitation, Central Chest Institute of Thailand, Nonthaburi, Thailand
| | - Witaya Mathiyakom
- Department of Physical Therapy, California State University, Northridge, CA, USA
| |
Collapse
|
8
|
Li J, Liu W, Ding X, Wang W, Li K. Breathing exercises in people with COPD: A realist review. J Adv Nurs 2020; 77:1698-1715. [PMID: 33615544 DOI: 10.1111/jan.14703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 10/16/2020] [Accepted: 11/16/2020] [Indexed: 10/22/2022]
Abstract
AIMS To determine the theoretical framework that explains the mechanisms of the success of breathing exercise interventions in people with chronic obstructive pulmonary disease. DESIGN A realist review. DATA SOURCES Seven bibliographic databases and the grey literature were searched from 2015-January 2020 to identify the studies of breathing exercises. REVIEW METHODS The evaluation criteria of realist review and the mixed method appraisal tool were both used to evaluate the included studies. We extracted and integrated the context-mechanism-outcome strings of each study to form the theoretical framework. RESULTS Six theoretical mechanisms that affected the success of the intervention were articulated: Wide acceptance of training methods, Integration of the intervention with life, Self-management of the participants, Confidence in controlling symptoms, Participation and support of practitioners, Motivation for intervention. Conversely, the other two mechanisms including the gap between implementation and training and the duration of the intervention, had negative impacts on the implementation of breathing exercises. CONCLUSION This review updates and expands the previous literature review on the impact of breathing exercises in people and provides researchers and clinical practitioners with theoretical mechanisms to ensure that the interventions achieve expected effects. IMPACT When formulating or selecting breathing exercise interventions, our theoretical framework will guide researchers and clinical practitioners to ensure that the intervention will have practical effects.
Collapse
Affiliation(s)
- Jing Li
- School of Nursing, Jilin University, Changchun, China
| | - Wei Liu
- Operation Room Department, The First Hospital of Jilin University, Changchun, China
| | - Xinxin Ding
- School of Nursing, Jilin University, Changchun, China
| | - Wenjing Wang
- School of Nursing, Jilin University, Changchun, China
| | - Kun Li
- School of Nursing, Jilin University, Changchun, China
| |
Collapse
|
9
|
McGrath M, Smith J, Rattray NA, Lillie A, Crow S, Myers LJ, Myers J, Perkins AJ, Wasmuth S, Burns DS, Cheatham AJ, Patel H, Bravata DM. Teaching pursed-lip breathing through music: MELodica Orchestra for DYspnea (MELODY) trial rationale and protocol. Arts Health 2020; 14:49-65. [PMID: 33064621 DOI: 10.1080/17533015.2020.1827277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Patients with chronic obstructive pulmonary disease (COPD) commonly experience dyspnea, which may limit activities of daily living. Pursed-lip breathing improves dyspnea for COPD patients; however, access to pursed-lip breathing training is limited. METHODS The proposed MELodica Orchestra for DYspnea (MELODY) study will be a single-site pilot study to assess the safety, feasibility, and efficacy of a music-based approach to teach pursed-lip breathing. Patients with COPD and moderate-severe dyspnea are randomized to intervention, education-control, or usual care control groups. Intervention patients meet twice weekly for eight weeks for melodica instruction, group music-making, and COPD education. Safety, feasibility, and efficacy is assessed qualitatively and quantitatively. RESULTS This manuscript describes the rationale and methods of the MELODY pilot project. CONCLUSIONS If pilot data demonstrate efficacy, then a multi-site randomized control trial will be conducted to evaluate program effectiveness and implementation.
Collapse
Affiliation(s)
| | - Joseph Smith
- Indiana University School of Medicine, Indianapolis, IN, USA.,Department of Internal Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.,Department of Medicine Division of Pulmonary, Critical Care, Sleep & Occupational Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.,Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA
| | - Nicholas A Rattray
- Department of Veterans Affairs (VA) Health Services Research and Development (HSR&D) Precision Monitoring to Transform Care (PRISM) Quality Enhancement Research Initiative (QUERI), Indianapolis, IN, USA.,VA HSR&D Center for Health Information and Communication (CHIC), Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA.,Center for Health Services Research, Regenstrief Institute, Indianapolis, IN, USA.,Department of Anthropology, IUPUI, Indianapolis, IN, USA
| | - Aimee Lillie
- Department of Veterans Affairs (VA) Health Services Research and Development (HSR&D) Precision Monitoring to Transform Care (PRISM) Quality Enhancement Research Initiative (QUERI), Indianapolis, IN, USA.,VA HSR&D Center for Health Information and Communication (CHIC), Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA
| | - Shannon Crow
- Department of Veterans Affairs (VA) Health Services Research and Development (HSR&D) Precision Monitoring to Transform Care (PRISM) Quality Enhancement Research Initiative (QUERI), Indianapolis, IN, USA
| | - Laura J Myers
- Department of Internal Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.,Department of Veterans Affairs (VA) Health Services Research and Development (HSR&D) Precision Monitoring to Transform Care (PRISM) Quality Enhancement Research Initiative (QUERI), Indianapolis, IN, USA.,VA HSR&D Center for Health Information and Communication (CHIC), Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA
| | - Jennifer Myers
- Department of Veterans Affairs (VA) Health Services Research and Development (HSR&D) Precision Monitoring to Transform Care (PRISM) Quality Enhancement Research Initiative (QUERI), Indianapolis, IN, USA.,VA HSR&D Center for Health Information and Communication (CHIC), Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA
| | - Anthony J Perkins
- Department of Veterans Affairs (VA) Health Services Research and Development (HSR&D) Precision Monitoring to Transform Care (PRISM) Quality Enhancement Research Initiative (QUERI), Indianapolis, IN, USA.,Department of Biostatistics, Indiana University School of Medicine, IUPUI, Indianapolis, IN, USA
| | - Sally Wasmuth
- School of Occupational Therapy, Indiana University School of Health & Human Sciences, Indianapolis, IN, USA
| | - Debra S Burns
- Department of Music and Arts Technology, Indiana University-Purdue University Indianapolis (IUPUI), Indianapolis, IN, USA
| | - Ariel J Cheatham
- Department of Veterans Affairs (VA) Health Services Research and Development (HSR&D) Precision Monitoring to Transform Care (PRISM) Quality Enhancement Research Initiative (QUERI), Indianapolis, IN, USA.,VA HSR&D Center for Health Information and Communication (CHIC), Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA
| | - Himalaya Patel
- VA HSR&D Center for Health Information and Communication (CHIC), Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA
| | - Dawn M Bravata
- Department of Internal Medicine, Indiana University School of Medicine, Indianapolis, IN, USA.,Department of Veterans Affairs (VA) Health Services Research and Development (HSR&D) Precision Monitoring to Transform Care (PRISM) Quality Enhancement Research Initiative (QUERI), Indianapolis, IN, USA.,VA HSR&D Center for Health Information and Communication (CHIC), Richard L. Roudebush VA Medical Center, Indianapolis, IN, USA.,Center for Health Services Research, Regenstrief Institute, Indianapolis, IN, USA.,Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
| |
Collapse
|
10
|
Jiandani MP, Agarwal B, Baxi G, Kale S, Pol T, Bhise A, Pandit U, Shetye JV, Diwate A, Damke U, Ravindra S, Patil P, Nagarwala RM, Gaikwad P, Agarwal S, Madan K, Jacob P, Surendran PJ, Swaminathan N. Evidence-based National Consensus: Recommendations for Physiotherapy Management in COVID-19 in Acute Care Indian Setup. Indian J Crit Care Med 2020; 24:905-913. [PMID: 33281313 PMCID: PMC7689134 DOI: 10.5005/jp-journals-10071-23564] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND With the Wuhan pandemic spread to India, more than lakhs of population were affected with COVID-19 with varying severities. Physiotherapists participated as frontline workers to contribute to management of patients in COVID-19 in reducing morbidity of these patients and aiding them to road to recovery. With infrastructure and patient characteristics different from the West and lack of adequate evidence to existing practices, there was a need to formulate a national consensus. MATERIALS AND METHODS Recommendations were formulated with a systematic literature search and feedback of physiotherapist experiences. Expert consensus was obtained using a modified Delphi method. RESULTS The intraclass coefficient of agreement between the experts was 0.994, significant at p < 0.001. CONCLUSION This document offers physiotherapy evidence-based consensus and recommendation to planning physiotherapy workforce, assessment, chest physiotherapy, early mobilization, preparation for discharge planning, and safety for patients and therapist in acutec are COVID 19 setup of India. The recommendations have been integrated in the algorithm and are intended to use by all physiotherapists and other stakeholders in management of patients with COVID-19 in acute care settings. HOW TO CITE THIS ARTICLE Jiandani MP, Agarwal B, Baxi G, Kale S, Pol T, Bhise A, et al. Evidence-based National Consensus: Recommendations for Physiotherapy Management in COVID-19 in Acute Care Indian Setup. Indian J Crit Care Med 2020;24(10):905-913.
Collapse
Affiliation(s)
- Mariya P Jiandani
- Physiotherapy School and Centre, Seth Gordhandas Sunderdas Medical College and King Edward Memorial Hospital, Parel, Mumbai, Maharashtra, India
| | - Bela Agarwal
- Department of Physiotherapy, MGM School of Physiotherapy, MGM Institute of Health Sciences, Navi Mumbai, Maharashtra, India
| | - Gaurang Baxi
- Department of Physiotherapy, Dr. DY Patil College of Physiotherapy, Dr. DY Patil Vidyapeeth, Pune, Maharashtra, India
| | - Sudeep Kale
- Department of Cardiorespiratory Physiotherapy, Terna Physiotherapy College, Navi Mumbai, Maharashtra, India
| | - Titiksha Pol
- Department of Physiotherapy, DY Patil University, School of Physiotherapy, Navi Mumbai, Maharashtra, India
| | - Anjali Bhise
- Department of Physiotherapy, Government Physiotherapy College and Spine Institute, Civil Hospital, Ahmedabad, Gujarat, India
| | - Unnati Pandit
- Department of Physiotherapy, DY Patil University, School of Physiotherapy, Navi Mumbai, Maharashtra, India
| | - Jaimala V Shetye
- Physiotherapy School and Centre, Seth Gordhandas Sunderdas Medical College and King Edward Memorial Hospital, Parel, Mumbai, Maharashtra, India
| | - Abhijit Diwate
- Department of Physiotherapy, Dr. Vithalrao Vikhe Patil Foundations College of Physiotherapy, Ahmednagar, Maharashtra, India
| | - Umanjali Damke
- Physiotherapy School and Center, Government Medical College, Nagpur, Maharashtra, India
| | - Savita Ravindra
- COO-Centre for Rehabilitation, M.S. Ramaiah Medical College and Hospitals, Bengaluru, Karnataka, India
| | - Prajakta Patil
- Department of Cardiorespiratory Physiotherapy, Smt. Kashibai Navale College of Physiotherapy, Pune, Maharashtra, India
| | - Raziya M Nagarwala
- Cardiovascular and Respiratory Physiotherapy Department, Sancheti Institute College of Physiotherapy, Pune, Maharashtra, India
| | - Pratibha Gaikwad
- Department of Physiotherapy, Lokmanya Tilak Municipal General Hospital and Medical College, Mumbai, Maharashtra, India
| | | | - Kushal Madan
- Department of Cardiology, Dharma Vira Heart Center, Sir Ganga Ram Hospital, New Delhi, India
| | - Prasobh Jacob
- Cardiac Rehabilitation Department, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Praveen J Surendran
- Cardiac Rehabilitation Department, Heart Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Narasimman Swaminathan
- Faculty of Allied Health Sciences, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India
| |
Collapse
|
11
|
Hasanpour Dehkordi A, Ebrahimi-Dehkordi S, Banitalebi-Dehkordi F, Salehi Tali S, Kheiri S, Soleimani Babadi A. The effect of teach-back training intervention of breathing exercise on the level of dyspnea, six-minutes walking test and FEV1/FVC ratio in patients with chronic obstructive pulmonary disease; a randomized controlled trial. Expert Rev Respir Med 2020; 15:161-169. [PMID: 32921199 DOI: 10.1080/17476348.2020.1822740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Chronic obstructive pulmonary disease (COPD) is an irreversible pulmonary obstruction. Respiratory exercise training by a feedback-based model besides the routine managements have been considered to perform. RESEARCH DESIGN AND METHODS Eighty exacerbated COPD patients with informed consent were divided to the control group (n = 40) received the routine approach and the intervention group (n = 40) received a teach-back training method (TBTM) of respiratory exercise including diaphragmatic breathing (DB), pursed-lip breathing (PLB), and effective coughing (EC) plus routine approach. The clinical outcomes were evaluated by measurement of the FEV1/FVC ratio, the Borg scale of dyspnea (BSD), and the 6-minute walking test (6MWT) results at the baseline, just after TBTM, and next 3 months. RESULTS FEV1/FVC ratio has been indicated the significant improvement followed by TBTM compare to the baseline (p < 0.001). Moreover, the BSD scores in 3-month follow-up after TBTM were significantly lower compared to the baseline (6 ± 1.3 vs. 3.8 ± 0.78, p < 0.001). Although a significant difference was reported in 6MWT distance between two groups after 3-month follow-up (p < 0.001), there was no significant difference immediately after the TBTM (p = 0.992) that suggested a long-term effect of educational intervention on physical activity. CONCLUSION Significant enhancement in the clinical variables can demonstrate the efficacy of the TBTM program in reducing COPD patients' symptoms. TRIAL REGISTRATION http//www.irct.ir.Unique identifier: IRCT20181024041449N5.
Collapse
Affiliation(s)
- Ali Hasanpour Dehkordi
- Social Determinants of Health Research Center, School of Allied Medical Sciences, Shahrekord University of Medical Sciences , Shahrekord, Iran
| | - Sepehr Ebrahimi-Dehkordi
- Student Research Committee, Shahrekord University of Medical Sciences , Shahrekord, Iran.,Medical Faculty, Shahrekord University of Medical Sciences , Shahrekord, Iran
| | - Fatemeh Banitalebi-Dehkordi
- Nursing Department, School of Nursing & Midwifery, Shahrekord University of Medical Sciences , Shahrekord, Iran
| | - Shahriar Salehi Tali
- Nursing Department, School of Nursing & Midwifery, Shahrekord University of Medical Sciences , Shahrekord, Iran
| | - Soleiman Kheiri
- Modeling in Health Research Center, Shahrekord University of Medical Sciences , Shahrekord, Iran
| | | |
Collapse
|
12
|
Olia JBH, Zinalpoor S, Sakhaei S, Sadagheyani HE, Motaarefi H. The Influence of Benson Relaxation on Oxidative Stress Marker of Premenstrual Syndrome in Students of Khoy University of Medical Sciences. Open Access Maced J Med Sci 2019; 7:4149-4154. [PMID: 32165968 PMCID: PMC7061381 DOI: 10.3889/oamjms.2019.865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 09/15/2019] [Accepted: 09/16/2019] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND: Premenstrual syndrome (PMS) is a common painful disorder in females. The use of Benson’s relaxation technique with a focus on sensations affects a range of physical and mental symptoms, reduces stress, and subsequently leads to changes in oxidative stress indexes. AIM: The present study aimed to determine the impact of Benson’s relaxation technique on oxidative stress indexes of premenstrual syndrome in students in Khoy University of Medical Sciences. METHODS: A quasi-experimental design with intervention and control groups was used in this study. The female nursing students at Khoy University of Medical Sciences were selected by convenience and were assigned by the simple random method to control and intervention groups, each of which with 30 samples. The data collection tool was a three-part questionnaire and a checklist for recording values. Data collection was done at two stages of before and after intervention on days 21 to 28 and the third day of menstruation by distributing questionnaires and a blood sampling. The Mean, standard deviation, frequency and percentage using descriptive statistics and Inferential statistically were utilised to analyse data through paired T-test, independent T-test, and Chi-square tests in addition to analysis of relations by using SPSS V25 at the p-value < 0.05. RESULTS: According to the findings, most of the samples were single (90%), native (61.6%) and had PMS symptoms (83.3%). The participants’ mean age was 21 ± 1.5 years, and most of them had physical symptoms of headache, fatigue, behavioural symptoms of nervous tension and mood swing. The results indicated a significant difference between control and intervention groups in malondialdehyde2 (MDA2) and Total Antioxidant Capacity2 (TAC2) (p = 0.001). The within-groups comparison indicated a statistically significant difference between the total MDA index with a mean difference of 0.126 and TAC index (-.122) of the intervention group (p = 0.001). CONCLUSION: The research results emphasised the importance of using Benson’s relaxation techniques as an alternative medicine on the variability of levels oxidative stress markers and Consequently for reducing physical and mental symptoms.
Collapse
Affiliation(s)
| | - Soryya Zinalpoor
- Department of Nursing, Khoy University of Medical Sciences, Khoy, Iran
| | - Shahriar Sakhaei
- Department of Nursing, Khoy University of Medical Sciences, Khoy, Iran
| | | | - Hossein Motaarefi
- Department of Nursing, Khoy University of Medical Sciences, Khoy, Iran
| |
Collapse
|