scholarly journals EFEKTIVITAS TEKNIK PURSED LIPSBREATHING PADA PASIEN PENYAKIT PARU OBSTRUKSI KRONIK (PPOK): STUDY SYSTEMATIC REVIEW

2019 ◽  
Vol 12 (2) ◽  
pp. 137
Author(s):  
Barakatul Qamila ◽  
Maria Ulfah Azhar ◽  
Risnah Risnah ◽  
Muhammad Irwan

Chronic obstructive pulmonary disease (COPD) is one of the chronic diseases characterized by limited air flow contained in the respiratory tract. Breathing shortness becomes the main complaint feeling by COPD patients. Pursed lips breathing (PLB) technique can increase pulmonary compliance to retrain the respiratory muscles to function properly and prevent respiratory distress. This study aims to determine the effectiveness of pursed lips breathing technique in COPD patients. The research used a quantitative descriptive design with a systematic review approach. There were 315 articles published from 2015-2019. From 315 articles, 7 articles that met the inclusion criteria and research questions. Based on the result of the Systematic Review that has been conducted on pursed lips breathing technique in COPD patients, it was concluded that the PLB technique is effective to reduce breathing frequency and improve oxygen saturation. PLB technique given 3 times per day in every morning, afternoon, and evening with a time of 6-30 minutes for 3 consecutive days. The PLB technique is effective in reduce frequency respiratory and increase oxygenation in COPD patients with ineffective breathing patterns. Furthermore, it is suggested that PLB techniques can be applied as one of the nurses' independent interventions in nursing care for COPD patients to reduce patients complaints of breathing shortness.ABSTRAKPenyakit paru obstruksi kronik (PPOK) merupakan salah satu penyakit kronik yang ditandai dengan terbatasnya aliran udara yang terdapat di dalam saluran pernapasan. Sesak napas menjadi keluhan utama yang dirasakan oleh pasien PPOK. Teknik pernapasan pursed lips breathing (PLB) merupakan teknik pernapasan yang membantu meningkatkan compliance paru untuk melatih kembali otot pernapasan berfungsi dengan baik serta mecegah distress pernapasan. Penelitian ini bertujuan untuk mengetahui efektivitas teknik pursed lips breathing pada pasien PPOK. Penelitian menggunakan desain deskriptif kuantitatif dengan pendekatan systematic review. Terdapat 315 artikel yang dipublikasi dari tahun 2015-2019. Dari 315 artikel 7 artikel yang sesuai dengan kriteria inklusidan pertanyaan penelitian, dimana kriteria inklusi tersebut ialah artikel tahun 2015-2019 full text yang sesuai dengan topik penelitia yaitu teknik PLB pada pasien PPOK, terdapat ISSN dan atau DOI, artikel yang berfokus pada intervensi terapi Pursed Lips Breathing, artikel yang berfokus pada pemenuhan oksigenisasi dan frekuensi pernapasan sebagai alat ukur. Berdasarkan hasil Systematic Review yang telah dilakukan tentang teknik pursed lips breathing pada pasien PPOK disimpulkan bahwa teknik PLB efektif menurunkan frekuensi pernapasan dan meningkatkan pemenuhan oksigenisasi dalam tubuh. Dengan demikian pemberian latihan yaitu 3x sehari setiap pagi, siang, dan sore dengan waktu 6-30 menit selama 3 hari berturut-turut. Teknik PLB efektif dalam menurunkan frekuensi pernapasan dan meningkatkan pemenuhan oksigenisasi pada pasien PPOK dengan pola napas tidak efektif. Selanjutnya, disarankan teknik PLB dapat dijadikan sebagai salah satu intervensi mandiri perawat dalam melakukan asuhan keperawatan pada pasien PPOK untuk mengurangi keluhan sesak.

2004 ◽  
Vol 96 (5) ◽  
pp. 1723-1729 ◽  
Author(s):  
Marieke L. Duiverman ◽  
Leo A. van Eykern ◽  
Peter W. Vennik ◽  
Gerard H. Koëter ◽  
Eric J. W. Maarsingh ◽  
...  

In the present study, we assessed the reproducibility and responsiveness of transcutaneous electromyography (EMG) of the respiratory muscles in patients with chronic obstructive pulmonary disease (COPD) and healthy subjects during breathing against an inspiratory load. In seven healthy subjects and seven COPD patients, EMG signals of the frontal and dorsal diaphragm, intercostal muscles, abdominal muscles, and scalene muscles were derived on 2 different days, both during breathing at rest and during breathing through an inspiratory threshold device of 7, 14, and 21 cmH2O. For analysis, we used the logarithm of the ratio of the inspiratory activity during the subsequent loads and the activity at baseline [log EMG activity ratio (EMGAR)]. Reproducibility of the EMG was assessed by comparing the log EMGAR values measured at test days 1 and 2 in both groups. Responsiveness (sensitivity to change) of the EMG was assessed by comparing the log EMGAR values of the COPD patients to those of the healthy subjects at each load. During days 1 and 2, log EMGAR values of the diaphragm and the intercostal muscles correlated significantly. For the scalene muscles, significant correlations were found for the COPD patients. Although inspiratory muscle activity increased significantly during the subsequent loads in all participants, the COPD patients displayed a significantly greater increase in intercostal and left scalene muscle activity compared with the healthy subjects. In conclusion, the present study showed that the EMG technique is a reproducible and sensitive technique to assess breathing patterns in COPD patients and healthy subjects.


2021 ◽  
Vol 10 (2) ◽  
pp. 269
Author(s):  
Elisabetta Zinellu ◽  
Alessandro G. Fois ◽  
Elisabetta Sotgiu ◽  
Sabrina Mellino ◽  
Arduino A. Mangoni ◽  
...  

Background: Chronic obstructive pulmonary disease (COPD) is a progressive condition characterized by chronic airway inflammation and lung parenchyma damage. Systemic inflammation and oxidative stress also play a role in the pathogenesis of COPD. Serum albumin is a negative acute-phase protein with antioxidant effects and an important marker of malnutrition. The aim of this meta-analysis was to investigate differences in serum albumin concentrations between patients with stable COPD and non-COPD subjects. Methods: A systematic search was conducted, using the terms “albumin” and “chronic obstructive pulmonary disease” or “COPD”, in the electronic databases PubMed and Web of Science, from inception to May 2020. Results: Twenty-six studies were identified on a total of 2554 COPD patients and 2055 non-COPD controls. Pooled results showed that serum albumin concentrations were significantly lower in COPD patients (standard mean difference, SMD = −0.50, 95% CI −0.67 to −0.32; p < 0.001). No significant differences were observed in SMD of serum albumin concentrations between COPD patients with forced expiratory volume in the 1st second (FEV1) < 50% and those with FEV1 > 50%. Conclusions: Our systematic review and meta-analysis showed that serum albumin concentrations are significantly lower in patients with stable COPD compared to non-COPD controls. This supports the presence of a deficit in systemic anti-inflammatory and antioxidant defense mechanisms in COPD.


2021 ◽  
Author(s):  
Niamh Kelly ◽  
Lewis Winning ◽  
Christopher Irwin ◽  
Fionnuala Lundy ◽  
Dermot Linden ◽  
...  

Abstract BackgroundA growing body of evidence suggests a role for oral bacteria in lung infections. This systematic review aimed to analyse the association between poor periodontal health and the frequency of chronic obstructive pulmonary disease (COPD) exacerbations. MethodsPubMed, Embase, Web of Science, CINAHL and Medline were searched for studies published until May 2020, with no language restriction. Studies reporting periodontal condition, or periodontal treatment outcomes, with data on the frequency of exacerbations of COPD, were identified. The primary outcome was the frequency of exacerbations and secondary outcomes included quality of life and hospitalisation. Studies were assessed for eligibility and quality by two assessors independently.Results Searches identified 532 records and 8 met the inclusion criteria. The data from intervention studies showed reduction in the frequency of exacerbations following periodontal treatment. Data from observational studies suggest association of worse plaque scores with exacerbation but not pocket depth or clinical attachment loss. Better periodontal health was also associated with reduced frequency of COPD exacerbations, hospitalisations and improved quality of life in COPD patients. Due to the high heterogeneity no meta-analysis was performed. The quality of some of the included studies was low and there was evidence of high risk of bias.ConclusionThe data supports possible association between poor periodontal health, the frequency of exacerbations and quality of life in COPD patients. The evidence is limited by high risk of bias suggesting need for well-designed and adequately powered randomised control trials.The PROSPERO registration number CRD42020180328


2021 ◽  
Vol 9 (1) ◽  
pp. 3724-3729
Author(s):  
Hetal M Mistry ◽  
◽  
Rutuja V Kamble ◽  

Background: In Chronic Obstructive Pulmonary Disease (COPD), as result of dynamic hyperinflation, primary respiratory muscles go into weakness and length tension relationship of muscles is altered. This leads to decreased ability of primary respiratory muscles to generate muscle tension. COPD patients mostly use accessory muscle for breathing and there is lack of facilitation of intercostal muscle and weakness of diaphragm. Few studies are conducted to assess the immediate effect of Chest Proprioceptive Neuromuscular Facilitation (PNF) i.e. intercostal stretch among COPD patients. Therefore, there is need to find out immediate effect of chest PNF- intercostal stretch on respiratory rate (RR), chest expansion, peak expiratory flow rate (PEFR) among patient with COPD. Objective: To find out immediate effect chest PNF on respiratory rate, chest expansion and peak expiratory flow rate. Methodology: Ethical clearance and participant consent was taken. Study design was Qausi experimental study. The 65 subjects were taken by convenient sampling. Intercostal stretch was applied over 2nd and 3rd rib bilaterally for 10 breaths with 1 minute rest with a 10 repetitions and Outcome measures were assessed before and immediately after giving chest PNF. SPSS 16 software was used to analyse the data. The normality of the data was assessed using parametric paired t test. Significance level was set at 0.05 and 95% Confidence Interval. Outcome Measures: Respiratory rate, Chest expansion, Peak expiratory flow rate. Result: Immediate effect of chest PNF showed that there was statistically significant increase in PEFR and chest expansion at three level (P=0.000) and there was statistically significant decrease in RR (P=0.000). Conclusion: There is immediate effect of Chest PNF- intercostal stretch on, Respiratory rate, Chest expansion at three level that is axillary, nipple and xiphisternal and Peak expiratory flow rate. It is an easy to use, less time consuming, easy to understand and cost effective technique. KEY WORDS: Chest PNF, intercostal stretch, COPD.


Author(s):  
João Simão De Melo Neto ◽  
Ana Elisa Zuliani Stroppa Marques ◽  
Fabiana De Campos Gomes

Introduction: COPD is a major cause of morbidity and mortality, which is preventable, thus studies that discusses the characterization of a given population are important for investment in treatments and prevention. Objective: Characterize individuals with Chronic Obstructive Pulmonary Disease, admitted to a pulmonary rehabilitation center. Method: Retrospective study, exploratory character of medical records of patients with COPD. Sample consisted of 37 patients diagnosed with COPD and age greater than 20 years. The following variables were analyzed: sex, age, marital status, occupation, diagnosis, main complaint, and cardiovascular risk factors presented by patients during admission. Results: Individuals aged >40 years and history of smoking have a higher prevalence in developing COPD. Pulmonary emphysema is a major pathological condition. The most common main complaint was dyspnea and cardiovascular risk factor was present sedentary lifestyle. Moreover, women with COPD were more likely to have depression than men. Conclusion: This study enabled the characterization of COPD patients, providing the possibility of investing in prevention and treatment.


Author(s):  
Shi-Jie Liu ◽  
Zhanbing Ren ◽  
Lin Wang ◽  
Gao-Xia Wei ◽  
Liye Zou

Baduanjin exercise is a traditional Chinese health Qigong routine created by an ancient physician for health promotion. Its mild-to-moderate exercise intensity is suitable for individuals with medical conditions. Recently, a large number of trials have been conducted to investigate the effects of Baduanjin exercise in patients with chronic obstructive pulmonary disease (COPD). It remains to be determined whether Baduanjin exercise prescription is beneficial for the management of COPD patients. Thus, we conducted a systematic review to objectively evaluate the existing literature on this topic. We searched six databases (PubMed, Web of Science, Cochrane Library, Scopus, China National Knowledge Infrastructure, and Wanfang) from inception until early May 2018. The adapted Physical Therapy Evidence Database (PEDro) scale was used for study quality assessment of all randomized controlled trials (RCTs). Based on 95% confidence interval (CI), the pooled effect size (Hedge’s g) of exercise capability (6-Minute Walking Test, 6-MWT), lung function parameters (forced expiratory volume in one second, FEV1; forced volume vital capacity, FVC; FEV1/FVC ratio), and quality of life were calculated based on the random-effects model. Twenty RCTs (n = 1975 COPD patients) were included in this review, with sum scores of the adapted PEDro scale between 5 and 9. Study results of the meta-analysis indicate that Baduanjin is effective in improving exercise capability (Hedge’s g = 0.69, CI 0.44 to 0.94, p < 0.001, I2 = 66%), FEV1 (Hedge’s g = 0.47, CI 0.22 to 0.73, p < 0.001, I2 = 68.01%), FEV1% (Hedge’s g = 0.38, CI 0.21 to 0.56, p < 0.001, I2 = 54.74%), FVC (Hedge’s g = 0.39, CI 0.22 to 0.56, p < 0.001, I2 = 14.57%), FEV1/FVC (Hedge’s g = 0.5, CI 0.33 to 0.68, p < 0.001, I2 = 53.49%), and the quality of life of COPD patients (Hedge’s g = −0.45, CI −0.77 to −0.12, p < 0.05, I2 = 77.02%), as compared to control groups. Baduanjin exercise as an adjunctive treatment may potentially improve exercise capability and pulmonary function of COPD patients as well as quality of life. Baduanjin exercise could be tentatively prescribed for COPD in combination with the conventional rehabilitation program to quicken the process of recovery. To confirm the positive effects of Baduanjin exercise for COPD patients, future researchers need to consider our suggestions mentioned in this article.


Antioxidants ◽  
2020 ◽  
Vol 9 (11) ◽  
pp. 1146
Author(s):  
Salvatore Sotgia ◽  
Panagiotis Paliogiannis ◽  
Elisabetta Sotgiu ◽  
Sabrina Mellino ◽  
Elisabetta Zinellu ◽  
...  

The aim of this systematic review and meta-analysis was to assess the blood concentrations of the total and reduced forms of the low-molecular-weight antioxidant thiol glutathione (GSH) in chronic obstructive pulmonary disease (COPD) patients in comparison to healthy individuals. A literature search was conducted in the PubMed and Web of Science databases from inception until June 2020. In the 18 studies identified (involving a total of 974 COPD patients and 631 healthy controls), the pooled reduced GSH concentrations were significantly lower in patients with COPD than controls (SMD  =  −3.04, 95% CI = −4.42 to −1.67; p  <  0.001). By contrast, the pooled total GSH concentrations were significantly higher in patients with COPD than controls (SMD = 0.42, 95% CI = 0.11 to 0.73; p = 0.009). Our meta-analysis showed that the blood concentrations of reduced GSH, even in the presence of higher total GSH concentrations, were significantly lower in patients with COPD when compared to healthy controls. This suggests that an impaired antioxidant defense system plays an important role in the pathogenesis of COPD.


2013 ◽  
Vol 114 (8) ◽  
pp. 1066-1075 ◽  
Author(s):  
Rita Priori ◽  
Andrea Aliverti ◽  
André L. Albuquerque ◽  
Marco Quaranta ◽  
Paul Albert ◽  
...  

Chronic obstructive pulmonary disease (COPD) patients often show asynchronous movement of the lower rib cage during spontaneous quiet breathing and exercise. We speculated that varying body position from seated to supine would influence rib cage asynchrony by changing the configuration of the respiratory muscles. Twenty-three severe COPD patients (forced expiratory volume in 1 s = 32.5 ± 7.0% predicted) and 12 healthy age-matched controls were studied. Measurements of the phase shift between upper and lower rib cage and between upper rib cage and abdomen were performed with opto-electronic plethysmography during quiet breathing in the seated and supine position. Changes in diaphragm zone of apposition were measured by ultrasounds. Control subjects showed no compartmental asynchronous movement, whether seated or supine. In 13 COPD patients, rib cage asynchrony was noticed in the seated posture. This asynchrony disappeared in the supine posture. In COPD, upper rib cage and abdomen were synchronous when seated, but a strong asynchrony was found in supine. The relationships between changes in diaphragm zone of apposition and volume variations of chest wall compartments supported these findings. Rib cage paradox was noticed in approximately one-half of the COPD patients while seated, but was not related to impaired diaphragm motion. In the supine posture, the rib cage paradox disappeared, suggesting that, in this posture, diaphragm mechanics improves. In conclusion, changing body position induces important differences in the chest wall behavior in COPD patients.


2016 ◽  
Vol 48 (1) ◽  
pp. 69-81 ◽  
Author(s):  
Leandro Cruz Mantoani ◽  
Noah Rubio ◽  
Brian McKinstry ◽  
William MacNee ◽  
Roberto A. Rabinovich

The broad range of interventions to increase physical activity (PA) in patients with chronic obstructive pulmonary disease (COPD) has not been systematically assessed. We aimed to perform a systematic review of the interventional studies that have assessed PA as an outcome in patients with COPD.A systematic search in five different databases (Medline, Embase, PsycINFO, CINAHL and Web of Science) was performed in March 2015. Two independent reviewers analysed the studies against the inclusion criteria (COPD defined by spirometry; prospective, randomised/nonrandomised studies, cohort and experimental studies with interventions using PA as an outcome), extracted the data and assessed the quality of evidence.60 studies were included. Seven intervention groups were identified. PA counselling increased PA levels in COPD, especially when combined with coaching. 13 studies showed positive effects of pulmonary rehabilitation (PR) on PA, while seven studies showed no changes. All three PR programmes >12 weeks in duration increased PA. Overall, the quality of evidence was graded as very low.Interventions focusing specifically on increasing PA, and longer PR programmes, may have greater impacts on PA in COPD. Well-designed clinical trials with objective assessment of PA in COPD patients are needed.


2013 ◽  
Vol 31 (1) ◽  
pp. 297-326 ◽  
Author(s):  
Janet L. Larson ◽  
Carol M. Vos ◽  
Dena Fernandez

People with chronic obstructive pulmonary disease (COPD) are very sedentary and this contributes to their health problems. The aim of this systematic review was to examine the effects of interventions designed to increase physical activity (PA) in people with COPD. Studies were included when PA was the primary outcome and measured objectively. Six databases were searched and 15 studies with a total of 761 subjects were identified that met inclusion criteria. Nine of the studies were quasi-experimental (QE) and six were randomized controlled trials (RCT). Interventions included pulmonary rehabilitation (


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