scholarly journals The effects of positioning and pursed-lip breathing exercise on dyspnea and anxiety status in patients with chronic obstructive pulmonary disease

2019 ◽  
Vol 9 (6) ◽  
pp. 41
Author(s):  
Salwa A. Mohamed

Background and objective: Chronic obstructive pulmonary disease (COPD) remains a significant burden for health. It is one of the most common respiratory disease and leads to limitation of airflow as well as deteriorating health status. The aim of the study was to determine the effects of positioning and pursed lip breathing exercise on dyspnea and anxiety status in patients with chronic obstructive pulmonary disease.Methods: The study was carried in the outpatient clinics in Mansoura University Hospital & Chest Hospital at Mansoura region, utilizing a quasi-experimental study design on sixty patients diagnosed COPD. Participation was randomized into both groups (study group and control group). Pretest, posttest and follow-up evaluation was done using Dyspnea Assessment Scale, Anxiety Assessment Scale and Demographic and Medical History Questionnaires (MHQ). The researcher established exercise program aimed at effecting dyspnea and anxiety in chronic obstructive pulmonary disease patients to help improve breathing and control anxiety. The research was accomplished over four steps namely assessment, planning, implementation and evaluation. Each patient was evaluated at baseline, immediately and three months after implementation of program.Results: There were statistically significant improvements after intervention of program on dyspnea symptoms and anxiety status at post and follow-up test (p < .05). There was a statistically significant improvement in temperature (T), heart rate (HR), blood pressure (BP) and respiratory rate (RR) throughout study (p < .05) after intervention. Also there are positive relation between anxiety and dyspnea after intervention.Conclusions: Developing breathing technique and forward leaning position in COPD patients help to improve physiological outcomes, dyspnea symptoms and anxiety status after implementing of program. It is recommended to implement exercise training program as a part of treatment by health professionals in the clinical setting.

Author(s):  
Somayeh Ghadimi ◽  
Atefeh Fakharian ◽  
Mohsen Abedi ◽  
Reyhaneh Zahiri ◽  
Mahsan Norouz Afjeh ◽  
...  

Background: Chronic Obstructive Pulmonary Disease (COPD) leads to limited activity and reduced quality of life. Treatment of this disease is a long-term process that requires the cooperation of patients in monitoring and treatment. Methods: In the present study which was conducted from April 2019 to March 2021 in Masih Daneshvari Hospital, Tehran, Iran, 75 patients were randomly divided into telerehabilitation and control groups. Patients in the control group received pulmonary rehabilitation including respiratory, isometric, and aerobic exercises for 8 weeks, three times per week. In the second group, patients were given a lung rehabilitation booklet and asked to repeat the exercises three times a week for four weeks according to a specific schedule. In addition, patients installed Behzee care application on the mobile phone that recorded various indicators such as heart rate, SpO2, dyspnea, fatigue, and daily activities. This application reminded the patient of the program every day and at a specific time. Finally, the patients’ conditions were compared in the two groups after 8 weeks using CAT and mMRC questionnaires and 6-Minute Walk (6MW) exercise indices as well as spirometry tests. Results: In all four indicators (6MW, CAT,  and mMRC questionnaires as well as spirometry), patients showed improvement after rehabilitation (p<0.001). This improvement was significantly higher in the telemedicine group compared to the other group (p<0.01). Conclusion: The use of telerehabilitation in COPD patients is effective in improving spirometry indices, quality of life, as well as activity and sports indices.


2002 ◽  
Vol 1 (4) ◽  
pp. 38-41
Author(s):  
G. N. Seitova ◽  
S. A. Bogushevich ◽  
E. A. Dementjeva ◽  
S. V. Nesterovich ◽  
E. B. Bukreeva

We present data of clinical-genealogical study of patients with chronic obstructive bronchitis (82 people) and control group (108 people). Study of frequency of lung’s disease in parents and relatives of seek patients and patients from control group revealed the prevalence of bronchopulmonary pathology in the first group in comparison with the second. Study of frequency morbidity depending on the gender of descendents determined the significant prevalence in girls than in boys. Study of type of family burdening in seek patients revealed the prevalence of the type «seek mother, healthy father».


2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Te-Wei Ho ◽  
Yi-Ju Tsai ◽  
Chun-Ta Huang ◽  
Angela Shin-Yu Lien ◽  
Feipei Lai

AbstractComorbidities adversely affect the quality of life and survival of patients with chronic obstructive pulmonary disease (COPD), and timely identification and management of comorbidities are important in caring for COPD patients. This study aimed to investigate the impact of COPD on long-term developmental trajectories of its comorbidities. From 2010 to 2013, all spirometry-confirmed COPD patients with a 5-year follow-up period were identified as the cases. The prevalence of comorbidities and their trajectories in COPD cases were obtained and compared with those in non-COPD controls matched for age, sex, smoking status and Charlson comorbidity index (CCI). Over the study period, a total of 682 patients, 341 each in COPD and control groups were included, with a mean age of 69.1 years and 89% male. The baseline mean CCI was 1.9 for both groups of patients and significantly increased to 3.4 and 2.7 in COPD and control groups after 5 years, respectively (both P < 0.001). Through the 5-year follow-up, a significant increase in the prevalence of all comorbidities of interest was observed in the COPD cohort and the incidence was remarkably higher for hypertension [incidence rate ratio (IRR) 1.495; 95% confidence interval (CI) 1.017–2.198], malignancy (IRR 2.397; 95% CI 1.408–4.081), diabetes mellitus (IRR 2.927; 95% CI 1.612–5.318), heart failure (IRR 2.531; 95% CI 1.502–4.265) and peptic ulcer disease (IRR 2.073; 95% CI 1.176–3.654) as compared to the non-COPD matched controls. In conclusion, our findings suggest that the presence of COPD may be considered a pathogenic factor involved in the development of certain comorbidities.


2020 ◽  
Vol 11 (SPL4) ◽  
pp. 1939-1944
Author(s):  
Ambiga K

The most frequent chronic lung disease characterized by increased resistivity to airflow as a result of airway obstruction. A study to assess the effectiveness of breathing exercises on selected pulmonary parameters on patients with chronic obstructive pulmonary disease. To assess the pulmonary function before administering breathing exercises, to assess the pulmonary function after administering breathing exercises. The research design used in this study was quasi-experimental, two groups before and after design. Non-probability convenient sampling technique was followed to allow the samples to an experimental and control group. The tool contains 3 parts part A-demographic variables, part B-measurement of pulmonary parameters and part C-self-instructional module on breathing exercises. The practicing of breathing exercise was found to be effective in improving the pulmonary parameters. Younger age patients gained more breathing hold time after practicing breathing exercise. Non-smokers gained more chest expansion and PEFR after practicing breathing exercise. The results of the study were concluded that selected breathing exercises (Pursed lip and Diaphragmatic Breathing Exercise) given to the COPD patients was effective to improve in their pulmonary parameters.


2020 ◽  
Vol 9 (5) ◽  
pp. 1442 ◽  
Author(s):  
Imane Achir Alispahic ◽  
Rikke Sørensen ◽  
Josefin Eklöf ◽  
Pradeesh Sivapalan ◽  
Anders Løkke ◽  
...  

Roflumilast is given as an add-on to inhalation medication in patients with chronic obstructive pulmonary disease (COPD) and chronic bronchitis. Animal experiments have documented deleterious effects of roflumilast in bacterial infections, but trials have not reported the risk of bacterial infections in patients. The objective of this study is to determine, among outpatients with severe COPD in a two-year follow-up period, the risk of hospitalization-requiring pneumonia, severe acute exacerbation in COPD (AECOPD-hosp), and death. Patients with COPD using roflumilast (roflumilast users) were compared to a propensity score-matched COPD control group not using roflumilast (non-roflumilast users). Roflumilast users had an increased 2-year risk of hospitalization-requiring pneumonia (HR 1.5, 95% CI 1.3 to 1.8, p-value < 0.0001) compared to controls, and of AECOPD-Hosp (hazard ratio(HR) 1.6, 95%, confidence interval (CI) 1.5 to 1.8, p-value < 0.0001) and. When adding an active comparator (theophylline) as a matching variable, the signal was largely unchanged. In conclusion, roflumilast was associated with an increased number of hospitalizations for pneumonia and for AECOPD. Since trials have not reported risks of bacterial complications and data regarding severe exacerbations in roflumilast users are sparse and diverging, these data are concerning. Trials focused on the risk of pneumonia, AECOPD, and other bacterial infections in roflumilast users are needed urgently.


2018 ◽  
Vol 27 (3) ◽  
pp. 222-226
Author(s):  
Yan Yan ◽  
Li Liu ◽  
Jing Zeng ◽  
Liang Zhang

Objective: This study aims to improve the management quality of chronic obstructive pulmonary disease (COPD) in rural areas. Methods: Two hundred forty discharged COPD patients were divided into an intervention group and a control group. In the intervention group, 120 patients established contact with doctors through the network consulting room, i.e., the doctor’s mobile platform, and were managed through video, voice, and text by the doctors, kept close contact with the doctors after discharge (education, consultation), and received electronic prescriptions, and drugs were sent to the patients’ door by online retailers. The patients in the control group were managed in the traditional manner. One year later, the predicted forced expiratory volume in 1 s (FEV1)%, FEV1/forced vital capacity (FVC), and CAT scores and the number of rehospitalized patients were compared between these 2 groups. Results: After 1 year of follow-up, the predicted FEV1% and the FEV1/FVC ratio were significantly higher in the intervention group than in the control group (p < 0.05). CAT scores were lower for patients in the intervention group than for those in the control group after 1 year of follow-up (p < 0.05). After 1 year of follow-up, 22 (18.33%) patients were rehospitalized in the intervention group and 58 (48.33%) patients were rehospitalized in the control group (p < 0.05). Conclusion: Doctors can improve the quality of life of patients with COPD and reduce the number of rehospitalizations through use of the network consulting room.


Author(s):  
N. P. Masik ◽  
S. V. Nechiporuk

Objective — to determine affects of the intermittent normobaric hypoxytherapy on the dynamics of general non‑specific adaptive reactions in the complex rehabilitation of patients with chronic obstructive pulmonary disease (COPD). Materials and methods. The treatment and examinations involved 450 patients with COPD, including GOLD 2 in 55.56 % (250 people) and GOLD 3 in 44.44 % (200 patients). The mean age was (52.65 ± 14.80) years, proportion of female and male subjects was equal. All patients received basic drug therapy according to the Order of MoH of Ukraine. The disease duration was 10 to 30 years, the remission stage was established in all patients. Patients were randomized into two groups: main (400 people) and control (50 people) with the same COPD severity distribution. Patients of the main group received additional 30 minutes sessions of interval normobaric hypoxytherapy for 20 days. The examination were performed for the dynamics of clinical symptoms, respiratory function, nonspecific resistance of an organism. Results. Most patients had symptoms of the disease against the background of basic COPD medication even on the remission stage. Unfavorable and intense adaptive reactions were determined in 71.33 % of COPD patients, and eustress reactions only in 16.89 %. Sanogenetic types of adaptive reactions were found in 28.45 % of subjects, maladaptive types — in 21.78 % of persons, pathogenetic — in 63.33 % of patients. At GOLD 2, tense reactions were diagnosed in 69.6 % of subjects, and in GOLD 3 in 73.0 %. As the severity of the disease increased, there was an increase in the development of intense training and activation responses. Upon completion of the course of hypoxytherapy, the exercise tolerance increased, and shortness of breath appeared only after severe physical activity in 90.25 % of patients in the main group, whereas in the control group similar changes were observed only in 20.0 % of patients. The respiratory function indicators in patients of the main group increased on average by 17.52 %, while in the control group — by 3.3 %. In the main group, favorable adaptation reactions prevailed in 88.25 % of patients, while in the control group this indicator was 32.0 %. The percentage of adverse reactions in the main group decreased significantly and was 11.75 % after treatment, the proportion of stress reactions — 46.25 %. In GOLD 2, the proportion of pathogenetic reactions decreased to 17.33 % and 56.00 % of the main and control groups, and in GOLD 3 — in 20.44 % and 44.0 %, respectively (p < 0.05). Conclusions. The use of a course of normobaric hypoxytherapy promoted the reduction of the main clinical COPD symptoms, increase of the frequency of favorable adaptive reactions up to 88.25 %, it raised clinical effectiveness of the treatment, which allowed to avoid disease exacerbations during the year in 80.95 % of patients.  


Author(s):  
Honesty Diana Morika ◽  
Indah Komala Sari ◽  
Rhona Sandra ◽  
Eliza Arman

Background: Chronic obstructive pulmonary disease (COPD) is a disease that is a problem throughout the world where its prevalence, morbidity and mortality are increasing every year. The high number of COPD visits is due to persistent and progressive shortness of breath complaints. Existing pharmacological therapies for COPD have not shown improvement in the long-term decline in pulmonary function that is a hallmark of COPD. It is very necessary for companion therapy that is non-pharmacological treatment is expected to be able to complete pharmacological treatment in reducing shortness of breath of COPD patients with pursed-lip breathing exercise.Methods: This study uses a quassy experiment design with two group pretest and posttes design approaches. This study was in obstructive pulmonary disease patients in the lung hospital in West Sumatra with an intervention group of 16 and a control of 16 respondents. Data analysis using univariate and bivariate using independent t-test statistics.Results: The results showed the average decrease in shortness of breath in the control group without pretest 3.19 and posttest 2.56 in the pretest pursed lip breathing exercise intervention group 3.19 and posttest performed 1.69. Test statistic p-value 0.026.Conclusions: There is an effect of pursed lip breathing exercise on reducing the level of shortness of breath in patients with chronic obstructive pulmonary disease.


2021 ◽  
pp. 35-64
Author(s):  
. Sumedi ◽  
Koshy Philip ◽  
Muhammad Hafizurrachman

Patients with chronic obstructive pulmonary disease can face increased resistance of airflow, air trapping, and lung hyperinflation. This condition can also cause decreased lung ventilation functions. Using a pursed lips breathing exercise can strengthen respiratory muscles that can improve oxygen saturation by maintaining airflow to bronchus and its branches and alveolus which then can prevent collapse in bronchiolus. The purpose of the study was to identify the effect of pursed lips breathing exercises on the oxygen saturation levels in patients with chronic obstructive lung disease in Persahabatan hospital, Jakarta. The design was quasi experimental, with a control group pre-post test design. A random sampling technique was used in the study. The exercise was provided to the intervention group for six days. The findings showed that the lung ventilation function is significantly different between preand post-intervention for both groups (p=0.00). Further, the average lung ventilation function in the intervention group is significantly different from that of the control group after intervention (p=0.012). In addition, while there is a significant relationship between subject age and the increase of the lung ventilation score (p=0.001), there was no relationship between height and the increase of oxygen saturation (p=0.091) and no significant relationship between sex and the increase of oxygen saturation (p=0.346). Based on these findings, the pursed lips breathing exercise is recommended to patients with chronic obstructive lung disease in order to improve the level of oxygen saturation.   Keywords: Oxygen saturation, Pursed lips breathing exercise, Chronic Obstructive Pulmonary Disease.


2020 ◽  
Vol 29 (2) ◽  
pp. 864-872
Author(s):  
Fernanda Borowsky da Rosa ◽  
Adriane Schmidt Pasqualoto ◽  
Catriona M. Steele ◽  
Renata Mancopes

Introduction The oral cavity and pharynx have a rich sensory system composed of specialized receptors. The integrity of oropharyngeal sensation is thought to be fundamental for safe and efficient swallowing. Chronic obstructive pulmonary disease (COPD) patients are at risk for oropharyngeal sensory impairment due to frequent use of inhaled medications and comorbidities including gastroesophageal reflux disease. Objective This study aimed to describe and compare oral and oropharyngeal sensory function measured using noninstrumental clinical methods in adults with COPD and healthy controls. Method Participants included 27 adults (18 men, nine women) with a diagnosis of COPD and a mean age of 66.56 years ( SD = 8.68). The control group comprised 11 healthy adults (five men, six women) with a mean age of 60.09 years ( SD = 11.57). Spirometry measures confirmed reduced functional expiratory volumes (% predicted) in the COPD patients compared to the control participants. All participants completed a case history interview and underwent clinical evaluation of oral and oropharyngeal sensation by a speech-language pathologist. The sensory evaluation explored the detection of tactile and temperature stimuli delivered by cotton swab to six locations in the oral cavity and two in the oropharynx as well as identification of the taste of stimuli administered in 5-ml boluses to the mouth. Analyses explored the frequencies of accurate responses regarding stimulus location, temperature and taste between groups, and between age groups (“≤ 65 years” and “> 65 years”) within the COPD cohort. Results We found significantly higher frequencies of reported use of inhaled medications ( p < .001) and xerostomia ( p = .003) in the COPD cohort. Oral cavity thermal sensation ( p = .009) was reduced in the COPD participants, and a significant age-related decline in gustatory sensation was found in the COPD group ( p = .018). Conclusion This study found that most of the measures of oral and oropharyngeal sensation remained intact in the COPD group. Oral thermal sensation was impaired in individuals with COPD, and reduced gustatory sensation was observed in the older COPD participants. Possible links between these results and the use of inhaled medication by individuals with COPD are discussed.


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