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Effectiveness of Breathing Exercises on Pulmonary Function Parameters and Quality of Life of Patients with Chronic Obstructive Pulmonary Disease

Authors:
  • Shree sathya sai college of nursing, sri Balaji vidyapeeth University

Abstract

Background: Chronic Obstructive Pulmonary Disease (COPD) is a progressive irreversible airway disease characterized by emphysema and chronic bronchitis, resulting in breathlessness, cough and sputum. Though medications are used to control the symptoms of COPD, but it will not give permanent cure. Performing breathing exercises reduces the frequent dyspnea and improves relaxation and pulmonary function. Limited empirical documentation exists to support the effectiveness of a nurse managed rehabilitation programme for older patients with COPD. Aims & Objectives: To assess the effectiveness of breathing exercises among COPD patients in reduction of dyspnea, improvement of pulmonary functional parameters and Quality of life. Materials & Methods: Pretest post test control group design was used in this study. The study includes 100 COPD patients in experimental group and 100 patients in control group. Results: After undergoing breathing exercises, in the experimental group the level of dyspnea was significantly reduced (P< 0.001) and there was significant improvement in the Quality Of Life (QOL) and pulmonary functional parameters such as FEV1 (Forced Expiratory Volume), FVC (Forced Vital Capacity), FEV1/ FVC ratio, and PEFR (Peak Expiratory Flow Rate) (P<0.001). However in the control group there were no significant changes in dyspnea, QOL and pulmonary function. Conclusion: There was a significant reduction in dyspnea, improvement in pulmonary function, and QOL of COPD patients after pulmonary rehabilitation exercises. So deep breathing exercises is an effective and economical method for improving the physical capacity and general wellbeing of patients with COPD.
International Journal of Health Sciences & Research (www.ijhsr.org) 80
Vol.3; Issue: 11; November 2013
International Journal of Health Sciences and Research
www.ijhsr.org ISSN: 2249-9571
Original Research Article
Effectiveness of Breathing Exercises on Pulmonary Function Parameters and
Quality of Life of Patients with Chronic Obstructive Pulmonary Disease
Helen Shaji John Cecily1*, Amal A. Alotaibi1
1Asst. Professor, Majmaah University.
*Correspondence Email: h.cecily@mu.edu.sa
Received: 04/09//2013 Revised: 03/10/2013 Accepted: 11/10/2013
ABSTRACT
Background: Chronic Obstructive Pulmonary Disease (COPD) is a progressive irreversible
airway disease characterized by emphysema and chronic bronchitis, resulting in breathlessness,
cough and sputum. Though medications are used to control the symptoms of COPD, but it will
not give permanent cure. Performing breathing exercises reduces the frequent dyspnea and
improves relaxation and pulmonary function. Limited empirical documentation exists to support
the effectiveness of a nurse managed rehabilitation programme for older patients with COPD.
Aims & Objectives: To assess the effectiveness of breathing exercises among COPD patients in
reduction of dyspnea, improvement of pulmonary functional parameters and Quality of life.
Materials & Methods: Pretest post test control group design was used in this study. The study
includes 100 COPD patients in experimental group and 100 patients in control group.
Results: After undergoing breathing exercises, in the experimental group the level of dyspnea
was significantly reduced (P< 0.001) and there was significant improvement in the Quality Of
Life (QOL) and pulmonary functional parameters such as FEV1 ( Forced Expiratory Volume),
FVC ( Forced Vital Capacity), FEV1/ FVC ratio, and PEFR (Peak Expiratory Flow Rate)
(P<0.001). However in the control group there were no significant changes in dyspnea, QOL and
pulmonary function.
Conclusion: There was a significant reduction in dyspnea, improvement in pulmonary function,
and QOL of COPD patients after pulmonary rehabilitation exercises. So deep breathing exercises
is an effective and economical method for improving the physical capacity and general wellbeing
of patients with COPD.
Key words: Breathing exercises, Pulmonary function parameters, Quality of life, COPD
INTRODUCTION
Chronic Obstructive Pulmonary
Disease (COPD) is a progressive irreversible
airway disease characterized by emphysema
and chronic bronchitis, resulting in
breathlessness, cough and sputum.[1] As the
International Journal of Health Sciences & Research (www.ijhsr.org) 81
Vol.3; Issue: 11; November 2013
disease progresses, subjects with COPD
experience increasing deterioration of their
health-related quality of life (HRQOL), with
greater impairment in their ability to work
and declining participation in social and
physical activities.[2]
The global burden of Diseases
(GBD) study showed that approximately 2.7
million deaths from COPD occurred in
2000, half of them in the Western Pacific
Region. About 400000 deaths occur each
year from COPD in industrialized countries
and this can be expected to rise unless
urgent action is taken to control leading risk
factors, particularly tobacco. (Laura
Cinobanu, et al., 2007).[3] In India, smoking
association with COPD was reported in 82.3
percent of male patients on an average in an
analysis of several population studies.[4]
Exertional dyspnea often causes
patients with chronic obstructive pulmonary
disease (COPD) to unconsciously reduce
their activities of daily living (ADLs) to
reduce the intensity of their distress. The
reduction in ADLs leads to decon-ditioning
which, in turn, further increases dyspnea.
Both dyspnea and fatigue are important
factors affecting health-related quality of life
(HRQOL).[5] Though medications are used
to control the symptoms of COPD, but it
will not give permanent cure. Performing
breathing exercises reduces the frequent
dyspnea and improves relaxation and
pulmonary function. Limited empirical
documentation exists to support the
effectiveness of a nurse managed
rehabilitation programme for older patients
with COPD. Pulmonary rehabilitation
programs help to reduce shortness of breath,
increasing exercise tolerance, decrease the
frequency and duration of hospital
admissions, socio economic gains from
reduced hospitali-zations, a reduction in
anxiety, depression and somatic concern, the
return of patients to employment and the
establishment of a better quality of life.[3,6,7]
Objectives
1. To assess the perceived severity of
dyspnea, pulmonary function, and
QOL of COPD patients.
2. To assess the effectiveness of
breathing exercises among COPD
patients in reduction of dyspnea.
3. To assess the influence of breathing
exercises on QOL of COPD patients
4. To assess the effectiveness of
breathing exercises among the
COPD patients on pulmonary
functional parameters such as FEV1,
FVC, FEV1/ FVC ratio, and PEFR.
5. To associate the QOL of the COPD
clients with their selected
demographic variables.
Research Hypothesis
1. The mean post-test scores of dyspnea
level of the experimental group will
be significantly lower than their
mean pre-test measurement.
2. The mean post-test scores of
pulmonary function of the
experimental group will be
significantly higher than their mean
pre-test measurement values in terms
of FEV1, FEC, FEVI/FVC ratio, and
PEFR.
3. The mean post-test scores of QOL of
the experimental group will be
significantly higher than their mean
pre-test measurement.
4. There will be a significant mean
difference in dyspnea level between
the experimental group and control
group.
5. There will be a significant difference
between the gains in pulmonary
measurement values in experimental
group and control group in terms of
FEV1, FVC, FEV1/FVC ratio, and
PEFR.
6. There will be a significant mean
difference in QOL between the
International Journal of Health Sciences & Research (www.ijhsr.org) 82
Vol.3; Issue: 11; November 2013
experimental group and control
group.
7. There will be a significant
association between QOL of COPD
patients with their selected
demographic variables.
METHODOLOGY
Research Approach: Experimental
approach
Research design: Pretest post test control
group design
Setting of the study: The study was
conducted in a Government Medical college
Hospital in India
Population: All the patients with COPD
who attend the OPD and admitted in the
hospital
Sample: It consists of 200 patients with
COPD, 100 patients in experimental group
and 100 in control group.
Sampling technique: Subjects were
selected by using simple random sampling
technique with random assignment for each
group.
Criteria for the selection of sample:
Inclusion criteria:
1. Clinically diagnosed moderate to
severe COPD patients by the
pulmonologists
2. Only males with the habit of
smoking were included
3. Age group between 31 80 years.
4. Those who are able to understand
and speak Tamil.
Exclusion criteria:
1. Patients who had acute breathing
difficulty
2. Those who were performing regular
breathing exercises or yoga
3. Patients who had recent abdominal
surgeries
4. Patients who were not willing to
participate
Description of the tool
Part I: Demographic variables such as age,
education, occupation, marital status,
smoking habit, alchohol use and duration of
illness
Part II: Assessment of Dyspnoea
Borg Dyspnoea scale was used to assess the
level of dyspnea among COPD patients. It is
a standardized scale to assess the level of
dyspnea among patients with respiratory
problems. In this scale dyspnoea is assessed
by patient‟s verbal description as mild,
moderate or severe. It starts at score 0 10,
from minimum to maximum breathing
difficulty.
Part III: Questionnaire on Quality of Life
WHO Quality Of Life Questionnaire
was modified and translated into Tamil
language and used for quality of life
assessment. It consists of 40 questions under
4 sections. Physical domain consisted of 16
questions, psychological domain had 16
questions, social domain had 6 questions
and spiritual domain had 2 questions. A
score of „4‟ was assigned to no symptoms or
low severity of symptoms and a score of „1‟
was assigned to maximum severity of
symptoms. The total QOL score of all the
domains was = 160.
Measurement of Pulmonary Function
Pulmonary function was tested with
a spirometer. It measures lung function,
specifically the measurement of the volume
and/ or speed (flow) of air that can be
inhaled and exhaled.1 Results are given in
both raw data (liters per second) and percent
of the “predicted values” for the patients of
similar characteristics (height, age, sex and
sometimes race and weight).
Data collection procedure:
Permission was obtained from
concerned hospital authorities. The samples
were selected by simple random sampling.
After explaining the nature and objective of
the study, the samples were asked to give
necessary background information through
International Journal of Health Sciences & Research (www.ijhsr.org) 83
Vol.3; Issue: 11; November 2013
interview. After that the severity of dyspnea
and the QOL were assessed using Borg
dyspnea scale and WHO Quality Of Life
questionnaire.
Subjects in the study group were
asked to do breathing exercises daily, each
session consists of at least 10 minutes for 3
times a day. The instruction booklets
regarding the performance of the exercises
were given to each of the samples and they
were supervised by the investigator for 10
full minutes every day for 30 days. Patients
in the control group were allowed to
continue with their usual physical activity.
RESULTS AND DISCUSSION
Demographic data showed that most
of them were between 61 and 70 years
(41%) both in experimental and control
group and majority of them were smoking
21 to 30 times per day in experimental group
(53%) and control group (62%) respectively.
Majority of them were illiterate in both
experimental (81%) and control group and
39% of them were doing moderate work.
Moreover 86% of them were married and
had the habit of alchoholism in both groups.
Regarding the duration of illness, majority
of them (73%) of them had COPD from 3 to
5 years in experimental and control group
respectively. Statistically no significant
difference was found in the distribution of
demographic variables among the patients
with COPD in experimental and control
groups.
In both groups more than 60% of
them had Family H/O diabetes mellitus from
1st degree relatives and 86% and 84% of
them didn‟t have any other systemic illness
in experimental and control group
respectively. Only 3 to 4% of them were
doing exercises regularly and about 94% of
them didn‟t have the habit of either
alchoholism or smoking in both groups. In
experimental group 28% and in control
group 36% of them didn‟t follow any dietary
restrictions.
Perceived severity of dyspnea, pulmonary
function, and QOL of COPD patients
In the pretest (before breathing
exercises) QOL was assessed using WHO
Quality Of Life Questionnaire. The overall
mean score of QOL in experimental group
was 89.97 and its standard deviation was
11.9 whereas the mean score of control
group was 84.98 and the S.D was 13.9.
In the pretest (before breathing
exercises) severity of dyspnea was assessed
using Borg Dyspnea scale. The overall mean
dyspnea score was almost same for both
experimental and control group, ie 6.29 and
its standard deviation was 1.0.
In the pretest (before breathing
exercises) pulmonary function was assessed
using spirometer. The overall mean FEV1
value was almost same for both
experimental (1.28) and control group (1.23)
and its standard deviation was 0.49 and 0.52
respectively. In the pretest, the mean FVC
value was 1.60 and the standard deviation
was 0.49 in Experimental group and the
mean FVC was 1.67 with the standard
deviation of 0.61 for the control group.
However the PEFR mean was 156.49 with
the standard deviation of 63.4 for the
Experimental group whereas in the control
group the mean was 164.23 and the standard
deviation was 91.7.
In the pretest, there was no
statistically significant difference was found
in the mean and standard deviation of QOL,
dyspnea score, FEV1, FVC and PEFR score
among patients with COPD in experimental
and control groups.
International Journal of Health Sciences & Research (www.ijhsr.org) 84
Vol.3; Issue: 11; November 2013
1. Comparison of pre and posttest level of mean and standard deviation of QOL, Dyspnea,
FEV1, FVC and PEFR among patients with COPD in experimental and control groups.
Physiological
functions
Period
Experimental
Control
Mean
Difference
„t‟ value
P value
Mean
mean
SD
Dyspnea
Before
6.29
6.32
1.0
0.03
0.212
0.0832
After
4.54
6.50
0.8
1.96
1.75
0.00
Quality Of Life
Before
86.97
84.98
13.1
2.0
1.124
0.262
After
94.95
80.9
10.9
14.05
8.987
0.00
FEV1
Before
1.28
1.23
0.52
0.05
0.770
0.442
After
1.42
1.18
0.51
0.24
3.524
0.001
FVC
Before
1.60
1.67
0.61
0.07
0.863
0.389
After
1.75
1.59
0.59
0.16
2.118
0.035
FEV1/FVC
Before
79.1
73.5
13.8
5.6
2.963
0.003
After
81.0
74.0
14.1
9.0
3.674
0.00
PEFR
Before
156.49
164.23
91.7
7.7
0.694
0.488
After
207.39
164.35
92.5
43.3
3.579
0.00
The results reveal that after
undergoing breathing exercises, in the
experimental group the dyspnea was
significantly reduced and there was
significant improvement in the QOL and
pulmonary functional parameters. However
in the control group there were no
significant changes in dyspnea, QOL and
pulmonary function.
2. Relationship between FEV1 and FVC
before and after intervention
Before intervention the correlation
coefficients of experimental and control
groups were 0.901 and 0.886 respectively.
After intervention the relationship of the
experimental and control group were 0.878
and 0.885 respectively. The above
correlation coefficients were statistically
significant (P < 0.01).
3. Association between QOL of patients
with COPD in experimental and control
group with their selected demographic
variables
Results revealed that there was a
significant relationship between the QOL
and occupation, smoking habit, marital
status and duration of illness at P < 0.05
level among the COPD patients in
experimental group. However there was
highly significant relationship between the
QOL and occupation, smoking habit and
duration illness at P < 0.001 level among the
patients with COPD in control group.
DISCUSSION
Findings of the study revealed that
after undergoing breathing exercises there
was a significant improvement (P< 0.001) in
the pulmonary functional parameters. This
finding is consistent with the studies
conducted by Holland AE (2012)[8] and
Gosselink R (2004)[9] on breathing exercises
for COPD patients. Moreover the current
study also revealed that there is a highly
significant reduction in the dyspnea level
and improvement in the QOL of COPD
patients after undergoing breathing
exercises. However the study conducted by
Holland AE (2012)[8] reported that there are
no consistent effects on dyspnea and Health
Related Quality Of Life after breathing
exercises which is not supporting to the
present study.
CONCLUSION
COPD is a common disease and a
common cause of mortality and morbidity.
Dyspnea is a characteristic and a troubling
manifestation of this disease. Loss of
physical capacity and the adverse
psychological effects of COPD contribute
greatly to morbidity. Medicines have limited
role in improving physical capacity of these
International Journal of Health Sciences & Research (www.ijhsr.org) 85
Vol.3; Issue: 11; November 2013
patients. People suffering from severe forms
of this disease, usually spend their
remaining years of life in bed and have
declining quality of life.
In the present study, there was a
significant reduction in dyspnea,
improvement in pulmonary function, and
QOL of COPD patients after pulmonary
rehabilitation exercises. It can be concluded
that deep breathing exercises is an effective
and economical method for improving the
physical capacity and general wellbeing of
patients with COPD
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How to cite this article: Cecily HSJ, Alotaibi AA. Effectiveness of breathing exercises on
pulmonary function parameters and quality of life of patients with chronic obstructive
pulmonary disease. Int J Health Sci Res. 2013;3(11):80-85.
... The heart of lung health is the lungs, complex organs involved in the exchange of oxygen and the removal of carbon dioxide. For every cell in the body to get a B constant supply of oxygen, supporting cellular metabolism and energy production, optimal pulmonary function is essential (Cecily & Alotaibi, 2013). In addition to being a strong defense mechanism, a healthy respiratory system removes dangerous particles and germs from the air we breathe. ...
Chapter
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Breathe Well is a program that uses an active and engaging approach to give people the tools they need to take control of their lung health. The program places a strong emphasis on the benefits of regular exercise, deep breathing techniques, respiratory muscle training etc the integration of yoga and mind-body activities into the Breathe Well program offers a comprehensive approach that enhances lung capacity, flexibility, and stress management. Respiratory health, which includes respiratory system health, is essential to our general well-being and day-today activities.
... The heart of lung health is the lungs, complex organs involved in the exchange of oxygen and the removal of carbon dioxide. For every cell in the body to get a B constant supply of oxygen, supporting cellular metabolism and energy production, optimal pulmonary function is essential (Cecily & Alotaibi, 2013). In addition to being a strong defense mechanism, a healthy respiratory system removes dangerous particles and germs from the air we breathe. ...
Chapter
Breathe Well is a program that uses an active and engaging approach to give people the tools they need to take control of their lung health. The program places a strong emphasis on the benefits of regular exercise, deep breathing techniques, respiratory muscle training etc the integration of yoga and mind-body activities into the Breathe Well program offers a comprehensive approach that enhances lung capacity, flexibility, and stress management. Respiratory health, which includes respiratory system health, is essential to our general well-being and day-today activities.
... Maneuvers from pursed lips breathing and diaphragmatic breathing exercises are known to be able to reduce shortness of breath at rest by changing breathing patterns and increasing alveolar ventilation so that impact on improving the quality of life in COPD patients regarding symptoms, daily activities or ultimate impact of disease. 8, 20 Studies conducted by Shaji and Durado found that there was an effect of pursed lips breathing exercise for 4 weeks and diaphragmatic breathing exercise on reducing severity of shortness of breath, increasing FEV1, and improving quality of life in COPD. Pursed lips breathing exercises may help the patient to achieve more controlled and efficient ventilation and to reduce the work of breathing, to increase maximal alveolar inflation and muscle relaxation, to relieve anxiety, and to eliminate uncoordinated patterns of activity of respiratory muscles. ...
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Introduction: Chronic obstructive pulmonary disease (COPD) is a chronic inflammation that causes a variety of pulmonary and systemic disorders. Pursed-lip breathing and diaphragmatic breathing exercises are useful techniques for improving ventilation, reducing the degree of breathlessness, enhancing performance, and improving quality of life. The aim of this study was to determine the effect of pursed-lip breathing and diaphragmatic breathing exercise on the value of the 6-min walk test and to improve quality of life by SGRQ in stable COPD patients. Methods: This study was an experimental study using group control before and after examining 60 stable COPD patients at Dr. RSUD Lung Center. Zainoel Abidin from November 2019 to February 2020. Samples were extracted by systematic random sampling and divided into two groups. The intervention group received indacaterol bronchodilator therapy in addition to four weeks of apron and diaphragmatic breathing exercises. The control group received only indacaterol therapy. A 6-minute walk test was administered and a quality of life questionnaire was completed using the SGRQ. A t-test and Wilcoxon test were performed to assess differences between groups, level of significance p < 0.05). Results: There was a significant effect on the 6-minute walk test in the intervention group compared with the control group (p = 0.001). There was a significant effect in improving quality of life using the SGRQ questionnaire in the intervention group compared with the control group (p = 0.001). Conclusion: There was a significant effect on the six-minute walking test in the intervention group compared to the control group. There was a significant effect on improving the quality of life using the SGRQ questionnaire in the intervention group compared to the control group.
... Even after two-years, respiratory sequalae related to post-acute SARS-CoV-2 infection have not been fully explored and understood. The main treatment for most COVID-19 respiratory complications is still symptomatic and supportivecare oriented 4 . As per the studies there is need to adopt the symptomatic modalities for the post covid respiratory problems which based on their symptoms and the severity without hospital admission. ...
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Introduction: Coronavirus disease 2019 is caused by Novel Coronavirus, it is a Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV2). There are several respiratory problems lasting for post covid period. Peoples are facing symptoms of respiratory illness in post covid period. Aim of the study: To assess the effectiveness of deep breathing exercise on respiratory problems among post covid patients. Material and method: The quantitative approach and pre-experimental pre-test post-test one group design was adopted for the study. 60 patient with post covid respiratory problems attending OPD were selected by purposive sampling technique. The group received intervention as diaphragmatic breathing exercise, and again respiratory problems were assessed. Result: According to the study majority 30% patients were complained of chest pain, majority 80% patients had cough and 28.3% patients had cold. The results of Wilcoxon sign test shows significally decrease in the respiratory problems in post intervention group, the deep breathing exercise is effective on respiratory problems among post COVID patients Conclusion: The study concluded that the deep breathing exercise was effective in terms of reducing the respiratory problems and complications in post covid patients.
... [20,21] In some other studies, FEV 1 and FVC values were observed to be more markedly improved, especially in COPD cases. [22,23] Although there were more patients in this study from GOLD Stages 3 and 4 in the emphysema-predominant group, FEV 1 , FVC, FEV 1 /FVC, and DLCO values were improved in both the groups. ...
... Sample size of 60 https://www.irct.ir/trial/58058 measured by using G Power Analysis Software, Version (3.1.9.2) with 0.80 power of study, with 0.05 margin of error and 95% con dence interval with effect size of 0.725 from quality of life of previous study [17]. Patients were recruited by assuming 10% attrition rate and will be divided into two groups with 30 patients each. ...
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Chronic Obstructive Pulmonary Disease is progressive respiratory disease characterized by cough, sputum, and shortness of breath due to increased airway resistance. The prevalence rate for COPD is about 2.1% with population of age 40 years. Long term effects of different treatments lead to decrease the quality of life. Relaxation techniques are simple and improve the relaxation of whole body. Objective: The objective was to compare the effects of Jacobson’s and Laura Mitchell’s technique on the quality of life and sleep in COPD patients. Methods: It was a randomized clinical trial. Sample size of 68 was calculated by keeping 95% confidence internal and 0.05 margin of error. Patients were induced through convenient sampling technique and then allocated by simple randomization process by opaque sealed envelope into group A and Group B. Group A was treated with Laura Mitchell Relaxation Technique and group B was treated with Jacobson’s Progressive Relaxation Technique for 5 sessions per week for 2 weeks. Post treatment evaluation was done by assessing sleep quality through Pittsburgh Sleep Quality Index Questionnaire and quality of life via St. George’s Respiratory Questionnaire. Results: Data analysis was done by using IBM-SPSS 25. Mean and Standard deviation of age and Body Mass Index (BMI) were as group A 40.13 + 5.06 years comparable to group B as 38.63 + 5.04 years. Body Mass Index (BMI) in group A was 23.86 + 4.139 kg/m2, and in group B was 23.80 + 4.130 kg/m2.It was determined that both methods of relaxation improved quality of life and sleep in COPD patients in which Laura Mitchell’s Relaxation Technique was clinically more significant as compared to Jacobson’s Progressive Relaxation Technique. Conclusion: It was concluded that both Laura Mitchell’s Relaxation Technique and Jacobson’s Progressive Relaxation Technique were effective on quality of life and sleep quality in COPD patients among stage 3 and stage 4 individuals. But Laura Mitchell’s Technique has greater clinical effects as compared to other technique.
... Sample size of 60 https://www.irct.ir/trial/58058 measured by using G Power Analysis Software, Version (3.1.9.2) with 0.80 power of study, with 0.05 margin of error and 95% con dence interval with effect size of 0.725 from quality of life of previous study [17]. Patients were recruited by assuming 10% attrition rate and will be divided into two groups with 30 patients each. ...
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Chronic Obstructive Pulmonary Disease is progressive respiratory disease characterized by cough, sputum, and shortness of breath due to increased airway resistance. The prevalence rate for COPD is about 2.1% with population of age 40 years. Long term effects of different treatments lead to decrease the quality of life. Relaxation techniques are simple and improve the relaxation of whole body. Objective: The objective was to compare the effects of Jacobson’s and Laura Mitchell’s technique on the quality of life and sleep in COPD patients. Methods: It was a randomized clinical trial. Sample size of 68 was calculated by keeping 95% confidence internal and 0.05 margin of error. Patients were induced through convenient sampling technique and then allocated by simple randomization process by opaque sealed envelope into group A and Group B. Group A was treated with Laura Mitchell Relaxation Technique and group B was treated with Jacobson’s Progressive Relaxation Technique for 5 sessions per week for 2 weeks. Post treatment evaluation was done by assessing sleep quality through Pittsburgh Sleep Quality Index Questionnaire and quality of life via St. George’s Respiratory Questionnaire. Results: Data analysis was done by using IBM-SPSS 25. Mean and Standard deviation of age and Body Mass Index (BMI) were as group A 40.13 + 5.06 years comparable to group B as 38.63 + 5.04 years. Body Mass Index (BMI) in group A was 23.86 + 4.139 kg/m2, and in group B was 23.80 + 4.130 kg/m2.It was determined that both methods of relaxation improved quality of life and sleep in COPD patients in which Laura Mitchell’s Relaxation Technique was clinically more significant as compared to Jacobson’s Progressive Relaxation Technique. Conclusion: It was concluded that both Laura Mitchell’s Relaxation Technique and Jacobson’s Progressive Relaxation Technique were effective on quality of life and sleep quality in COPD patients among stage 3 and stage 4 individuals. But Laura Mitchell’s Technique has greater clinical effects as compared to other technique.
... In addition to dyspnea, fatigue is a major symptom commonly complained by the COPD patients [13]. A quasi-experimental study was carried out on 60 hospitalized patients with COPD found that respiratory exercise is helpful in decrease the level of fatigue in COPD patients [14][15][16][17][18][19][20][21][22][23][24][25][26][27]. ...
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Chronic Obstructive Pulmonary Disease (COPD) is one of the most frequent chronic respiratory diseases. An electronic searching was performed in the electronic database: CINAHL, EBSCO, Google Scholar, and PubMed. The review illustrate that breathing exercises may decrease dyspnea, reduce hyperinflation, and increase respiratory muscle performance and exercise tolerance, and QoL in COPD patients. Future studies is necessary to verify the effectiveness of each types of breathing exercises in the management of COPD patients. Abstract Introduction
Article
Dyspnea is a common symptom and anxiety is a common comorbidity of chronic obstructive pulmonary disease (COPD). They affect individuals with COPD in a multifaceted way, causing many disabilities. Progressive relaxation exercises (PREs) are an important intervention in reducing symptoms and comorbidity. The aim of this study was to determine the effects of PREs on dyspnea and anxiety levels in individuals with COPD. A pretest-posttest randomized controlled trial was conducted at the chest diseases clinic of a university hospital in Turkey. Forty-four patients with COPD who met the inclusion criteria for participation in the study were assigned either to an intervention or a control group, with 22 patients in each group. In the intervention group, the patients performed PREs once a day for 4 weeks in addition to the standard treatment. The patients in the control group received the standard treatment. In the data collection stage of the study, questionnaire forms, namely, the Modified Borg Scale (MBS), Modified British Medical Research Council Dyspnea Scale, COPD Assessment Test (CAT), and Beck Anxiety Inventory (BAI), were used. Data were collected before (the first follow-up) and after the intervention (the second follow-up). In the second follow-up, the MBS, BAI, and CAT scores decreased significantly in the intervention group (P < .05) but showed no significant changes in the control group (P > .05). This study demonstrates that PREs can reduce dyspnea and anxiety levels in individuals with COPD.
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The aim of this study was to evaluate the association between health-related quality of life (HRQL) and disease severity using lung function measures. A survey was performed in subjects with COPD in Sweden. 168 subjects (70 women, mean age 64.3 years) completed the generic HRQL questionnaire, the Short Form 36 (SF-36), the disease-specific HRQL questionnaire; the St George's Respiratory Questionnaire (SGRQ), and the utility measure, the EQ-5D. The subjects were divided into four severity groups according to FEV1 per cent of predicted normal using two clinical guidelines: GOLD and BTS. Age, gender, smoking status and socio-economic group were regarded as confounders. The COPD severity grades affected the SGRQ Total scores, varying from 25 to 53 (GOLD p = 0.0005) and from 25 to 45 (BTS p = 0.0023). The scores for SF-36 Physical were significantly associated with COPD severity (GOLD p = 0.0059, BTS p = 0.032). No significant association were noticed for the SF-36, Mental Component Summary scores and COPD severity. Scores for EQ-5D VAS varied from 73 to 37 (GOLD I-IV p = 0.0001) and from 73 to 50 (BTS 0-III p = 0.0007). The SGRQ Total score was significant between age groups (p = 0.0047). No significant differences in HRQL with regard to gender, smoking status or socio-economic group were noticed. The results show that HRQL in COPD deteriorates with disease severity and with age. These data show a relationship between HRQL and disease severity obtained by lung function.
Article
People with chronic obstructive pulmonary disease (COPD) often have an altered breathing pattern and experience shortness of breath, particularly when they exercise. This review aimed to determine whether breathing exercises that are designed to retrain the breathing pattern could reduce breathlessness, increase exercise capacity and improve well being for people with COPD. Sixteen trials with 1233 participants were included, most of whom had severe COPD. The breathing techniques studied included pursed lip breathing (breathing out slowly with the lips in a whistling position), diaphragmatic breathing (deep breathing focusing on the abdomen), pranayam yoga breathing (timed breathing with a focus on exhalation), changing the breathing pattern using computerised feedback to slow the respiratory rate and increase exhalation time, or combinations of these techniques. The study quality was generally low. Breathing exercises appeared to be safe for people with COPD. Yoga breathing, pursed lip breathing and diaphragmatic breathing improved the distance walked in six minutes by an average of 35 to 50 metres in four studies. Effects of breathing exercises on shortness of breath and well being were variable. When added to whole body exercise training, breathing exercises did not appear to have any additional benefit.
Article
The objective of this study was to compare the health-related quality of life (HRQL) of patients with epilepsy with populations suffering from different chronic diseases, using the short form 36 (SF-36) health profile measure. The populations to be compared were adult patients drawn from hospital based registers, with confirmed epilepsy (n = 397), angina pectoris (n = 785), rheumatoid arthritis (n = 1,030), asthma (n = 117) and chronic obstructive pulmonary disease (COPD) (n = 221). Health-related quality of life scores were compared using analysis of covariance (ANCOVA) for predicting mean scores adjusted for age, gender, education and comorbidity. Patients with epilepsy on average scored highest on all scales, reflecting that in our sample the majority had well-controlled epilepsy. Our results indicate that the HRQL of a representative sample of patients with epilepsy is good, when compared with other chronic disorders, although reduced in several dimensions compared with a general reference population. Patients with rheumatoid arthritis (RA) and COPD scored lowest on the physical function scales, while rheumatoid arthritis patients reported most pain.
Article
This paper reports a study to determine whether a nurse-initiated telephone follow-up programme could increase patients' self-efficacy in managing dyspnoea and decrease health care service use. Chronic obstructive pulmonary disease is a worldwide health problem and has been labelled a burdensome disease. Because of the fear of activity-induced dyspnoea, patients with chronic obstructive pulmonary disease lack the confidence to perform daily activities. Studies of cardiac and diabetic patients have shown that telephone follow-up care is an effective approach to increasing self-efficacy. However, little such research has been done with patients with chronic obstructive pulmonary disease. This was a randomized controlled study. A total of 60 participants (30 telephone follow-up, 30 control) with chronic obstructive pulmonary disease were recruited from an acute care hospital in Hong Kong. The Chinese Self-Efficacy Scale was used to assess self-efficacy. Measures of health care use were numbers of visits to an accident and emergency department, hospitalizations, and unscheduled visits by physicians. The self-efficacy scores (U = 272.5, P = 0.009) of patients who were followed up by telephone improved significantly compared with those of patients in the control group. Multiple regression analyses showed that telephone follow-up (Beta = 0.33, CI: 0.19-0.48, P = 0.001), the pulmonary rehabilitation programme (Beta = 0.44, CI: 0.16-0.72, P = 0.003), smoking (Beta = 0.34, CI: 0.09-0.57, P = 0.009), and health care use (Beta = -0.27, CI: -0.47-(-0.07), P = 0.008) were significant factors in predicting patient self-efficacy. Nurse-initiated telephone follow-up care was effective in increasing self-efficacy in managing dyspnoea. The study needs to be replicated in other setting to strengthen its external validity.
Breathing techniques in patients with COPD. Chronic Respiratory Diseases
  • R Gosselink
Gosselink R. Breathing techniques in patients with COPD. Chronic Respiratory Diseases. 2004; 1(3):
The health-related quality of life of patients with epilepsy compared with angina pectoris, rheumatoid arthritis, asthma and chronic obstructive pulmonary disease
  • K Stavem
  • Ml Lossius
  • Tk Kvein
Stavem K, Lossius ML, Kvein TK. et al. The health-related quality of life of patients with epilepsy compared with angina pectoris, rheumatoid arthritis, asthma and chronic obstructive pulmonary disease. Qual Life Res. 2005; 14: 2315-2321.