Effect of 12-week pulmonary rehabilitation on cognitive function in patients with stable chronic obstructive pulmonary disease: study protocol for a single-center randomised controlled trial

Abstract

IntroductionCognitive impairment, an important complication in patients with chronic obstructive pulmonary disease (COPD), seriously affects self-management of the disease and quality of life (QoL). As an exercise-based intervention programme, pulmonary rehabilitation (PR)—especially aerobic exercise (mainly mind–body exercise) and resistance exercise (RE)—has been proposed for its potential effectiveness in improving cognitive function. However, there is still a lack of strong evidence for PR’s effectiveness. In this study, we expect to clarify the effects of pulmonary-based Qigong exercise and elastic band-based RE on cognitive function in patients with COPD and to fill in the relevant evidence blanks.Methods and analysisThis study is a single-centre randomised controlled trial with assessor and data analyst blinding. We will recruit 108 participants with stable COPD starting on 23 December 2019, and randomly allocate them into the pulmonary-based Qigong exercise group, elastic band-based RE group, pulmonary-based Qigong exercise and elastic band-based RE combined group, or control group at a 1:1:1:1 ratio. Participants in intervention groups will perform 30 min of exercise two times per day, 5 days a week, for 12 weeks. The primary outcome will be the global cognitive function as assessed by the Montreal Cognitive Assessment and auditory event-related potential P300. Secondary outcomes will include the specific cognitive domains—attention, memory, executive function, verbal fluency and mental-processing speed; psychological functions and QoL. Exploratory outcomes will include grey matter volume and levels of inflammatory mediators. Outcomes will be measured before and after the interventions.Ethics and disseminationEthics approval has been granted by the Ethics Committee of Yue-Yang Integrative Medicine Hospital, an affiliate of Shanghai University of Traditional Chinese Medicine, Shanghai, China (Grant No. 2019-141). Written informed consent will be obtained from each participant before any procedures are performed. The findings will be published in peer-reviewed journals and presented at academic conferences.Trial registration numberChiCTR1900026869; pre-results.

Effect of Pursed-Lip Breathing using a Windmill Toy Model on Breathing Efficiency in Chronic Obstructive Pulmonary Disease Patients

“…This was consistent with the study of investigating the effects of different intensity breathing exercises on heart rate and perception of fatigue [29,30]. In addition, the inhalation and chest muscles were enlarged [30]. The increased strength and performance of the breathing muscles allow the inhaled air in force inspiration to lift and expand the chest in the anterior-posterior line [29,30].…”

“…By stimulating an increase in muscle mass, the diaphragm and the muscles that attach the outer ribs undergo structural changes, causing the inhalation muscles to also increase [27,28]. This was consistent with the study of investigating the effects of different intensity breathing exercises on heart rate and perception of fatigue [29,30]. In addition, the inhalation and chest muscles were enlarged [30].…”

“…In addition, the inhalation and chest muscles were enlarged [30]. The increased strength and performance of the breathing muscles allow the inhaled air in force inspiration to lift and expand the chest in the anterior-posterior line [29,30]. As a result of better lung function and performance, the results of 6-minute walk distance (6MWD) were significantly different within the intervention group at week 6 and 12 [24,30].…”

“…The increased strength and performance of the breathing muscles allow the inhaled air in force inspiration to lift and expand the chest in the anterior-posterior line [29,30]. As a result of better lung function and performance, the results of 6-minute walk distance (6MWD) were significantly different within the intervention group at week 6 and 12 [24,30]. The intervention group received the pursed-lip breathing training using a windmill toy, and the results within the group at baseline and week 6 were compared and found statistically significant p < 0.05, which was explained as a result of an increase in respiratory performance.…”

Relationship between stigma and quality of life in people with pulmonary tuberculosis in East Java, Indonesia

“…The quality of life is a person's perception in the context of culture and norms that correspond to the person's place of life and are related to the purpose and expectation of the standard of care during their life (40,51). The quality of life of individuals with each other is different, and it depends on the definition or interpretation of each individual about good quality of life (37,52).…”