Effect of Balloon-Blowing on Dyspnea and Oxygenation in Hospitalized COVID-19 Patients: A Pilot Study

Abstract

Dyspnea and decreased O2 saturation are the most common causes of hospitalization in noncritical COVID-19 patients. Breathing exercises and chest physiotherapy are used for managing the patients. These treatments are, however, not well supported by scientific evidence. In a randomized controlled trial, 80 patients were randomly assigned to planned breathing exercises (n=40) and control groups (n=40). The participants in the intervention group were instructed to blow into a balloon five times a day while lying down. Other therapies were similar in both groups. The severity of dyspnea at rest/after activity and peripheral oxygen saturation (SpO2) with/without O2 therapy were compared between the two groups on the first, second, and third days. The study findings showed no statistically significant difference in SpO2 with/without O2 therapy on the first, second, and third days between the two groups. Although the severity of dyspnea showed no significant difference between the two groups, the mean score of dyspnea at rest (2.72±2.25 vs. 1.6±1.21, P=0.007) and after activity (4.53±2.04 vs. 3.52±1.66, P=0.017) improved in the intervention group on the third day. Balloon-blowing exercise improves dyspnea in noncritical Covid-19 patients, but it does not significantly improve oxygenation.

Pulmonary Rehabilitation in SARS-CoV-2: A Systematic Review and Meta-Analysis of Post-Acute Patients

“…The range of article types included in this review is broad. Six randomized controlled trials [ 49 , 50 , 51 , 52 , 53 , 54 ], three cohort studies [ 55 , 56 , 57 ], one observational study [ 58 ], and one case-control trial [ 59 ]. The 11 included studies were conducted in Spain [ 49 ], China [ 50 ], Brazil [ 51 ], Iran [ 52 , 53 ], Turkey [ 54 ], France [ 55 ], Germany [ 56 ], Belgium [ 57 ], Switzerland [ 58 ], and Saudi Arabia [ 59 ].…”

“…In total, six studies were evaluated. Only one of the included studies was evaluated as having a “low risk of bias” [ 49 ], three as “some concerns” [ 50 , 51 , 54 ], and two as a “high risk of bias” [ 52 , 53 ], suggesting that only 16% of the included randomized controlled trials have a low risk of bias. According to the domain analysis, the random sequencing and reporting of incomplete data had a low risk of bias in all the included studies, while the blinding participants and allocation concealment were the main risks of bias in the included studies.…”

“…Eight studies analyzed the effects of pulmonary rehabilitation on dyspnea [ 49 , 50 , 51 , 52 , 53 , 54 , 56 , 59 ]. To assess dyspnea, three studies used the modified Medical Research Council scale [ 50 , 54 , 56 ], four studies the Borg and Modified Borg Scale [ 49 , 51 , 52 , 53 ], one study the Dyspnea Severity Index [ 59 ], and the last one the Multidimensional Dyspnea 12 [ 49 ].…”

“…Eight studies analyzed the effects of pulmonary rehabilitation on dyspnea [ 49 , 50 , 51 , 52 , 53 , 54 , 56 , 59 ]. To assess dyspnea, three studies used the modified Medical Research Council scale [ 50 , 54 , 56 ], four studies the Borg and Modified Borg Scale [ 49 , 51 , 52 , 53 ], one study the Dyspnea Severity Index [ 59 ], and the last one the Multidimensional Dyspnea 12 [ 49 ]. Six of the included studies were randomized controlled trials [ 49 , 50 , 51 , 52 , 53 , 54 ], and the risk of bias ranged from a low (16.6%), to unclear (49.8%) to a high risk of bias (33.6%).…”

“…To assess dyspnea, three studies used the modified Medical Research Council scale [ 50 , 54 , 56 ], four studies the Borg and Modified Borg Scale [ 49 , 51 , 52 , 53 ], one study the Dyspnea Severity Index [ 59 ], and the last one the Multidimensional Dyspnea 12 [ 49 ]. Six of the included studies were randomized controlled trials [ 49 , 50 , 51 , 52 , 53 , 54 ], and the risk of bias ranged from a low (16.6%), to unclear (49.8%) to a high risk of bias (33.6%). Two of included studies were observational [ 56 , 59 ], one of them of low quality [ 56 ], and the other one of high quality [ 59 ].…”