Effect of Balloon-Blowing on Dyspnea and Oxygenation in Noncritical Adult Covid19 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-exercise (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. Keywords: breathing exercises, balloon-blowing, BBE, chest physiotherapy, covid-19, dyspnea, oxygenation, pulmonary rehabilitation.

Efficacy of Pulmonary Rehabilitation in Post-COVID-19: A Systematic Review and Meta-Analysis

“…Nine studies were excluded due to population (included patients with acute COVID-19, still testing positive in COVID-19 test), two were excluded due to intervention (robot devices, ventilation therapy), one study was excluded due to outcomes (salivary biomarkers), and five due to study design (congress abstract, protocol). Finally, 34 studies were included for qualitative analysis in the present review (20 RCTs and 14 observational studies) [ 36 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 ]. For quantitative analysis, 26 studies were included.…”

“…Isolated breathing exercises were used in seven studies, five performed via telerehabilitation [ 42 , 58 , 62 , 68 , 71 ], and two face-to-face [ 39 , 40 ]. Breathing exercises were performed in addition to myofascial release in two studies [ 41 , 50 ].…”

“…The risk of bias of RCTs ranged from low to high, with ten studies with low risk of bias [ 42 , 45 , 47 , 50 , 51 , 54 , 62 , 66 , 70 , 71 ], eight with some concerns [ 36 , 39 , 40 , 41 , 46 , 52 , 55 , 68 ], and two with high risk [ 48 , 56 ]. Domains of bias due to the randomization process and bias due to deviation from the intended interventions were the domains with higher issues, while the domain related to the selection of the reported results was the domain with better scores.…”

“… Risk of bias of randomized controlled trials (RoB 2.0) [ 36 , 39 , 40 , 41 , 42 , 45 , 46 , 47 , 48 , 50 , 51 , 52 , 54 , 55 , 62 , 66 , 68 , 70 , 71 ]. …”

Effectiveness of Balloon Blowing Exercise on Cough Strength in Patients with Spinal Cord Injury

“…It is a known fact that respiratory exercises with an assist of device such as balloon are found to be effective not only in healthy young population but also in populations with cardiorespiratory disorders like COPD, asthma, COVID-19 [6,12,13] . Numerous breathing exercises have been proven to be effective in enhancing lung capacity and function in neurological conditions like SCI [3] .…”