Effects of Home-Based Breathing Exercises in Subjects With COPD

Lu, Yufan; Li, Peijun; Li, Ning; Wang, Zhengrong; Li, Jian; Liu, Xiaodan; Wu, Wenqing

doi:10.4187/respcare.07121

Cited by 44 publications

(48 citation statements)

References 60 publications

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“…The copyright holder for this preprint this version posted March 9, 2021. ; https://doi.org/10.1101/2021.03.08.21253007 doi: medRxiv preprint study did not detect any effects of the program on quality of life (SF-36) or lower-limb strength (measured as gluteus maximum and anterior deltoid strength with dynamometer). While a recent systematic review and meta-analysis reported superior effects of breathing exercise on lung function parameters (FEV1 and FEV1/FVC) as compared to control for COPD 42 , no such effects were found in the present study. In contrast to COPD, Covid-19 does not necessarily involve permanent impairment of structures of the lung and patients in our study from both groups seem to have naturally improved regarding lung function parameters.…”

Section: Sensitivity Analysiscontrasting

confidence: 95%

Effectiveness of a telerehabilitation program for COVID-19 survivors (TERECO) on exercise capacity, pulmonary function, lower limb muscle strength, and quality of life: a randomized controlled trial

Xia

Zhan³

et al. 2021

Preprint

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Objectives To investigate superiority of a telerehabilitation program for Covid-19 (TERECO) over no rehabilitation with regard to functional exercise capacity, lower-limb muscle strength (LMS), pulmonary function, health-related quality of life (HRQOL), and perceived dyspnoea. Design Parallel-group randomised controlled-trial with 1:1 block-randomisation. Setting Three major hospitals from Jiangsu and Hubei provinces, China. Participants 120 Covid-19 survivors with modified Medical Research Council (mMRC) dyspnoea score of 2-3 who had been discharged from hospital were randomised. 61 were allocated to the control group and 59 to the TERECO group. Intervention The control group received educational instructions. The TERECO group participated in a 6-week home-based, pulmonary rehabilitation program delivered via smartphone and monitored with chest-worn heart rate telemetry. Exercise types comprised breathing control and thoracic expansion, aerobic exercise, and LMS exercise. Outcomes Primary outcome was 6-minute walking distance (6MWD) in metres. Secondary outcomes were LMS measured as squat time in seconds; pulmonary function assessed by spirometry with parameters being forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), FEV1/FVC, maximum voluntary ventilation (MVV), and peak expiratory flow; HRQOL measured with SF-12 physical component score (PCS) and mental component score (MCS); and mMRC dyspnoea, favourable outcome (no dyspnoea). Outcomes were assessed at 6 weeks (post-treatment) and 28 weeks (follow-up). Results 120 patients were randomised, 15 (12.5%) were lost to follow-up at study endpoint. No serious adverse events occurred. 38 participants in the TERECO group complied with the exercise protocol (64.41% of randomized). The adjusted between-group difference in change in 6MWD from baseline was 65.45 metres (95% CI 43.8-87.1, p<0.001) at post-treatment and 68.62 metres (95% CI 46.39-90.85, p<0.001) at follow-up. Treatment effects for LMS were 20.12 seconds (95% CI 12.34-27.9, p<0.001) post-treatment and 22.23 seconds (95% CI 14.24-30.21, p<0.001) at follow-up. No group differences were found for lung function apart from post-treatment MVV (10.57 litres/minute, 95% CI 0.26-17.88, p=0.005). Increase in SF-12 PCS was greater in the TERECO group with treatment effects estimated as 3.79 (95% CI 1.24-6.35, p=0.004) at post-treatment and 2.69 (95% CI 0.06-5.32, p=0.045) at follow-up. No significant between-group differences were found for improvements in SF-12 MCS. At post-treatment 90.4% endorsed a favourable outcome for mMRC dyspnoea in the TERECO group vs. 61.7% in control (adjusted RR 1.46, 1.17-1.82, p=0.001). Conclusions This trial demonstrated superiority of TERECO over no rehabilitation for 6MWD, LMS, and SF-12 PCS. We found no persistent effects on pulmonary function, SF-12 MCS, and perceived dyspnoea. Trial registration: Chinese Clinical Trial Registry: ChiCTR2000031834, 11 Apr 2020, URL: http://www.chictr.org.cn/showproj.aspx?proj=52216

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Section: Sensitivity Analysiscontrasting

confidence: 95%

Effectiveness of a telerehabilitation program for COVID-19 survivors (TERECO) on exercise capacity, pulmonary function, lower limb muscle strength, and quality of life: a randomized controlled trial

Xia

Zhan³

et al. 2021

Preprint

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“…As an important non-drug intervention in the treatment of respiratory diseases, respiratory rehabilitation training is increasingly accepted in clinical practice, [ 7 – 9 ] which mainly includes sports training (such as breathing training, aerobic training, and resistance training) as well as disease health education and self-management. [ 10 – 12 ] Among them, exercise training, as one of the most effective rehabilitation methods for respiratory diseases, forms the core part. And a large batch of clinical and basic studies have demonstrated that respiratory rehabilitation training, with exercise training as the main component, can improve the activity ability and quality of life of patients with respiratory diseases by strengthening their lung functions, reducing the airway resistance, improving immune functions, and boosting exercise abilities.…”

Section: Introductionmentioning

confidence: 99%

Effect of respiratory rehabilitation training on elderly patients with COVID-19

Yan¹,

Ouyang²,

Wang

et al. 2020

Medicine

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Background: Patients with the Corona Virus Disease 2019 (COVID-19) often see their respiratory, physical, and psychological functions impaired to varying degrees, especially for the elderly patients. Timely respiratory rehabilitation intervention for such patients may improve their prognoses. However, its relative effectiveness has not been proved. Therefore, this study is purposed to determine the effect of respiratory rehabilitation on elderly patients with COVID-19. Methods: This study will search the following electronic databases: Embase, MEDLINE, PubMed, Cochrane Library, China national knowledge infrastructure database, Wan Fang database, Chinese Science and Technology Periodical Database, and Chinese Biomedical Literature Database, with the retrieval period running from their inception to August 2020. All randomized controlled trials of respiratory rehabilitation training on elderly patients with COVID-19 are collected, and the data are selected and extracted independently according to the pre-designed inclusion/exclusion criteria. Cochrane bias risk assessment tool is used to evaluate the method quality and bias risk. All data analyses will be implemented by using Revman5.3 and Stata14 software. Results: This study will make a high-quality and comprehensive evaluation of the efficacy of respiratory rehabilitation training on elderly patients with COVID-19. Conclusion: The conclusions of this systematic review will deliver more convincing evidence. Ethics and dissemination: The private information collected from individuals will not be published. And this systematic review will also not involve impairing the participants’ rights. Ethical approval is not required. The results may be published in a peer-reviewed journal or disseminated in relevant conferences.

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“…The results published by Mayer et al (2018) illustrated that the acute application of PLB during exercise could effectively reduce the respiratory rate and minute ventilation in people, yet how these people benefit from the application of PLB remains unknown. Moreover, the systematic reviews of Lu et al (2020) and Borge et al (2014) also determined that dyspnoea and health-related QOL were significantly improved through a period of BEs, but the long-term effects of these interventions on pulmonary function were nonetheless indistinct (Lu et al, 2020). The relationship between BEs and PR has not yet been evaluated, so it was difficult to provide healthcare providers with detailed recommendations on which breathing training techniques are most beneficial (Borge et al, 2014;Ubolnuar et al, 2019).…”

Section: Introductionmentioning

confidence: 99%

“…Moreover, the systematic reviews of Lu et al. (2020) and Borge et al. (2014) also determined that dyspnoea and health‐related QOL were significantly improved through a period of BEs, but the long‐term effects of these interventions on pulmonary function were nonetheless indistinct (Lu et al., 2020).…”

Section: Introductionmentioning

confidence: 99%

“…(2020) and Borge et al. (2014) also determined that dyspnoea and health‐related QOL were significantly improved through a period of BEs, but the long‐term effects of these interventions on pulmonary function were nonetheless indistinct (Lu et al., 2020). The relationship between BEs and PR has not yet been evaluated, so it was difficult to provide healthcare providers with detailed recommendations on which breathing training techniques are most beneficial (Borge et al., 2014; Ubolnuar et al., 2019).…”

Section: Introductionmentioning

confidence: 99%

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Breathing exercises in people with COPD: A realist review

Liu

Ding

et al. 2020

Journal of Advanced Nursing

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Aims To determine the theoretical framework that explains the mechanisms of the success of breathing exercise interventions in people with chronic obstructive pulmonary disease. Design A realist review. Data sources Seven bibliographic databases and the grey literature were searched from 2015–January 2020 to identify the studies of breathing exercises. Review Methods The evaluation criteria of realist review and the mixed method appraisal tool were both used to evaluate the included studies. We extracted and integrated the context–mechanism–outcome strings of each study to form the theoretical framework. Results Six theoretical mechanisms that affected the success of the intervention were articulated: Wide acceptance of training methods, Integration of the intervention with life, Self‐management of the participants, Confidence in controlling symptoms, Participation and support of practitioners, Motivation for intervention. Conversely, the other two mechanisms including the gap between implementation and training and the duration of the intervention, had negative impacts on the implementation of breathing exercises. Conclusion This review updates and expands the previous literature review on the impact of breathing exercises in people and provides researchers and clinical practitioners with theoretical mechanisms to ensure that the interventions achieve expected effects. Impact When formulating or selecting breathing exercise interventions, our theoretical framework will guide researchers and clinical practitioners to ensure that the intervention will have practical effects.

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Effects of Home-Based Breathing Exercises in Subjects With COPD

Cited by 44 publications

References 60 publications

Effectiveness of a telerehabilitation program for COVID-19 survivors (TERECO) on exercise capacity, pulmonary function, lower limb muscle strength, and quality of life: a randomized controlled trial

Effectiveness of a telerehabilitation program for COVID-19 survivors (TERECO) on exercise capacity, pulmonary function, lower limb muscle strength, and quality of life: a randomized controlled trial

Effect of respiratory rehabilitation training on elderly patients with COVID-19

Breathing exercises in people with COPD: A realist review

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