Pilot Study of Self-care Breath Training Exercise for Reduction of Chronic Dyspnea

Abstract

Purpose Dyspnea related to chronic pulmonary disorders is difficult to manage. In this single-arm study, we evaluated feasibility and potential efficacy of a self-care breath-training program to reduce dyspnea that persists despite standard treatments in patients with chronic lung disease. Methods Adult patients with a chronic pulmonary disorder and stable moderate dyspnea received one 30-minute training on specific breathing techniques, followed by audio-guided at-home practice 15 minutes twice daily for 6 weeks, supported with weekly telephone monitoring/coaching. Feasibility endpoints, Baseline and Transition Dyspnea Indexes (BDI/TDI), Six Minute Walk Test (6MWT), Hospital Anxiety and Depression Scale (HADS), and oxygen saturation at rest and exercise were evaluated at baseline and week 6. Results Of 23 patients enrolled over 2 years, 19 completed the study. A majority (74%; 95% CI 49%, 91%) completed at least 75% of the home practice sessions. Significant objective improvements in physical performance, defined as distance walked, were observed after 6 weeks of intervention. On average, patients walked 59 more feet in the 6MWT (95% CI 18, 99; P=.007). In addition, 53% reported clinically significant (20%, defined a priori) subjective improvement in TDI, although the difference was not statistically significant (mean TDI, 0.7, 95% CI −0.8, 2.3; P=.3). No significant differences were seen in HADS or oxygen saturation. Conclusions A low-burden, low-cost, self-care breath training program improved distance walked by patients with chronic dyspnea after 6 weeks of home practice. Promising data suggest that a randomized trial of this breath training program is warranted.