Effects Of Shrinking Lips Abdominal Breathing Combined With Vertical Breathing Gymnastics On Patients With Moderate To Severe Chronic Obstructive Pulmonary Disease

ObjectiveTo evaluate the effect of breathing exercise program(shrinking lips abdominal breathing combined with vertical breathing gymnastics) on dyspnea, pulmonary function,exercise tolerance and quality of life in patients with moderate to severe effects of chronic obstructive pulmonary disease(COPD).Method1.90 hospitalized patients with moderate to severe chronic obstructive pulmonary disease(COPD) were collected from respiratory medicine ward of the Third Affiliated Hospital of Soochow University(Changzhou First People’s Hospital). According to the order of admission and random number table, they were randomly divided into experimental and control groups, 45 cases in each group.2.During hospitalization experimental and control groups are treated with the same treatment,such as low-flow oxygen,prescribed medication,health education,and learning shrink lip abdominal breathing.Control group:take exercises by self, Experimental group:train shrinking lips abdominal breathing combined with vertical breathing gymnastics after medical staff’s care, with folk music as the background. Exercise frequency: Morning, afternoon, 2 times / day, 15 min per time.Researchers take telephone interviews once a week after discharge. Control group: only to get the patient’s condition and drug use; Experimental group:to get the patient’s condition changes, movement,exercise,feelings,and to give breathing exercises training-related guidance and supervision.Intervention continued three months.3. The indicators as dyspnea,pulmonary function,exercise tolerance and life quality of both groups are assessed respectively before and after the intervention.Result1.There are no significant differences of baseline data such as age, sex, education level, severity of COPD, duration, smoking history, smoking and drug use between the two groups.During the intervention,the experimental group lost one case and the control group lost three cases, 86 patients finished the experiment( experimental group:44 cases, control group: 42 cases).2. Symptom of dyspnea(m MRC dyspnea score)After the intervention, the symptom of dyspnea was relieved in the experimental group comparing to before.There was a significant decrease in m MRC dyspnea score(P<0.01). There was no significant change in m MRC dyspnea scores in the control group(P>0.05).After the intervention, m MRC dyspnea score in the experimental group was significantly lower than the control group(P<0.05).3. Pulmonary functionAfter the intervention, the experimental group showed no significant difference in pulmonary function(P>0.05); FEV1 / FVC in control group was significantly lower(P<0.05), the other indexes(FVC, FEV1, FEV1%, PEF) have no significant difference(P>0.05).After the intervention, there were no statistically significant differences between two groups(P>0.05).4. Exercise toleranceAfter the intervention, there was significantly increased in six minutes walking distance(6MWD) in experimental group[(315.00±62.53)m vs(371.34 ±67.74)m, P<0.01];and was significantly lower in 6MWD in control group [(315.05 ± 60.89) m vs(301.57 ±61.67) m, P<0.01].After the intervention, the differences between the two groups was statistically significant [(-56.34 ± 7.90) m vs(13.48 ± 5.91) m, P<0.01].5. Quality of life [St George’s Respiratory Questionnaire(SGRQ) scores]After the intervention,the score of SGRQ(respiratory symptoms score, limited activity score, disease impacts score and total score) in the experimental group were significantly lower(P<0.01);There were no significant change in the score of SGRQ(respiratory symptoms score, limited activity score, disease impacts score and total score) in the control group(P>0.05).After the intervention,the score of SGRQ(respiratory symptoms score,limited activity score, disease impacts score and total score) in the experimental group was significantly lower than the control group [(respiratory symptoms score 5.20±2.80 vs 0.48±2.58,P<0.05);(limited activity score, 5.80±3.15 vs-0.98±4.50, P<0.05);(disease impacts score5.18±2.31vs-0.02±2.90, P<0.05);(totalscore5.32±1.41 vs-0.04±1.70,P<0.05)].ConclusionThe program of shrinking lips abdominal breathing combined with vertical breathing gymnastics can relieve dyspnea in patients with moderate to severe COPD, improve exercise tolerance and quality of life, which is a safe and effective rehabilitation for patients with COPD.