| Aim To provide more evidence for the medical staffs to guide the COPD patients’education about breathing exercises through investigating the status of the breathing exercises in elderly patients and observing the effects of four different kinds of breathing exercises on pulmonary function and health status of elderly patients with COPD.Methods 1.Questionnaire survey: A questionnaire designed by our researching team was used to investigate the breathing exercises status of 106 elderly patients with COPD. 2.Clinical controlled trial: 120 elderly COPD patients were randomly divided into four groups ordinary lipstick breathing exercise group (BEG), strengthened lipstick breathing exercise group (EBEG), respiratory training device group (RTG), and enhaced respiratory trainer group (ERTG). The pulmonary function and health status in the four groups were compared after intervention for 3 months.Results 1. The average age of 106 elderly patients with COPD were 75.3 years old.10.38% of the patients can regularly complete the breathing exercise, 61.32% of the patients can carry out partlt breathing exercises other than completely exercises required by medical staffs, and 28.30% of the patients never have respiratory exercises. The influencing factors of breathing exercises adherance in elderly patients with COPD are related to the patients’education degree. 2. After 3 months of breathing exercises: ①Blood gas analysis: oxygen partial pressure and blood oxygen saturation were increased in all four groups and partial pressure of carbon dioxide were discreased in all four groups. The improving effects of blood gas analysis in ERTG group were superier than any other three groups. ②The pulmonary function: FEVi% (% of predicted) and FEVi/FVC were increased in all the four groups. The increasement of FEV1% in ERTG group was higher than that of BEG and RTG groups. The increasement of FEV1/FVC in ERTG and EBEG groups were higher than that of BEGand RTG groups.③The CAT score and BORG index decreased in all four groups. The CAT score of the ERTG group was significantly lower than any other three groups. The BORG index of the ERTG group was significantly lower than BEG and RTG group. ④6MWT: The distance was increased significantly in all four groups, and the distance in the ERTG group was significantly longer than any other three groups.⑤SF-36: The scores of physiological function, vitality and social function in ERTG group were higher than EBG and ETG groups. The scores of role-physical in EBEG groups were higher than BEG and RTG groups. The scores of mental health in EBEG groups were higher than any other three groups. Generally scores of SF-36 in ERTG groups were higher BEG and RTG groups.General health, body pain and role-emotional scores were not differently between the four groups significantly. Compared with baseline, the scores of all the eight indexes were increased in EBEG and ERTG groups, the scores of all the indexes except social function were increased in BEG group, and the scores of all the indexes except body pain were increased in RTG group.Conclusions Only 10.3% of elderly patients with COPD adhere to daily breathing exercises. The influencing factors of breathing exercises in patients were related to the educational level. Breathing exercises for three months can improve blood gas analysis,pulmonary function, quality of life, six-minute walking distance, CAT and BORG score in the elderly patients with COPD. The effects of strengthened breathing exercise is better than ordinary breathing exercise, and enhaced respiratory trainer is the best of all breathing exercise. To improve the rehabilatory effects of elderly patients with COPD,the enhaced respiratory trainer should be preferred. |
