Effect of Breathing Exercises on Fatigue Dimensions in Patients with COPD

Abstract

Objective:  Fatigue is known as an important and multidimensional symptom in patients with chronic obstructive pulmonary disease (COPD). Pulmonary Rehabilitation (PR) is one of the effective ways to reduce fatigue and improve the quality of life in patients with COPD. However, equal recovery to all dimensions of fatigue is unclear after the rehabilitation program. This study aims to determine the effect of breathing exercises on the fatigue dimensions in patients with COPD Method: This study aimed to determine the effect of breathing exercises on fatigue dimensions in patients with COPD. The population in this clinical-trial research included 70 COPD patients who had been hospitalized in the Thorax Ward of Razi Hospital in Rasht. The samples were divided into two groups of 35 subjects, by which the control group was tried to be in a separate room from the experimental group. The experimental group participated in the breathing exercises program where the patients were asked to perform their respiratory exercises 4 times a day for 10 days. The control group received the routine care. Dimensions of fatigue (physical, general, mental, reduced activity, and reduced motivation) were measured and compared in both groups. SPSS (version 21) was used to analyze the data and descriptive and inferential tests were used. Results: There were significant statistical improvements in mean score of fatigue dimensions after breathing exercises, general fatigue (p=0.0001), physical exhaustion (p=0.0001), reduced activity (p=0.0001) and reduced motivation (p=0.0001), but there was no significant difference in mental fatigue. Predictors of changes in total fatigue score, breathing exercises (p<0.0001) and Salbutamol spray (p<0.013) were considered as two factors affecting fatigue score changes in multiple analysis. Conclusion: According to the obtained findings, breathing exercises are effective in many dimensions of fatigue as a non-pharmacological, low-cost, and safe method in care-and-treatment process in patients with COPD, but their effect on mental fatigue, as an important dimension, requires different plans and designs in doing breathing exercises.

Keywords

• Chronic obstructive pulmonary disease,Fatigue

Kaynakça

1. 1. Mirbagher-Ajorpaz N, Rezaei M. The effect of pulmonary rehabilitation program on quality of life of elderly patients with chronic obstructive pulmonary disease. Zahedan Journal of Research in Medical Sciences. 2010;13(1):30-5.
2. 2. Jokar Z, Mohammadi F, Khankeh H, Tafti S. Effect of Home-based Pulmonary Rehabilitation on Fatigue in Patients with COPD. Hayat. 2012;18(5):64-72.
3. 3. Theander K, Jakobsson P, Jörgensen N, Unosson M. Effects of pulmonary rehabilitation on fatigue, functional status and health perceptions in patients with chronic obstructive pulmonary disease: a randomized controlled trial. Clinical rehabilitation. 2009;23(2):125-36.
4. 4. Zakerimoghadam M, Tavasoli k, Kazemnejad A, Shaban M. The effect of breathing exercises on the fatigue levels of copd patients Hayat 2006;12(3):17-25.
5. 5. Deng Gj, Liu Fr, Zhong Ql, Chen J, Yang Mf, He HG. The effect of non‐pharmacological staged interventions on fatigue and dyspnoea in patients with chronic obstructive pulmonary disease: A randomized controlled trial. International journal of nursing practice. 2013;19(6):636-43.
6. 6. Lewko A, Bidgood PL, Jewell A, Garrod R. Evaluation of multidimensional COPD-related subjective fatigue following a Pulmonary Rehabilitation programme. Respiratory medicine. 2014;108(1):95-102.
7. 7. Shahdadi H, Hodki RM, Abadi AA, Sheikh A, Moghadasi A.The effect of slow stroke backmassageon fatiguein patients undergoing hemodialysis: Arandomized clinical trial.International Journal of Pharmacy and Technology.2016;8(3):16016-16023
8. 8. Wong CJ, Goodridge D, Marciniuk DD, Rennie D. Fatigue in patients with COPD participating in a pulmonary rehabilitation program. International journal of chronic obstructive pulmonary disease. 2010;5:319-26.

9. 9. Mirbagher N, Memarian R. The effects of rehabilitation techniques on the pulmonary function tests in moderate severity COPD patients. Ofogh-e-Danesh. 2009;14(4):19-26.
10. 10. Liu XL, Tan JY, Wang T, Zhang Q, Zhang M, Yao LQ, et al. Effectiveness of Home‐Based Pulmonary Rehabilitation for Patients with Chronic Obstructive Pulmonary Disease: A Meta‐Analysis of Randomized Controlled Trials. Rehabilitation Nursing. 2014;39(1):36-59.
11. 11. Lin WC, Yuan SC, Chien JY, Weng SC, Chou MC, Kuo HW. The effects of respiratory training for chronic obstructive pulmonary disease patients: a randomised clinical trial. Journal of clinical nursing. 2012;21(19pt20):2870-8.
12. 12. Cancelliero-Gaiad KM, Ike D, Pantoni CB, Borghi-Silva A, Costa D. Respiratory pattern of diaphragmatic breathing and pilates breathing in COPD subjects. Brazilian journal of physical therapy. 2014;18(4):291-9.
13. 13. Izadi F, Afshar M, Bagheri A. The efficacy of pursed-lips breathing in patient with chronic obstructive pulmonary disease. J shahid sadoughi med sci 2006;14(2):61-7.
14. 14. Smets E, Garssen B, Cull A, De Haes J. Application of the multidimensional fatigue inventory (MFI-20) in cancer patients receiving radiotherapy. British journal of cancer. 1996;73(2):241.
15. 15. Fillion L, Gélinas C, Simard S, Savard J, Gagnon P. Validation evidence for the French Canadian adaptation of the Multidimensional Fatigue Inventory as a measure of cancer-related fatigue. Cancer nursing. 2003;26(2):143-54.
16. 16. Baghai-Ravary R, Quint JK, Goldring JJ, Hurst JR, Donaldson GC, Wedzicha JA. Determinants and impact of fatigue in patients with chronic obstructive pulmonary disease. Respiratory medicine. 2009;103(2):216-23.
17. 17. Peters JB, Heijdra YF, Daudey L, Boer LM, Molema J, Dekhuijzen PR, et al. Course of normal and abnormal fatigue in patients with chronic obstructive pulmonary disease, and its relationship with domains of health status. Patient education and counseling. 2011;85(2):281-5.
18. 18. Theander K, Unosson M. Fatigue in patients with chronic obstructive pulmonary disease. Journal of advanced nursing. 2004;45(2):172-7.
19. 19. Lacasse Y, Martin S, Lasserson T, Goldstein R. Meta-analysis of respiratory rehabilitation in chronic obstructive pulmonary disease. A Cochrane systematic review. Europa medicophysica. 2007;43(4):475-85.
20. 20. Lewko A, Bidgood PL, Garrod R. Evaluation of psychological and physiological predictors of fatigue in patients with COPD. BMC pulmonary medicine. 2009;9(1):47.