Respiratory Exercise Diary in Major Abdominal Surgery

Effect of Respiratory Exercise Diary Use on Pulmonary Complications and Functional Capacity in Major Abdominal Surgery: A Randomized Controlled Study

Postoperative pulmonary complications are common and lead to increased morbidity and mortality in patients. These complications are observed especially after major surgical interventions. Breathing exercises performed with or without the use of a device are extremely important in preventing postoperative pulmonary complications. Breathing exercises that increase total lung capacity by encouraging the use of the diaphragm reverse alveolar collapse and postoperative hypoxemia. This study aim to determine the effect of postoperative respiratory exercise diary use in patients undergoing major abdominal surgery on dyspnea, fatigue, respiratory parameters (respiratory rate, SPO2, cough, sputum), early pulmonary complications, spirometry use and functional capacity.The research is planned to be conducted in a single-blind, randomized controlled manner. In the study, 60 patients (30 intervention and 30 control) who underwent major abdominal surgery will be included.Data will be collected using the Patient Introduction Form, Visual Analogue Scale, Medical Research Board Scale, 2-minute walk test, breathing exercise diary and patient follow-up chart.Patients in the intervention and control groups will be visited by the researcher for 3 postoperative days, respiratory parameters, cough, and sputum status will be recorded in the patient follow-up chart, and the use of a respiratory exercise diary will be evaluated.

Study Overview

• Status: Completed
• Conditions: Pulmonary Complication
• Intervention / Treatment: Other: respiratory exercise diary

• Study Type: Interventional
• Enrollment (Actual): 60
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Kayseri, Turkey (Türkiye)
    • Erciyes University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Undergoing elective surgery
• Receiving general anesthesia
• Having major abdominal surgery (colorectal surgery, gastrectomy, liver resection, pancreatectomy)
• Staying in the general surgery service for at least 3 days after the surgery
• Becoming literate

Exclusion Criteria:

• Psychoactive drug use
• Having Alzheimer's or dementia
• Having chronic respiratory diseases (COPD, asthma)

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Diagnostic
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Intervention group; Patients in this group will be asked to perform breathing exercises in the form of using a spirometer 10 times every hour during the preoperative period while they are awake for three days, starting from the first day after the surgery. Patients in this group will be given a breathing exercise diary.	Other: respiratory exercise diary; Patients in the intervention group will be asked to perform breathing exercises in the form of using a spirometer 10 times every hour during the preoperative period while they are awake for three days, starting from the first day after the surgery. Patients in this group will be given a breathing exercise diary.
No Intervention: Control group; Patients in this group will not undergo any treatment and will continue to receive care according to their clinical routine. In the clinic, when patients are admitted to the hospital, nurses give them a spirometer during the pre-operative period and it is stated that they should use it before and after the surgery. After the data collection tools are applied to the patients in this group, they will be asked how many times a day they use a spirometry.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Spirometry use	The respiratory exercise diary was prepared in line with the literature for patients to record the time, number and frequency of breathing exercises they performed using a spirometer. There is an illustrated information note to remind you how and how often the spirometer should be used, and a chart where patients will write the number and frequency of exercises they did with the spirometry for three days before and after the surgery, opposite the relevant clock.	1-3 days

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
dyspnea	The presence of dyspnea will be evaluated using the Medical Research Board Scale (MAKS). This scale is a five-item scale based on various physical activities that create a feeling of dyspnea. Here, patients are asked to mark the level of activity that causes dyspnea. MAX is easy to administer because it allows patients to indicate the extent to which shortness of breath affects their mobility.	1-3 days
fatigue	In the study, fatigue severity will be evaluated using a visual analog scale. The range of 0 and 10 cm is determined on a line. In the fatigue severity assessment, 0 (zero) means "I do not feel tired" and 10 means "I feel very tired." An increase in score indicates that the patient's fatigue severity is increasing.	1-3 days
Pulmonary functional capacity	In the 2-minute walk test, two points are selected 30 meters away from each other and a mark is placed every 3 meters. The patient walks quickly within 2 minutes and the distance traveled is recorded. Walking tests used to assess functional capacity are simple, inexpensive and safe performance-based tests that provide information about individuals' functional exercise capacity compared to laboratory-based aerobic capacity indices such as cycling, treadmill and arm ergometry, which are expensive and not always available.	1-3 days
Respiratory rate	Preoperative and postoperative respiratory rate will be recorded in the patient follow-up chart.	1-3 days
Oxygen saturation	Preoperative and postoperative oxygen saturation will be recorded in the patient follow-up chart.	1-3 days
Cough	The presence of cough after surgery will be recorded in the patient follow-up chart.	1-3 days
Mucus	The presence of mucus after surgery will be recorded in the patient follow-up chart.	1-3 days

Collaborators and Investigators

• Sponsor: TC Erciyes University

Publications and helpful links

General Publications

• Toor H, Kashyap S, Yau A, Simoni M, Farr S, Savla P, Kounang R, Miulli DE. Efficacy of Incentive Spirometer in Increasing Maximum Inspiratory Volume in an Out-Patient Setting. Cureus. 2021 Oct 4;13(10):e18483. doi: 10.7759/cureus.18483. eCollection 2021 Oct.
• Unver S, Kivanc G, Alptekin HM. Deep breathing exercise education receiving and performing status of patients undergoing abdominal surgery. Int J Health Sci (Qassim). 2018 Jul-Aug;12(4):35-38.
• Westerdahl E, Lindmark B, Eriksson T, Hedenstierna G, Tenling A. The immediate effects of deep breathing exercises on atelectasis and oxygenation after cardiac surgery. Scand Cardiovasc J. 2003 Dec;37(6):363-7. doi: 10.1080/14017430310014984.
• McTier L, Botti M, Duke M. Patient participation in pulmonary interventions to reduce postoperative pulmonary complications following cardiac surgery. Aust Crit Care. 2016 Feb;29(1):35-40. doi: 10.1016/j.aucc.2015.04.001. Epub 2015 May 1.

Study record dates

Study Major Dates

• Study Start (Actual): October 9, 2023
• Primary Completion (Actual): December 1, 2025
• Study Completion (Actual): December 1, 2025

Study Registration Dates

• First Submitted: September 27, 2023
• First Submitted That Met QC Criteria: October 9, 2023
• First Posted (Actual): October 12, 2023

Study Record Updates

• Last Update Posted (Actual): April 14, 2026
• Last Update Submitted That Met QC Criteria: April 10, 2026
• Last Verified: March 1, 2026

More Information

Terms related to this study

• Keywords: breathing exercises; fatigue; dyspnea; general surgery
• Additional Relevant MeSH Terms: Respiratory Tract Diseases; Respiration Disorders; Signs and Symptoms, Respiratory; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Fatigue; Dyspnea
• Other Study ID Numbers: Erüsbf

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No