Effect of a Breathing Exercise in Patients Under Hemodialysis

Effect of a Breathing Exercise on Respiratory Function and 6-Minute Walking Distance in Patients Under Hemodialysis

Purpose: To examine the effects of breathing exercises on respiratory functions and 6 Minute Walk Test (6 WT) distance in patients receiving hemodialysis treatment.

Method: This is a quasi-experimental study with a single group pretest-posttest design. It was conducted with 30 individuals in the hemodialysis unit of a public hospital between July 2022 and October 2022. Data were also collected before starting the intervention (week 1) and after completing the intervention (week 8). Socio-Demographic Data Survey, 6 Minute Walk Test and Respiratory Function Test were used as data collection tools and data were collected face to face. In the analysis of the data, mean, standard deviation, percentage, t test in dependent groups, and Wilcoxon analysis were used.

KeyWords: Individuals receiving hemodialysis treatment, respiratory exercise program, nursing care

Study Overview

• Status: Completed
• Conditions: Breathing Exercise
• Intervention / Treatment: Other: breathing exercise

Detailed Description

Creating and Implementing an Exercise Program Data were collected before starting the intervention (1st week) and after the intervention was completed (8th week). 6 Minute Walking Test and Respiratory Function Test were applied to the patients before the implementation of the exercise program and after 8 weeks of application. According to the results of the Pulmonary Function Test evaluated by the pulmonologist, COPD is in Grades 3 and 4. Stage 1 patients were not included in the study. A practical explanation was given about how to use the flow-oriented Intensive Spirometry Device (ICC) (Triflow) after the 3rd hour of the treatment in the HD unit. Each of the patients was given the same brand and model flow-focused intensive spirometer (Triflow) device for breathing exercise. The Triflow device has three compartments with a capacity of 1200 ml, with a ball of different colors in each compartment. The Triflow device is based on the patient taking a maximal inspiration, then holding the breath for as long as he can (at least 5 seconds), and then exhaling slowly. The patient watches the movement of the balls for visual feedback.

During Triflow use, patients were placed in a sitting position. They were told to hold the device in an upright position, put the mouthpiece of the Triflow in their mouth, completely cover the mouthpiece with their lips to prevent air from escaping, take a deep and slow breath after a quiet exhalation, increase the duration of holding their breath as much as the patient can tolerate, and then release the balls by exhaling. Patients were instructed to bring their devices with them to each session. Since some patients forgot their hemodialysis unit and exercise device and stated that they had difficulty in bringing them back and forth due to the long distance between the dialysis unit and home, each patient was given a special triflo device to be kept in the hemodialysis unit, separate from the ones they use at home.

The exercise program was performed 3 times a week for 8 weeks, under the supervision of the researcher, with 10 repetitions at the 3rd and 4th hours of the dialysis treatment. It was recommended that they do 10 repetitions every hour after waking up on days when there was no dialysis session. In the study, patients adhered to the breathing exercise program, and no problems were reported regarding device use during the session or at home.

• Study Type: Interventional
• Enrollment (Actual): 30
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey
  • Ori̇ji̇n
    • Çankırı, Ori̇ji̇n, Turkey, 18100
      • Cankiri Karatekin University

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Being ≥18 years old;
• Receiving HD treatment three times a week for at least 3 months;
• Not having a condition that prevents walking;

Exclusion Criteria:

• Having a history of Myocardial Infarction or Anginapectoris within the last month,
• Uncontrolled arrhythmia and heart rate >120/min,
• Having uncontrolled hypertension (BP>180/100 mm-Hg),
• Having a history of cerebrovascular accident
• Having advanced stage COPD (Stage 3, Stage 4) and advanced Stage Heart Failure (Stage 3/Stage 4),
• Having profound anemia (Hb<7 g/dl),
• Having a history of blood transfusion in the last month,
• Having an active and chronic infection (Tuberculosis, osteomyelitis, rheumatoid arthritis),
• Needing additional oxygen therapy,
• Hospitalization in the last 1 month,
• Patients with physical or mental health problems that would prevent communication were not included in the study.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: respiratory exercise program; A practical explanation was given about how to use the flow-oriented Intensive Spirometry Device (ICC) (Triflow) after the 3rd hour of the treatment in the HD unit. Each of the patients was given the same brand and model flow-focused intensive spirometer (Triflow) device for breathing exercise.	Other: breathing exercise; Patients Under Hemodialysis; Other Names: 6 minute walking test

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Respiratory Function Test- FVC	Forced Vital Capacity (FVC): The amount of air that is exhaled forcefully and rapidly after taking as much breath as possible.	0- 8. weeks
Respiratory Function Test- FEV1	1st Second Forced Expiratory Volume (FEV1): The amount of air exhaled in the first second of the FVC test.	0- 8. weeks
Respiratory Function Test- FEF	Forced Expiratory Flow (FEF): The average flow rate during the middle half of the FVC test.	0- 8. weeks
Respiratory Function Test- PEFR	Peak Expiratory Flow Rate (PEFR): The maximum airflow rate achieved during a forced exhalation.	0- 8. weeks

Collaborators and Investigators

• Sponsor: Çankırı Karatekin University

Study record dates

Study Major Dates

• Study Start (Actual): July 15, 2022
• Primary Completion (Actual): October 15, 2022
• Study Completion (Actual): October 15, 2022

Study Registration Dates

• First Submitted: March 18, 2024
• First Submitted That Met QC Criteria: November 25, 2024
• First Posted (Estimated): November 26, 2024

Study Record Updates

• Last Update Posted (Estimated): November 26, 2024
• Last Update Submitted That Met QC Criteria: November 25, 2024
• Last Verified: November 1, 2024

More Information

Terms related to this study

• Keywords: nursing care; hemodialysis patient; breathing exercise program
• Additional Relevant MeSH Terms: Pathologic Processes; Respiratory Tract Diseases; Respiration Disorders; Respiratory Aspiration
• Other Study ID Numbers: 28-06-2022/26

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