The Effects of Two Different Breathing Techniques and Forward-Leaning Position on Physiological Parameters

Determination of the Effects of Two Different Breathing Techniques and Forward-Leaning Position on Physiological Parameters in Patients With Chronic Obstructive Pulmonary Disease

This study aims to determine the effects of balloon inflation and pursed-lip breathing exercises, in addition to the forward-leaning position, on physiological parameters in individuals with Chronic Obstructive Pulmonary Disease (COPD).

The hypotheses of the study are as follows:

H1_1: The forward-leaning position and balloon inflation breathing exercise have a positive effect on physiological parameters in patients with Chronic Obstructive Pulmonary Disease (COPD).

H1_2: The forward-leaning position and pursed-lip breathing exercise have a positive effect on physiological parameters in patients with COPD.

H1_3: There is a significant difference in physiological parameters between the balloon inflation and pursed-lip breathing exercise groups and the control group.

Within this scope, the study will be conducted with three groups:

Intervention Group 1: Balloon inflation exercise applied in addition to the forward-leaning position.

Intervention Group 2: Pursed-lip breathing exercise applied in addition to the forward-leaning position.

Control Group: Standard practice implemented in the institution where the study is conducted.

Participants:

• A home exercise program will be designed for both intervention groups, allowing them to perform the exercises independently each day.
• The exercises will start with three sessions per day and will be increased by one session each week, continuing for a total of four weeks.
• Participants will visit the outpatient clinic in the 4th week for assessments and tests.
• Patients will be contacted weekly by the researcher via phone to ensure adherence to the program.

Study Overview

• Status: Completed
• Conditions: Chronic Obstructive Pulmonary Disease, COPD
• Intervention / Treatment: Other: Pursed-lip breathing exercise; Other: Balloon inflation exercise; Other: Control (Standard treatment)

Detailed Description

The exercise program will be determined in collaboration with a respiratory physiotherapist and implemented by the researcher. Accordingly, patients with stage II-III COPD (as determined by a physician) who visit the pulmonology outpatient clinic of the relevant hospital and meet the inclusion criteria will be given brief information about respiratory exercises, their benefits, and duration. They will then be instructed on how to perform the exercises through verbal commands for approximately 30 minutes. At the end of the session, the exercise guidelines will be practiced under the supervision of the researcher.

Before starting, the patient will be seated in a chair and allowed to rest for about 15 minutes. The patient will be informed about how to perform the walking test, the expected walking pace, and that they can stop and rest if they feel fatigued. Then, the patient will be asked to walk at a brisk pace for six minutes under the supervision of the researcher. During the walk, the researcher will continuously monitor the patient's oxygen saturation using a handheld pulse oximeter. If the patient exhibits signs of excessive sweating, pallor, or a significant drop in oxygen levels, the test will be terminated early.

Before and after the test, blood pressure, pulse rate, respiratory rate, oxygen saturation [SpO2], and dyspnea score using the Modified Borg Scale will be assessed, and the distance the patient walks in six minutes will be recorded. The six-minute walk test will be repeated at the end of the study. Subsequently, the patient will undergo a pulmonary function test, and the values for FVC, FEV1, FEV1/FVC ratio, and peak expiratory flow will be recorded.

• Study Type: Interventional
• Enrollment (Actual): 96
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey
  • Üsküdar
    • İstanbul, Üsküdar, Turkey
      • University of Health Sciences Turkey

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Patients who have no communication and cooperation problems,
• Can speak and understand Turkish,
• Have a baseline saturation of >90%,
• Have been diagnosed with Stage II and Stage III COPD,
• Have not had any infection or COPD exacerbation for at least 3 months,
• Have not participated in a pulmonary rehabilitation program in the last 3 months,
• Can walk without assistance,
• Do not have serious and/or unstable heart disease, neuromuscular disease, orthopedic disease or mental illness that may impair their physical activities of daily living,
• Willing to participate in the study will be included.

Exclusion Criteria:

• Patients who have been hospitalized since the start of the study,
• Those receiving continuous oxygen therapy,
• Those who have cooperation problems,
• Those who cannot adapt to exercise,
• Those who have 2-3 or more acute attacks per year,
• Those with a history of pulmonary hypertension, malignancy, pulmonary thromboembolism, obstructive sleep apnea, unstable angina or myocardial infarction,
• Patients with a pulse rate over 120/minute will be excluded from the study.

Study Plan

How is the study designed?

Design Details

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

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Pursed-lip breathing exercise	Other: Pursed-lip breathing exercise; The pursed-lip breathing exercise was applied in addition to the forward-leaning position.
Experimental: Balloon inflation exercise	Other: Balloon inflation exercise; Balloon inflation exercise was applied in addition to the forward-leaning position.
Experimental: Standard treatment	Other: Control (Standard treatment); Standard practice is implemented in the institution where the study is conducted.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
blood pressure	4 weeks later
pulse	4 weeks later
respiratory rate	4 weeks later
saturation	4 weeks later

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Forced Vital Capacity (FVC)		4 weeks later
Forced Expiratory Volume in One Second (FEV1)		4 weeks later
FEV1/FVC ratio		4 weeks later
Peak Expiratory Flow (PEF)		4 weeks later
Modified Borg Dyspnea Scale (MBS)	MBS determines the severity of dyspnea at rest and during exertion. It consists of 10 items that define the severity of dyspnea according to its degree. A score of 0 indicates no dyspnea, and a score of 10 indicates very severe dyspnea.	4 weeks later
6 Minute Walking Test (6MWT)	The test evaluates functional exercise capacity by measuring the distance in meters that the patient will cover in 6 minutes by walking as fast as possible but without running in a 30-meter uninterrupted corridor.	4 weeks later

Collaborators and Investigators

• Sponsor: Saglik Bilimleri Universitesi
• Investigators: Principal Investigator: Semra Aciksoz, RN, Assistant Professor, PhD, University of Health Sciences Turkey, Hamidiye Faculty ofNursing

Study record dates

Study Major Dates

• Study Start (Actual): January 3, 2024
• Primary Completion (Actual): January 4, 2025
• Study Completion (Actual): February 2, 2025

Study Registration Dates

• First Submitted: March 28, 2025
• First Submitted That Met QC Criteria: April 7, 2025
• First Posted (Actual): April 15, 2025

Study Record Updates

• Last Update Posted (Actual): April 15, 2025
• Last Update Submitted That Met QC Criteria: April 7, 2025
• Last Verified: March 1, 2025

More Information

Terms related to this study

• Keywords: Chronic Obstructive Pulmonary Disease; Physiological Parameters; Breathing Techniques; Forward-Leaning Position
• Additional Relevant MeSH Terms: Pathologic Processes; Chronic Disease; Disease Attributes; Respiratory Tract Diseases; Lung Diseases; Lung Diseases, Obstructive; Pulmonary Disease, Chronic Obstructive
• Other Study ID Numbers: SaglikBilimleriU Semra Aciksoz

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

Drug and device information, study documents

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