Effects of Vibration and Breathing Exercises on Pain and Anxiety During Chest Tube Removal

The Effect of Vibration and Breathing Exercises Applied Before Chest Tube Removal on Pain and Anxiety: A Randomized Controlled Trial

Removing a chest tube is a common procedure after chest surgery, but it can cause significant pain and anxiety for patients. Although medications can help reduce these symptoms, they may have side effects and are not always sufficient. Therefore, simple and safe non-drug methods are increasingly used to improve patient comfort.

This randomized controlled study aims to examine the effects of vibration and breathing exercises applied before chest tube removal on patients' pain and anxiety levels. Adult patients with a chest tube will be randomly assigned to one of three groups: a vibration group, a breathing exercise group, or a control group receiving standard care. Pain and anxiety levels will be measured before the procedure and after chest tube removal using validated scales.

The findings of this study are expected to show whether vibration and breathing exercises are effective in reducing pain and anxiety during chest tube removal. If effective, these methods may offer nurses an easy, low-cost, and safe way to improve patient comfort and support evidence-based nursing care.

Study Overview

• Status: Active, not recruiting
• Conditions: Postoperative Pain; Anxiety; Thoracic Drainage
• Intervention / Treatment: Other: Vibration; Other: Breathing Exercises

Detailed Description

Chest tube removal is a necessary clinical procedure following thoracic surgery, but it is frequently associated with acute pain and heightened anxiety. These symptoms may negatively affect patient comfort, cooperation, and recovery. While pharmacological interventions are commonly used to manage procedure-related pain and anxiety, concerns regarding side effects and limited effectiveness have increased interest in non-pharmacological approaches within nursing care.

This randomized controlled study is designed to evaluate the effectiveness of vibration and breathing exercises applied prior to chest tube removal on pain and anxiety levels. Eligible adult patients hospitalized in a thoracic surgery unit and scheduled for chest tube removal will be randomly assigned to one of three groups: a vibration group, a breathing exercise group, or a control group receiving routine care. Randomization will be performed using a web-based randomization tool to ensure equal allocation.

In the vibration group, a portable vibration device will be applied to the area proximal to the chest tube insertion site for a standardized duration before the removal procedure. In the breathing exercise group, participants will be guided through structured breathing exercises designed to promote relaxation and diaphragmatic breathing. The control group will receive standard clinical care without any additional non-pharmacological intervention.

Pain intensity and anxiety levels will be assessed at two time points: prior to the chest tube removal procedure and shortly after the procedure. Validated measurement tools will be used to ensure reliability of the findings. Data will be analyzed to compare changes in pain and anxiety levels within and between groups.

The results of this study are expected to provide evidence regarding the use of vibration and breathing exercises as simple, safe, and cost-effective nursing interventions to reduce pain and anxiety associated with chest tube removal. These findings may contribute to the development of evidence-based, non-pharmacological strategies in clinical nursing practice.

• Study Type: Interventional
• Enrollment (Estimated): 90
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Erzurum
    • Erzurum, Erzurum, Turkey (Türkiye), 25000
      • Atatürk Universty

Participation Criteria

Eligibility Criteria

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

Description

Inclusion criteria

• 18 years of age and older,
• Conscious, oriented, and cooperative (e.g., Glasgow Coma Score ≥ 13),
• Able to speak and understand Turkish,
• Having a chest tube and undergoing chest tube removal for the first time,
• Hemodynamically stable,
• Having not taken analgesic, sedative, or anxiolytic drugs at least 4 hours prior to the procedure,
• Able to communicate and respond to pain assessment scales during the procedure,
• No severe hearing, visual, or communication impairment,
• No neurological or cognitive disease that could affect the assessment of cognitive functions,
• No history of psychiatric diagnosis or active psychiatric treatment,
• Patients who voluntarily participate in the study and provide written consent will be included.

Exclusion criteria

• Patients with past or current cognitive and psychological disorders,
• Those who have previously had chest tube insertion,
• Those who are mechanically ventilated (intubated),
• Those who have chronic pain and routinely use analgesics,
• Those who used analgesics immediately before chest tube removal,
• Those who did not volunteer to participate in the study.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Supportive Care
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: Control Group (Standard Care); Participants in the control group will receive routine clinical care according to standard hospital protocols prior to chest tube removal. No additional non-pharmacological interventions, including vibration or breathing exercises, will be applied before the procedure.
Experimental: Vibration; Participants in this group will receive a non-pharmacological intervention consisting of vibration before chest tube removal. Vibration will be applied proximal to the chest tube insertion site for a standard duration using a portable vibrating device. The interventions will be performed in addition to routine clinical care.	Other: Vibration; Vibration will be applied using a portable data device inserted for a standard duration, combined with chest tube placement. The procedure will be performed with the patient in a comfortable position.
Experimental: Breathing Exercise Group; Individuals in the breathing exercise group will be led through breathing exercises by the researcher in their room before the procedure begins. The exercise duration is approximately 8-10 minutes. The environment should be quiet, at room temperature, and well-ventilated during the exercises. The patient should be seated in a comfortable position, and the following steps will be followed.	Other: Breathing Exercises; The remaining patients will be given breathing exercises including slow, deep, diaphragmatic, and iced-lip breathing techniques. These exercises will be performed calmly and quietly by the researcher to promote relaxation. The combined intervention will continue in addition to routine clinical care until the procedures and chest tube removal expense are completed.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pain Intensity	Pain intensity associated with chest tube removal will be assessed using the Visual Analog Scale (VAS), a validated 10-cm scale ranging from 0 (no pain) to 10 (worst imaginable pain). Participants will self-report their pain level.	Assessed immediately before chest tube removal and 10 minutes after the procedure.

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Anxiety Level	Anxiety levels will be measured using the State Anxiety Inventory (State-Trait Anxiety Inventory - State subscale), a validated self-report questionnaire designed to assess situational anxiety. Higher scores indicate higher levels of anxiety.	Assessed immediately before chest tube removal and 10 minutes after the procedure.

Collaborators and Investigators

• Sponsor: Gamze BULUT
• Collaborators: Ataturk University

Study record dates

Study Major Dates

• Study Start (Actual): June 15, 2026
• Primary Completion (Estimated): September 15, 2026
• Study Completion (Estimated): October 15, 2026

Study Registration Dates

• First Submitted: December 26, 2025
• First Submitted That Met QC Criteria: December 26, 2025
• First Posted (Actual): January 8, 2026

Study Record Updates

• Last Update Posted (Actual): July 23, 2026
• Last Update Submitted That Met QC Criteria: July 22, 2026
• Last Verified: December 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Pain; Neurologic Manifestations; Mental Disorders; Postoperative Complications; Pathologic Processes; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Pain, Postoperative; Anxiety Disorders; Therapeutics; Mind-Body Therapies; Complementary Therapies; Exercise Movement Techniques; Physical Therapy Modalities; Mechanical Phenomena; Physical Phenomena; Breathing Exercises; Vibration
• Other Study ID Numbers: CTT-VIBREATH-RCT-ATAU-2025

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data (IPD) will not be shared. The data collected in this study include sensitive health information, and sharing IPD may pose a risk to participant confidentiality and privacy. In addition, the informed consent obtained from participants does not include permission for data sharing beyond the research team. Therefore, IPD will be used solely for the purposes of this study and related scientific

Drug and device information, study documents

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