Investigation of the Effect of Structured Energy Conservation Techniques Training on COPD Patients

Investigation of the Effects of Structured Energy Conservation Techniques Training on Activities of Daily Living, Fatigue, and Exercise Capacity in COPD Patients

Chronic obstructive pulmonary disease (COPD) is a heterogeneous lung disease characterized by chronic respiratory symptoms (dyspnea, cough, sputum production, and/or exacerbations) due to persistent, often progressive airflow obstruction resulting from abnormalities in the airways (bronchiolitis, bronchitis) and/or alveoli (emphysema). COPD is a multifaceted disease that is not limited to respiratory symptoms but also negatively affects individuals' functional capacity, physical endurance, and participation in daily living activities. Common symptoms include shortness of breath (dyspnea) and a significant feeling of fatigue; this can lead to decreased exercise capacity, limitations in daily living activities, and ultimately dependence over time. Therefore, in the treatment of COPD, not only drug therapy but also interventions aimed at symptom control and improving functional capacity are becoming increasingly important. Energy conservation techniques, included in pulmonary rehabilitation programs, are based on the view that dyspnea occurs most intensely during daily living activities, and that performing these activities in an energy-conserving manner will result in less dyspnea. Energy conservation techniques are one of the trainings given to improve symptom management in COPD patients. Disease symptoms can increase in COPD patients during tasks such as washing hair, drying hair, shaving, reaching, bending, lifting, carrying, pushing, and pulling weights. When appropriate body mechanics and tools that facilitate tasks are used, the amount of energy required during these tasks decreases. In this way, it is thought that patients will be more active in their daily living activities. Breathing exercises are also a component of pulmonary rehabilitation and support the increase of respiratory muscle function and exercise tolerance. Accordingly, it is thought that structured energy conservation techniques training can improve daily living activities, fatigue, and exercise capacity in COPD patients. This research will be conducted as a pre-test-post-test, single-blind, randomized controlled trial to examine the effect of structured energy conservation techniques training on daily living activities, fatigue, and exercise capacity in COPD patients.

Study Overview

• Status: Not yet recruiting
• Conditions: Chronic Obstructive Pulmonary Disease (COPD)
• Intervention / Treatment: Other: Structured Energy Conservation Techniques Training

Detailed Description

In chronic diseases, education is the most important tool for enabling self-treatment, lifestyle modifications, and the development of methods to prevent disease progression. The goals of patient education in COPD are to reduce disease symptoms and acute exacerbations. Another goal is to prevent COPD-related complications and to educate patients or their families. Energy conservation techniques are one type of education given to improve symptom management in COPD patients. Energy conservation techniques consist of personal energy conservation methods when performing physical activities. With these approaches, the energy requirements of activities are reduced. Thanks to energy conservation techniques during physical activity, it is possible to complete the activity with less dyspnea. Some energy conservation techniques include performing daily activities while sitting, placing frequently used objects between waist and shoulder level, using long-handled tools that make tasks easier, and using a wheeled carrier to facilitate carrying items. Breathing exercises, on the other hand, improve the exercise tolerance of patients by effectively using the diaphragm. Pursed-lip breathing and diaphragmatic breathing are frequently used in COPD patients. Pursed-lip breathing is defined as active and prolonged exhalation performed with slightly parted lips. After taking a deep breath through the nose, exhalation is performed by pursing the lips in a whistling manner, increasing pressure in the bronchi. This breathing exercise prevents premature closure of the bronchi by increasing the pressure during exhalation, extending the expiration time and allowing more air to be expelled. In diaphragmatic breathing, the patient lies on their back or in a semi-sitting position, placing one hand on the front of their chest and the other on their abdomen. As they slowly inhale as much air as possible through their nose, they feel their abdomen slowly rise. While slowly exhaling the air taken in with pursed-lip breathing, they gently apply pressure with the hand on their abdomen. When both breathing exercises are performed regularly, they help reduce the patient's respiratory distress. In conclusion, structured energy conservation techniques training can be effective in increasing functional capacity and improving symptoms in COPD patients. Therefore; This study aimed to investigate the effects of structured energy conservation techniques training on daily living activities, fatigue, and exercise capacity in patients with COPD.

• Study Type: Interventional
• Enrollment (Estimated): 70
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Zeynep Asal, NURSE; Phone Number: 539 386 19 72; Email: zasal1889@gmail.com

Study Locations

• Turkey (Türkiye)
  • Isparta, Turkey (Türkiye), 32040
    • Isparta Şehir Hastanesi
    • Contact: Zeynep Asal; Email: zasal1889@gmail.com

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Patients who have been admitted to the pulmonary diseases ward or have applied to the pulmonary diseases outpatient clinic,
• Patients diagnosed with COPD,
• Patients in category E of the GOLD A, B, E classification (patients experiencing more than 2 moderate exacerbations or having multiple hospitalizations) (GOLD, 2025)
• Patients over 40 years of age (Adeloye et al, 2015).
• Patients who will continue their health check-ups at the Isparta City Hospital Pulmonology Outpatient Clinic,
• Patients who agree to participate in the study,
• Patients or at least one of their relatives who can read and write,
• Patients or at least one of their relatives who does not have communication problems will be included in the study.

Exclusion Criteria:

• Patients with serious orthopedic problems that may have a significant impact on daily activities,
• Patients with progressive neuromuscular disease,
• Patients who have experienced unstable angina pectoris or myocardial infarction within the last month,
• Patients living alone,
• Patients in groups A and B of the GOLD ABE classification will not be included. For patients in group A, mMRC 0-1, CAT<10 are used as criteria; for patients in group B, mMRC≥2, CAT≥10 are used as criteria (GOLD, 2025).

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: intervention group; Structured energy conservation techniques training will be conducted with this group. The 'structured energy conservation techniques training,' conducted by the researcher, will last approximately 20-30 minutes. A brochure will be used as training material. Videos related to the topic will be utilized during the training. The videos used in the training will be shared with patients via WhatsApp, and patients will be asked to review the brochure twice a week. During the four-week follow-up period, reminders will be sent to these patients twice a week via WhatsApp or phone calls.	Other: Structured Energy Conservation Techniques Training; Energy conservation techniques (ECT) consist of personal energy conservation methods while performing physical activities. These approaches modify or reduce the energy requirements of activities. Thanks to ECT, it is possible to complete physical activity with little or no dyspnea (Özyılmaz and Gürses, 2012). ECT training consists of six principles: prioritizing activities, planning a daily schedule, adjusting it to suit oneself, positioning, pursed-lip breathing, and a positive attitude (Pohaci, Riani, and Hartoyo, 2013). The content of ECT training includes teaching diaphragmatic breathing to the patient, encouraging them to perform activities requiring upper limb support while seated, emphasizing the importance of asking for help from family members when needed, planning the day and allocating time for rest, holding materials between the shoulder blade and pelvis, avoiding bending, training on proper postures, and demonstrating how to perform activities (Velloso, 2006).
No Intervention: control group; Routine procedures will be carried out.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Activities of Daily Living Scale	The "Activities of Daily Living Scale" specific to COPD patients is based on the 12 activities of daily living (ensuring a safe environment, communication, breathing, feeding, excretion, personal hygiene and clothing, body temperature control, movement, work and leisure, sexual expression, sleep, and death) specified in the nursing model. The Activities of Daily Living Scale consists of 12 sub-dimensions and 47 items. The development of this scale utilizes the validity and reliability assessment principles adopted in the literature. It is developed by the researcher.	1 month

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Functional Assessment of Chronic Illness Therapy-Fatigue Scale	The fatigue-related items in the 40-item FACIT Scale are located under the "Other Concerns" subcategory. The FACIT Fatigue Scale is a 13-item scale that assesses self-reported fatigue. Each item on the scale is rated from 0 to 4.	1 month
Six-Minute Walk Test (6MWT)	Time-distance walking was first introduced by Balke in the 1960s as a simple and objective measure of functional capacity (Balke, 1963). The six-minute walk test is an easily applicable physical performance test reflecting functional capacity, performed on a flat surface. The test evaluates the maximum walking distance within six minutes. In the study, oxygen saturation values, heart rate, blood pressure, and dyspnea scores using the modified Borg scale will be recorded before and after each test.	1 month

Collaborators and Investigators

• Sponsor: Akdeniz University

Study record dates

Study Major Dates

• Study Start (Estimated): July 10, 2026
• Primary Completion (Estimated): December 10, 2026
• Study Completion (Estimated): January 10, 2027

Study Registration Dates

• First Submitted: May 6, 2026
• First Submitted That Met QC Criteria: May 6, 2026
• First Posted (Actual): May 12, 2026

Study Record Updates

• Last Update Posted (Actual): May 14, 2026
• Last Update Submitted That Met QC Criteria: May 12, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: COPD; Activities of Daily Living; Energy Conservation
• Additional Relevant MeSH Terms: Pathologic Processes; Chronic Disease; Disease Attributes; Respiratory Tract Diseases; Lung Diseases; Lung Diseases, Obstructive; Pathological Conditions, Signs and Symptoms; Pulmonary Disease, Chronic Obstructive
• Other Study ID Numbers: !---''ZEYNEP-ASAL-000000000001

Drug and device information, study documents

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