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Effectiveness of Active Cycle of Breathing Techniques in Patients With Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial

8 września 2026 zaktualizowane przez: National Yang Ming Chiao Tung University Hospital
This study aims to examine the effects of Active Cycle of Breathing Technique (ACBT) on pulmonary function, sleep quality, depressive symptoms, and dyspnea in patients with Chronic Obstructive Pulmonary Disease. A block-randomized crossover trial will be conducted at the pulmonology outpatient clinic of a regional teaching hospital in eastern Taiwan. Participants aged 40-90 years with physician-diagnosed COPD (post-bronchodilator FEV₁/FVC < 70%) will be randomly allocated into two groups. The total observation period is 16 weeks with 5 data collection time points: T0 (baseline), T1 (Week 4), T2 (Week 8), T3 (Week 12), and T4 (Week 16). Each intervention period lasts 8 weeks. Primary outcomes are dyspnea (mMRC) and COPD symptom burden (CAT). Secondary outcomes include pulmonary function (FEV₁, FVC), sleep quality (PSQI), and depressive symptoms (DASS-21).

Przegląd badań

Status

Jeszcze nie rekrutacja

Warunki

Interwencja / Leczenie

Szczegółowy opis

Chronic Obstructive Pulmonary Disease (COPD) is a progressive and irreversible airway obstruction disease. Patients frequently experience dyspnea, sputum retention, repeated exacerbations, reduced exercise tolerance, poor sleep quality, and depressive symptoms. Traditional pulmonary rehabilitation is largely hospital-based and limited by patient age, comorbidities, transportation barriers, and healthcare resource constraints. Active Cycle of Breathing Technique (ACBT) is a non-invasive, low-cost structured breathing method comprising three phases: breathing control, thoracic expansion exercises, and forced expiration technique. Oscillatory Positive Expiratory Pressure (O-PEP) uses a tube valve device to generate oscillatory airflow and positive pressure during expiration, facilitating airway secretion mobilization and clearance. This study adopts a block-randomized crossover design. Group A receives ACBT combined with O-PEP during Weeks 1-8, then standard care during Weeks 9-16. Group B receives standard care during Weeks 1-8, then ACBT combined with O-PEP during Weeks 9-16. Intervention consists of 3 ACBT cycles followed by 10-15 O-PEP expirations, twice daily (at least 8 hours apart), for 8 weeks. All participants receive one-on-one standardized training prior to intervention, with weekly remote follow-up. The O-PEP device will be collected from Group A after Week 8 to prevent carryover. Standard care includes disease education, smoking cessation, self-management skills, and conventional breathing exercises. Data analysis will use Generalized Estimating Equations (GEE) following Intention-to-Treat (ITT) principles.

Typ studiów

Interwencyjne

Zapisy (Szacowany)

60

Faza

  • Nie dotyczy

Kontakty i lokalizacje

Ta sekcja zawiera dane kontaktowe osób prowadzących badanie oraz informacje o tym, gdzie badanie jest przeprowadzane.

Kontakt w sprawie studiów

Lokalizacje studiów

  • Tajwan
    • Taiwan
      • Yilan, Taiwan, Tajwan, 260
        • National Yang Ming Chiao Tung University Hospital
        • Kontakt:

Kryteria uczestnictwa

Badacze szukają osób, które pasują do określonego opisu, zwanego kryteriami kwalifikacyjnymi. Niektóre przykłady tych kryteriów to ogólny stan zdrowia danej osoby lub wcześniejsze leczenie.

Kryteria kwalifikacji

Wiek uprawniający do nauki

  • Dorosły
  • Starszy dorosły

Akceptuje zdrowych ochotników

Nie

Opis

Inclusion Criteria:

  • 1. Diagnosed with COPD by a pulmonologist, with spirometry confirming post-bronchodilator FEV₁/FVC < 70% within the past 12 months 2. Aged between 40 and 90 years, receiving regular follow-up at the pulmonology outpatient clinic 3. Able to communicate and follow instructions in Mandarin or Taiwanese 4. Willing to participate and comply with home-based pulmonary rehabilitation intervention

Exclusion Criteria:

  • 1. Active pulmonary tuberculosis, pneumothorax, or malignant respiratory disease 2. Severe cognitive impairment, intellectual disability, or communication disorder preventing instruction comprehension or intervention compliance 3. Currently in acute exacerbation of COPD, or primary diagnosis of bronchial asthma 4. GOLD Stage I COPD (mild, post-bronchodilator FEV₁ ≥ 80% predicted)

Plan studiów

Ta sekcja zawiera szczegółowe informacje na temat planu badania, w tym sposób zaprojektowania badania i jego pomiary.

Jak projektuje się badanie?

Szczegóły projektu

  • Główny cel: Leczenie
  • Przydział: Randomizowane
  • Model interwencyjny: Zadanie krzyżowe
  • Maskowanie: Brak (otwarta etykieta)

Broń i interwencje

Grupa uczestników / Arm
Interwencja / Leczenie
Eksperymentalny: ACBT + O-PEP First (Group A)
Participants undergo an 8-week standardized home-based pulmonary rehabilitation program combining Active Cycle of Breathing Technique (ACBT) with Oscillatory Positive Expiratory Pressure (O-PEP) therapy. Training (Week 0): Each participant receives individual face-to-face instruction from a trained research nurse covering: (1) the three ACBT phases - Breathing Control (BC), Thoracic Expansion Exercises (TEE), and Forced Expiration Technique (FET); and (2) correct use of the tube-valve O-PEP device. Competency is verified by return demonstration. A home practice manual, self-monitoring diary, and instructional videos (via LINE group) are provided. Training Protocol (Weeks 1-8): Each session consists of one ACBT cycle (BC → TEE ×3 → FET), followed immediately by 10-15 O-PEP exhalations, then FET, coughing, and expectoration. Sessions are performed twice daily (≥8 hours apart), approximately 30-60 minutes per session. Biweekly remote monitoring is conducted by the research team via LINE
Behawioralne: ACBT+OPEP
Participants undergo an 8-week home-based pulmonary rehabilitation program combining ACBT with O-PEP therapy. At baseline (Week 0), each participant receives individual face-to-face instruction covering the three ACBT phases - Breathing Control (BC), Thoracic Expansion Exercises (TEE), and Forced Expiration Technique (FET) - and correct use of the tube-valve O-PEP device. Competency is verified by return demonstration. A practice manual, self-monitoring diary, and instructional videos are provided. Each session follows the sequence: BC → TEE ×3 → FET, immediately followed by 10-15 O-PEP exhalations, then FET, coughing, and expectoration. Sessions are performed twice daily (≥8 hours apart), 30-60 minutes per session, for 8 weeks. Biweekly remote monitoring is conducted via LINE. Upon completion, the O-PEP device is retrieved to prevent carryover contamination.
Behawioralne: Usual Care (Standard Medical Care)
Participants receive standard outpatient medical care only, consisting of routine pulmonology follow-up, prescribed pharmacological management (bronchodilators and/or inhaled corticosteroids as clinically indicated), and standard respiratory health education including disease self-management, smoking cessation, pursed-lip breathing, and diaphragmatic breathing. No ACBT training, O-PEP device, or individualized airway clearance instruction is provided during this period.
Eksperymentalny: Active Comparator: Usual Care First / Delayed Intervention (Group B)
Participants in Group B receive standard outpatient medical care only during Period 1 (Weeks 1-8). Standard care consists of routine pulmonology outpatient follow-up, prescribed pharmacological management (bronchodilators and/or inhaled corticosteroids as clinically indicated), and standard respiratory health education including disease self-management, smoking cessation, pursed-lip breathing, and diaphragmatic breathing. No ACBT training, O-PEP device, practice manual, or individualized airway clearance instruction is provided during this period. Upon crossover at Week 9, participants in Group B begin the active intervention: they receive the same standardized one-on-one ACBT and O-PEP training as Group A (conducted at the Week 8 visit), and subsequently perform the home-based ACBT combined with O-PEP protocol twice daily for 8 weeks (Weeks 9-16), following the identical protocol delivered to Group A during Period 1.
Behawioralne: ACBT+OPEP
Participants undergo an 8-week home-based pulmonary rehabilitation program combining ACBT with O-PEP therapy. At baseline (Week 0), each participant receives individual face-to-face instruction covering the three ACBT phases - Breathing Control (BC), Thoracic Expansion Exercises (TEE), and Forced Expiration Technique (FET) - and correct use of the tube-valve O-PEP device. Competency is verified by return demonstration. A practice manual, self-monitoring diary, and instructional videos are provided. Each session follows the sequence: BC → TEE ×3 → FET, immediately followed by 10-15 O-PEP exhalations, then FET, coughing, and expectoration. Sessions are performed twice daily (≥8 hours apart), 30-60 minutes per session, for 8 weeks. Biweekly remote monitoring is conducted via LINE. Upon completion, the O-PEP device is retrieved to prevent carryover contamination.
Behawioralne: Usual Care (Standard Medical Care)
Participants receive standard outpatient medical care only, consisting of routine pulmonology follow-up, prescribed pharmacological management (bronchodilators and/or inhaled corticosteroids as clinically indicated), and standard respiratory health education including disease self-management, smoking cessation, pursed-lip breathing, and diaphragmatic breathing. No ACBT training, O-PEP device, or individualized airway clearance instruction is provided during this period.

Co mierzy badanie?

Podstawowe miary wyniku

Miara wyniku
Opis środka
Ramy czasowe
Dyspnea - mMRC, COPD Symptoms - CAT
Ramy czasowe: Time Frame: T0 (Baseline), T1 (Week 4), T2 (Week 8), T3 (Week 12), T4 (Week 16)
Modified Medical Research Council Dyspnea Scale; 5-grade scale (Grade 0-4); higher score = more severe dyspnea; ICC = 0.83-0.91, COPD Assessment Test; 8-item scale scored 0-40; higher score = worse health status; ICC = 0.80-0.96
Time Frame: T0 (Baseline), T1 (Week 4), T2 (Week 8), T3 (Week 12), T4 (Week 16)

Miary wyników drugorzędnych

Miara wyniku
Opis środka
Ramy czasowe
Pulmonary function - FEV₁ Pulmonary function - FVC, Pulmonary function - FEV₁/FVC ratio
Ramy czasowe: T0 (Baseline), T1 (Week 4), T2 (Week 8), T3 (Week 12), T4 (Week 16)

  1. Pulmonary Function - FEV₁

    Measure: Forced Expiratory Volume in 1 Second (FEV₁)

    Description: Post-bronchodilator FEV₁ (L and % predicted) measured via standardized spirometry following inhalation of Berotec N MDI 100 mcg × 4 doses (total 400 mcg), with re-measurement at 15 minutes post-inhalation. Conducted at the hospital pulmonary function laboratory.

  2. Pulmonary Function - FVC

    Measure: Forced Vital Capacity (FVC)

    Description: Post-bronchodilator FVC (L) measured via standardized spirometry under the same protocol as FEV₁ assessment.

  3. Pulmonary Function - FEV₁/FVC Ratio

Measure: FEV₁/FVC Ratio (%)

Description: Ratio of post-bronchodilator FEV₁ to FVC, used to confirm airflow obstruction severity per GOLD criteria.
T0 (Baseline), T1 (Week 4), T2 (Week 8), T3 (Week 12), T4 (Week 16)
Sleep Quality
Ramy czasowe: T0 (Baseline), T1 (Week 4), T2 (Week 8), T3 (Week 12), T4 (Week 16)
Sleep Quality Measure: Pittsburgh Sleep Quality Index (PSQI) - Chinese Version Description: A 19-item self-report questionnaire assessing sleep quality over the past month across 7 components: subjective sleep quality, sleep latency, sleep duration, habitual sleep
T0 (Baseline), T1 (Week 4), T2 (Week 8), T3 (Week 12), T4 (Week 16)
Depressive Symptoms
Ramy czasowe: T0 (Baseline), T1 (Week 4), T2 (Week 8), T3 (Week 12), T4 (Week 16)
Depression Anxiety Stress Scales-21 (DASS-21), Chinese Version Description: The Chinese version of the Depression Anxiety Stress Scales-21 (DASS-21) is a validated self-report questionnaire consisting of 21 items that assesses three domains: depression, anxiety, and stress (7 items per subscale). Each item is scored on a 4-point Likert scale ranging from 0 ("Did not apply to me at all") to 3 ("Applied to me very much or most of the time"). Scores for each subscale are summed and multiplied by two to obtain the final score, with higher scores indicating greater severity of depressive symptoms. In this study, the depression subscale score will be used to evaluate depressive symptoms.
T0 (Baseline), T1 (Week 4), T2 (Week 8), T3 (Week 12), T4 (Week 16)

Współpracownicy i badacze

Tutaj znajdziesz osoby i organizacje zaangażowane w to badanie.

Sponsor

National Yang Ming Chiao Tung University Hospital

Daty zapisu na studia

Daty te śledzą postęp w przesyłaniu rekordów badań i podsumowań wyników do ClinicalTrials.gov. Zapisy badań i zgłoszone wyniki są przeglądane przez National Library of Medicine (NLM), aby upewnić się, że spełniają określone standardy kontroli jakości, zanim zostaną opublikowane na publicznej stronie internetowej.

Główne daty studiów

Rozpoczęcie studiów (Szacowany)

1 września 2026

Zakończenie podstawowe (Szacowany)

30 czerwca 2027

Ukończenie studiów (Szacowany)

30 czerwca 2027

Daty rejestracji na studia

Pierwszy przesłany

8 września 2026

Pierwszy przesłany, który spełnia kryteria kontroli jakości

8 września 2026

Pierwszy wysłany (Rzeczywisty)

14 września 2026

Aktualizacje rekordów badań

Ostatnia wysłana aktualizacja (Rzeczywisty)

14 września 2026

Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości

8 września 2026

Ostatnia weryfikacja

1 sierpnia 2026

Więcej informacji

Terminy związane z tym badaniem

Słowa kluczowe

Dodatkowe istotne warunki MeSH

Inne numery identyfikacyjne badania

  • 2026B004

Plan dla danych uczestnika indywidualnego (IPD)

Planujesz udostępniać dane poszczególnych uczestników (IPD)?

NIEZDECYDOWANY

Informacje o lekach i urządzeniach, dokumenty badawcze

Bada produkt leczniczy regulowany przez amerykańską FDA

Nie

Bada produkt urządzenia regulowany przez amerykańską FDA

Nie

Te informacje zostały pobrane bezpośrednio ze strony internetowej clinicaltrials.gov bez żadnych zmian. Jeśli chcesz zmienić, usunąć lub zaktualizować dane swojego badania, skontaktuj się z register@clinicaltrials.gov. Gdy tylko zmiana zostanie wprowadzona na stronie clinicaltrials.gov, zostanie ona automatycznie zaktualizowana również na naszej stronie internetowej .

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