Year 2013,
Volume: 16 Issue: 4, 219 - 226, 13.04.2013
Dilek Kara
Hicran Yıldız
Ahmet Ertürk
Ahmet Gürsel
Fürüzan Köktürk
,
Neriman Akansel
Abstract
The Effects of Pursed Lip and Diaphragmatic Breathing Exercises on Severity of Dyspnea and Pulmonary Functions Tests for The Patients with Chronic Obstructive Pulmoner Disease Objective: The study wascarried out to investigate the effects of breathing exercises on severity of dyspnea and pulmonary functions tests for the patients with Chronic Obstructive Pulmoner Disease. Method: This study was carried out in Chest Diseases Clinic of Bursa Çekirge State Hospital between June to August 2012.Case group were involved 10 patients and control group were involved 10 patients. All of the patients were made severity of dyspnea and pulmonary function tests after their hospitalizations. For the patients in the control group, care and treatment were applied only in the framework of clinical routineduring the research. The patients in the case was applied pursed lip and diapdragmatic breathing exercises for ten days. After ten days,severity of dyspnea and pulmonary function test measurements of all patients were made applied again. Permissions of scientific ethics committee was granted to realize the research. Results:It was found that there did not have statistical difference betweenvalues of the pulmonary function tests that measured before and after pursed lip and diaphragmatic breathing exercises of patients in the case group (p>0.05), while between their the mean oxygen saturation values and the severity of dyspnea was statistically significant (p<0.05). Conclusion: Pursed lip and diaphragmatic breathing exercises are effective in increasing the oxygen saturation and reducing severity of dyspnea.
References
- Acıcan T, Gülbay BE. Kronik Obstrüktif Akciğer Hastalığı (KOAH) Atak ve Tedavisi. Türkiye Klinikleri Cerrahi Tıp Bilimleri Dergisi 2006;2(11):40-4.
- Adams L. Lines, Numbers and Words in The Scaling of Dyspnea. Biological Psychology 1995;41(1):83
- Akıncı AÇ, Pınar R. Kronik Obstrüktif Akciğer Hastalığı Olan Hastalarda Dispne Rehabilitasyonu. Cumhuriyet Hemşirelik Dergisi 2012;1(1):24-9.
- Ambrose MS. Controlling A Perplexing Symptom: Chronic Dyspnea. Nursing 1998;28(5):41-7.
- American Thoracic Society. Standards for The Diagnosis and Care of Patients with Chronic Obstructive Pulmonary Disease. American Journal of Respiratory and Critical Care Medicine 1995;152(5 Pt 2):77-121.
- American Thoracic Society. Dyspnea. Mechanisms, Assessment and Management: A Consensus Statement. American Journal of Respiratory and Critical Care Medicine 1999;159(1):321-40.
- Bianchi R, Gigliotti F, Romagnoli I, Lanini B, Castellani C, Grazzini M et al. Chest Wall Kinematics and Breathlessness During Pursed-Lip Breathing in Patients with COPD. Chest 2004;125(2):459-65.
- Breslin EH. The Pattern of Respiratory Muscle Recruitment During Pursed-Lip Breathing. Chest 1992;101(1):75-8.
- Calverley PMA, Georgopoulos D. Chronic Obstructive Pulmonary Disease: Symptoms and Signs. European Respiratory Monograph 2006;11(38):7-23.
- Collins EG, Longbein WE, Fehr L, Maloney C. Breathing Pattern Retraining and Exercise in Persons with COPD. AACN Clinical Issues 2001;12(2):202-9.
- Çiçek HS, Akbayrak N. Kronik Obstrüktif Akciğer Hastalığı Olan Bireylerde Solunum Egzersizlerinin Kan Gazları ve Solunum Fonksiyon Testlerine Etkisi. Gülhane Tıp Dergisi 2004;46(1):1-9.
- Demir G, Akkoca Ö, Doğan R, Saryal S, Karabıyıkoğlu G. KOAH’da Dispne ve Yaşam Kalitesinin Değerlendirilmesi. Tüberküloz ve Toraks Dergisi 2003;51(4):365-72.
- Donado JR, Hill NS. Outpatient Management. Respiratory Care Clinics of North America. 1998;4(3):391-423.
- Eakin EG, Resnikoff PM, Prewitt LM, Ries AL, Kaplan RM. Validation of A New Dyspnea Measure: The UCSD Shortness of Breath Questionnaire. Chest 1998;113(3):619-24.
- Ekren PK, Gürgün A. KOAH’da Pulmoner Rehabilitasyon: Kime, Ne Zaman, Nasıl? Güncel Göğüs Hastalıkları Serisi 2013;1(1):124-35.
- Faager G, Stahle A, Larsen FF. Influence of Spontanous Pursed Lips Breathing on Walking Endurance and Oxygen Saturation in Patients with Moderate to Severe Chronic Obstructive Pulmonary Disease. Clinical Rehabilitation 2008;22(8):675-83. Ferguson GT. Recommendations for the Management of COPD. Chest 2000;117(2):23-8.
- Gigliotti F, Romagnoli I, Scano G. Breathing Retraining and Exercise Conditioning in Patients with Chronic Obstructive Pulmonary Disease (COPD): A Physiological Approach. Respiratory Medicine 2003;97(3):197-204.
- Gosselink RA, Wagenaar RC, Rijswijk H, Sargeant AJ, Decramer ML. Diaphragmatic Breathing Reduces Efficiency Of Breathing in Patients with Chronic Obstructive Pulmonary Disease. American Journal of Respiratory and Critical Care Medicine 1995;151(4):1136-42.
- Gosselink R. Controlled Breathing and Dyspnea in Patients with Chronic Obstructive Pulmonary Disease (COPD). Journal of Rehabilitation Research and Development 2003;40(5):25-34.
- Grant S, Aitchison T, Henderson E, Christie J, Zare S, McMurray J et al. A Comparison of The Reproducibility and The Sensitivity to Change of Visual Analogue Scales, Borg Scales, and Likert Scales in Normal Subjects During Submaximal Exercise. Chest 1999;116(5):1208-17.
- Hylkema MN, Sterk PJ, Boer de WI, Postma DS. Tobacco Use in Relation to COPD and Asthma. European Respiratory Journal 2007;29(3):438-45.
- Jones PW, Quirk FH, Baveystock CM, Littlejohns P. A Self-Complete Measure of Health Status For Chronic Airflow Limitation. The St. George’s Respiratory Questionnaire. American Review of Respiratory Disease 1992;145(6):1321-7.
- Jones PW. Health Status Measurement in Chronic Obstructive Pulmonary Disease. Thorax 2001;56(11):880-7.
- Mahler DA, Horowitz MB. Clinical Evaluation of Exertional Dyspnea. Clincs in Chest Medicine 1994;15(2):259-69.
- Mahler DA. Pulmonary Rehabilitation. Chest 1998;113(4):263-68.
- Martinez JA, Straccia L, Sobrani E, Silva G, Vianna EO, Terra Filho J. Dyspnea Scales in The Assessment of Illitera Patients with COPD. The American Journal of Medical Sciences 2000;320(4):240-3.
- Nault D, Siok MA, Borycki E, Melanson D, Rousseau L, Lacasse Y. Psychosocial considerations in COPD. In: Bourbeau J, Nault D, Borycki E, eds. Chronic Obstructive Pulmonary Disease. 1 st ed. London: BC Decker; 2002. p. 215-43.
- Nield MA, Hoo GWS, Roper JM, Santiago S. Efficacy of Pursed-Lips Breathing: A Breathing Pattern Retraining Strategy For Dyspnea Reduction. Journal of Cardiopulmonary Rehabilitation & Prevantion 2007;27(4):237-44.
- Olgun N, Eti Aslan F, Çil A. Toraks ve Alt Solunum Sistemi Hastalıkları. Karadakovan A, Eti Aslan F, editör. Dahili ve Cerrahi Hastalıklarda Bakım. 1. Baskı. Adana: Nobel Kitabevi;2010. p.411-56.
- Onodera A, Yazaki K. Effects of Short Term Pulmonary Rehabilitation Program on Patients with Chronic Respiratory Failure Due To Pulmonary Emphysema. Nihon Kokyuki Gakkai Zasshi 1998;36(8):679-83.
- Ovayolu N, Ovayolu Ö, Ateş Ç. Kronik Obstrüktif Akciğer Hastalığı ve Hemşirelik Bakımı. Fırat Sağlık Hizmetleri Dergisi 2008;3(9):3-16.
- Özalevli S, Uçan ES. Farklı Dispne Skalalarının Kronik Obstrüktif Akciğer Hastalığında Karşılaştırılması. Toraks Dergisi 2004;5(2):90-4.
- Rose VL. American Thoracic Society Issues Consensus Statement on Dyspne. American Family Physician 1999;59(11):3259-60.
- Spahija J, Marchie M de, Grassino A. Effects of Imposed Pursed-Lips Breathing on Respiratory Mechanics and Dyspnea at Rest and During Exercise in COPD. Chest 2005;128(2):640-50.
- Steiner MC, Morgan MDL. Enhancing Physical Performance in Chronic Obstructive Pulmonary Disease. Thorax 2001;56(1):73-7.
- Tatlıcıoğlu T. Kronik Obstrüktif Akciğer Hastalığı (KOAH) ve Geleceği. Tüberküloz ve Toraks Dergisi 2007;55(3):303-18.
- Tiep BL. Disease Management of COPD with Pulmonary Rehabilitation. Chest 1997;112(6):1630
- Üçsular FD, Demir AT, Polat G, Güçlü SZ. KOAH’lı Olguların Sigara İçme Özellikleri. İzmir Göğüs Hastanesi Dergisi 2004;18(3):107-112.
- Verrill D, Barton C, Beasley W, Lippard WM. The Effects of Short-Term and Long-Term Pulmonary Rehabilitation on Functional Capacity, Perceived Dyspnea, and Quality of Life. Chest 2005;128(2):673
- Vitacca M, Clini E, Bianchi L, Ambrosino N. Acute Effects of Deep Diapragmatic Breathing in COPD Patients with Chronic Respiratory Insufficiency. European Respiratory Journal 1998;11(2):408-15.
- Wedzicha JA, Donaldson GC. Exacerbations of Chronic Obstructive Pulmonary Disease. Respiratory Care 2003;48(12):1204-15.
- Yüksel EG, Ursavaş A, Irdesel J, Koç M, Uzaslan EK, Güneş S ve ark. Kronik Obstrüktif Akciğer Hastalığında Multidisipliner Pulmoner Rehabilitasyon Programının Etkinliği. Türkiye Klinikleri Akciğer Arşivi 2005;6(3):115-9.
- Yürüktümen A, Karcıoğlu Ö, Topacoğlu H, Karbek F. Dispne ile Başvuran Geriyatrik Olgularda Yakınma Şiddeti ile Klinik ve Laboratuar Verilerinin Değerlendirilmesi. Türkiye Acil Tıp Dergisi 2009;9(4):163-8.
KRONİK OBSTRÜKTİF AKCİĞER HASTALARINA UYGULANAN PURSED LİP VE DİYAFRAGMATİK SOLUNUM EGZERSİZLERİNİN DİSPNE ŞİDDETİ VE SOLUNUM FONKSİYON TESTLERİ ÜZERİNE ETKİSİ
Year 2013,
Volume: 16 Issue: 4, 219 - 226, 13.04.2013
Dilek Kara
Hicran Yıldız
Ahmet Ertürk
Ahmet Gürsel
Fürüzan Köktürk
,
Neriman Akansel
Abstract
Amaç: Araştırma, Kronik Obstrüktif Akciğer Hastalığı olan hastalara uygulanan pursed lip ve
diyafragmatik solunum egzersizlerinin hastaların dispne şiddetleri ve solunum fonksiyon testi sonuçlarına
etkisini incelemek amacıyla yapılmıştır.
Yöntem: Araştırma, Haziran-Ağustos 2012 tarihleri arasında, Bursa Çekirge Devlet Hastanesi Göğüs
Hastalıkları Servisinde yürütülmüştür. Deney grubu olarak 10, kontrol grubu olarak 10 hasta alınmıştır. Tüm
hastaların hastaneye yatışlarından sonra dispne şiddetleri ve solunum fonksiyon testi ölçümleri yapılmıştır.
Kontrol grubundaki hastaların araştırma süresince sadece klinik rutinleri çerçevesinde tedavi ve bakımları
yapılmıştır. Deney grubundaki hastalara ise on gün süresince pursed lip ve diyafragmatik solunum egzersizleri
uygulanmıştır. On gün sonra tüm hastaların dispne şiddetleri ve solunum fonksiyon testi ölçümleri tekrar
yapılmıştır. Araştırmanın yürütülmesi için bilimsel etik kuruldan izin alınmıştır.
Bulgular: Deney grubundaki hastaların pursed lip ve diyafragmatik solunum egzersizleri öncesi ve
sonrasında ölçülen solunum fonksiyon testleri değerleri arasında istatiksel bir fark bulunmazken (p > 0.05),
oksijen satürasyonu değerleri ve dispne şiddeti ortalamaları arasında istatistiksel olarak anlamlı bir fark
saptanmıştır (p < 0.05).
Sonuçlar: Pursed lip ve diyafragmatik solunum egzersizleri, oksijen satürasyonunu arttırmada ve dispne
şiddetini azaltmada etkilidir.
References
- Acıcan T, Gülbay BE. Kronik Obstrüktif Akciğer Hastalığı (KOAH) Atak ve Tedavisi. Türkiye Klinikleri Cerrahi Tıp Bilimleri Dergisi 2006;2(11):40-4.
- Adams L. Lines, Numbers and Words in The Scaling of Dyspnea. Biological Psychology 1995;41(1):83
- Akıncı AÇ, Pınar R. Kronik Obstrüktif Akciğer Hastalığı Olan Hastalarda Dispne Rehabilitasyonu. Cumhuriyet Hemşirelik Dergisi 2012;1(1):24-9.
- Ambrose MS. Controlling A Perplexing Symptom: Chronic Dyspnea. Nursing 1998;28(5):41-7.
- American Thoracic Society. Standards for The Diagnosis and Care of Patients with Chronic Obstructive Pulmonary Disease. American Journal of Respiratory and Critical Care Medicine 1995;152(5 Pt 2):77-121.
- American Thoracic Society. Dyspnea. Mechanisms, Assessment and Management: A Consensus Statement. American Journal of Respiratory and Critical Care Medicine 1999;159(1):321-40.
- Bianchi R, Gigliotti F, Romagnoli I, Lanini B, Castellani C, Grazzini M et al. Chest Wall Kinematics and Breathlessness During Pursed-Lip Breathing in Patients with COPD. Chest 2004;125(2):459-65.
- Breslin EH. The Pattern of Respiratory Muscle Recruitment During Pursed-Lip Breathing. Chest 1992;101(1):75-8.
- Calverley PMA, Georgopoulos D. Chronic Obstructive Pulmonary Disease: Symptoms and Signs. European Respiratory Monograph 2006;11(38):7-23.
- Collins EG, Longbein WE, Fehr L, Maloney C. Breathing Pattern Retraining and Exercise in Persons with COPD. AACN Clinical Issues 2001;12(2):202-9.
- Çiçek HS, Akbayrak N. Kronik Obstrüktif Akciğer Hastalığı Olan Bireylerde Solunum Egzersizlerinin Kan Gazları ve Solunum Fonksiyon Testlerine Etkisi. Gülhane Tıp Dergisi 2004;46(1):1-9.
- Demir G, Akkoca Ö, Doğan R, Saryal S, Karabıyıkoğlu G. KOAH’da Dispne ve Yaşam Kalitesinin Değerlendirilmesi. Tüberküloz ve Toraks Dergisi 2003;51(4):365-72.
- Donado JR, Hill NS. Outpatient Management. Respiratory Care Clinics of North America. 1998;4(3):391-423.
- Eakin EG, Resnikoff PM, Prewitt LM, Ries AL, Kaplan RM. Validation of A New Dyspnea Measure: The UCSD Shortness of Breath Questionnaire. Chest 1998;113(3):619-24.
- Ekren PK, Gürgün A. KOAH’da Pulmoner Rehabilitasyon: Kime, Ne Zaman, Nasıl? Güncel Göğüs Hastalıkları Serisi 2013;1(1):124-35.
- Faager G, Stahle A, Larsen FF. Influence of Spontanous Pursed Lips Breathing on Walking Endurance and Oxygen Saturation in Patients with Moderate to Severe Chronic Obstructive Pulmonary Disease. Clinical Rehabilitation 2008;22(8):675-83. Ferguson GT. Recommendations for the Management of COPD. Chest 2000;117(2):23-8.
- Gigliotti F, Romagnoli I, Scano G. Breathing Retraining and Exercise Conditioning in Patients with Chronic Obstructive Pulmonary Disease (COPD): A Physiological Approach. Respiratory Medicine 2003;97(3):197-204.
- Gosselink RA, Wagenaar RC, Rijswijk H, Sargeant AJ, Decramer ML. Diaphragmatic Breathing Reduces Efficiency Of Breathing in Patients with Chronic Obstructive Pulmonary Disease. American Journal of Respiratory and Critical Care Medicine 1995;151(4):1136-42.
- Gosselink R. Controlled Breathing and Dyspnea in Patients with Chronic Obstructive Pulmonary Disease (COPD). Journal of Rehabilitation Research and Development 2003;40(5):25-34.
- Grant S, Aitchison T, Henderson E, Christie J, Zare S, McMurray J et al. A Comparison of The Reproducibility and The Sensitivity to Change of Visual Analogue Scales, Borg Scales, and Likert Scales in Normal Subjects During Submaximal Exercise. Chest 1999;116(5):1208-17.
- Hylkema MN, Sterk PJ, Boer de WI, Postma DS. Tobacco Use in Relation to COPD and Asthma. European Respiratory Journal 2007;29(3):438-45.
- Jones PW, Quirk FH, Baveystock CM, Littlejohns P. A Self-Complete Measure of Health Status For Chronic Airflow Limitation. The St. George’s Respiratory Questionnaire. American Review of Respiratory Disease 1992;145(6):1321-7.
- Jones PW. Health Status Measurement in Chronic Obstructive Pulmonary Disease. Thorax 2001;56(11):880-7.
- Mahler DA, Horowitz MB. Clinical Evaluation of Exertional Dyspnea. Clincs in Chest Medicine 1994;15(2):259-69.
- Mahler DA. Pulmonary Rehabilitation. Chest 1998;113(4):263-68.
- Martinez JA, Straccia L, Sobrani E, Silva G, Vianna EO, Terra Filho J. Dyspnea Scales in The Assessment of Illitera Patients with COPD. The American Journal of Medical Sciences 2000;320(4):240-3.
- Nault D, Siok MA, Borycki E, Melanson D, Rousseau L, Lacasse Y. Psychosocial considerations in COPD. In: Bourbeau J, Nault D, Borycki E, eds. Chronic Obstructive Pulmonary Disease. 1 st ed. London: BC Decker; 2002. p. 215-43.
- Nield MA, Hoo GWS, Roper JM, Santiago S. Efficacy of Pursed-Lips Breathing: A Breathing Pattern Retraining Strategy For Dyspnea Reduction. Journal of Cardiopulmonary Rehabilitation & Prevantion 2007;27(4):237-44.
- Olgun N, Eti Aslan F, Çil A. Toraks ve Alt Solunum Sistemi Hastalıkları. Karadakovan A, Eti Aslan F, editör. Dahili ve Cerrahi Hastalıklarda Bakım. 1. Baskı. Adana: Nobel Kitabevi;2010. p.411-56.
- Onodera A, Yazaki K. Effects of Short Term Pulmonary Rehabilitation Program on Patients with Chronic Respiratory Failure Due To Pulmonary Emphysema. Nihon Kokyuki Gakkai Zasshi 1998;36(8):679-83.
- Ovayolu N, Ovayolu Ö, Ateş Ç. Kronik Obstrüktif Akciğer Hastalığı ve Hemşirelik Bakımı. Fırat Sağlık Hizmetleri Dergisi 2008;3(9):3-16.
- Özalevli S, Uçan ES. Farklı Dispne Skalalarının Kronik Obstrüktif Akciğer Hastalığında Karşılaştırılması. Toraks Dergisi 2004;5(2):90-4.
- Rose VL. American Thoracic Society Issues Consensus Statement on Dyspne. American Family Physician 1999;59(11):3259-60.
- Spahija J, Marchie M de, Grassino A. Effects of Imposed Pursed-Lips Breathing on Respiratory Mechanics and Dyspnea at Rest and During Exercise in COPD. Chest 2005;128(2):640-50.
- Steiner MC, Morgan MDL. Enhancing Physical Performance in Chronic Obstructive Pulmonary Disease. Thorax 2001;56(1):73-7.
- Tatlıcıoğlu T. Kronik Obstrüktif Akciğer Hastalığı (KOAH) ve Geleceği. Tüberküloz ve Toraks Dergisi 2007;55(3):303-18.
- Tiep BL. Disease Management of COPD with Pulmonary Rehabilitation. Chest 1997;112(6):1630
- Üçsular FD, Demir AT, Polat G, Güçlü SZ. KOAH’lı Olguların Sigara İçme Özellikleri. İzmir Göğüs Hastanesi Dergisi 2004;18(3):107-112.
- Verrill D, Barton C, Beasley W, Lippard WM. The Effects of Short-Term and Long-Term Pulmonary Rehabilitation on Functional Capacity, Perceived Dyspnea, and Quality of Life. Chest 2005;128(2):673
- Vitacca M, Clini E, Bianchi L, Ambrosino N. Acute Effects of Deep Diapragmatic Breathing in COPD Patients with Chronic Respiratory Insufficiency. European Respiratory Journal 1998;11(2):408-15.
- Wedzicha JA, Donaldson GC. Exacerbations of Chronic Obstructive Pulmonary Disease. Respiratory Care 2003;48(12):1204-15.
- Yüksel EG, Ursavaş A, Irdesel J, Koç M, Uzaslan EK, Güneş S ve ark. Kronik Obstrüktif Akciğer Hastalığında Multidisipliner Pulmoner Rehabilitasyon Programının Etkinliği. Türkiye Klinikleri Akciğer Arşivi 2005;6(3):115-9.
- Yürüktümen A, Karcıoğlu Ö, Topacoğlu H, Karbek F. Dispne ile Başvuran Geriyatrik Olgularda Yakınma Şiddeti ile Klinik ve Laboratuar Verilerinin Değerlendirilmesi. Türkiye Acil Tıp Dergisi 2009;9(4):163-8.