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Pilot Study of Self-care Breath Training Exercise for Reduction of Chronic Dyspnea

Deng, Gary, MD, PhD; Feinstein, Marc B., MD; Benusis, Lara, MA; Tin, Amy L., MA; Stover, Diane E., MD

Journal of Cardiopulmonary Rehabilitation and Prevention: January 2019 - Volume 39 - Issue 1 - p 56–59
doi: 10.1097/HCR.0000000000000368
Pulmonary Rehabilitation
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Purpose: Dyspnea related to chronic pulmonary disorders is difficult to manage. In this single-arm study, we evaluated feasibility and potential efficacy of a self-care breath training program to reduce dyspnea that persists despite standard treatments in patients with chronic lung disease.

Methods: Adult patients with a chronic pulmonary disorder and stable moderate dyspnea received one 30-min training on specific breathing techniques, followed by audio-guided at-home practice 15 min twice daily for 6 wk, supported with weekly telephone monitoring/coaching. The feasibility endpoints, Baseline and Transition Dyspnea Indexes, 6-min walk test, Hospital Anxiety and Depression Scale, and oxygen saturation at rest and exercise were evaluated at baseline and wk 6.

Results: Of the 23 patients enrolled over 2 yr, 19 completed the study. A majority (74%; 95% CI, 49%-91%) completed at least 75% of the home practice sessions. Significant objective improvements in physical performance, defined as distance walked, were observed after 6 wk of intervention. On average, patients walked significantly further in the 6-min walk test (59 ft; 95% CI, 18-99; P = .007). In addition, 53% reported clinically significant (20%, defined a priori) subjective improvement in the Transition Dyspnea Index, although the difference was not statistically significant (0.7; 95% CI, −0.8 to 2.3; P = .3). No significant differences were seen in the Hospital Anxiety and Depression Scale or oxygen saturation.

Conclusions: A low-burden, low-cost, self-care breath training program improved distance walked by patients with chronic dyspnea after 6 wk of home practice. Promising data suggest that a randomized trial of this breath training program is warranted.

We have developed a low-cost, low-burden, and flexible self-care tool for patients to do breathing exercises at home. Patients showed significant improvement in physical performance after 6 wk of home practice with this innovative breath training program in a prospective clinical trial we conducted.

Integrative Medicine Service (Dr Deng and Ms Benusis), Pulmonary Medicine Service (Drs Feinstein and Stover), and Department of Epidemiology and Biostatistics (Ms Tin), Memorial Sloan Kettering Cancer Center, New York.

Correspondence: Gary E. Deng, MD, PhD, Memorial Sloan Kettering Cancer Center, Integrative Medicine Service, 1429 First Ave, New York, NY 10021 (dengg@mskcc.org).

Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal's Web site (www.jcrpjournal.com).

The authors declare no conflicts of interest.

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