Breathing Exercise Phone App May Help People With COPD, Study Finds
Breathing exercises through a mobile app help patients with severe chronic obstructive pulmonary disease (COPD) improve respiratory muscle strength and diaphragm mobility, research shows. A team led by Romanian researchers published the article “Respiratory muscle training program enhanced by mobile phone app in COPD patients with severe airflow limitation” in the journal Respiratory Medicine.
Smartphone apps, in particular, allow for continuous monitoring and collection of patient health information, but whether this type of app would benefit patients with COPD is poorly studied. Romanian researchers evaluated the effectiveness of an online respiratory muscle training performed at least three times a week for six months through a mobile app called Pneumocontrol. The sessions were led by a professional physiotherapist in pulmonary rehabilitation.
Exercise training is a mainstay of pulmonary rehabilitation for COPD, with patients showing improvements in exercise capacity and quality of life, as well as relief of shortness of breath (dyspnea). Training typically involves training of the respiratory muscles, involving both inspiratory and expiratory muscles, and has traditionally been performed in a hospital setting requiring constant monitoring. However, “modern times have led to a paradigm shift in which hospital settings are moved to home care settings, thus reducing healthcare resources. In addition, mobile phone applications and other technologies are increasingly used to support change in the management of care, ”the researchers wrote.
Pneumocontrol has been specially developed for patients with COPD by a group of pulmonologists and an IT specialist. It includes rehabilitation programs recommended by the American Thoracic Society, including breathing, strength and endurance exercises. A group of 49 patients with severe but stable COPD were included in the study. These patients were unable to complete their rehabilitation training at the hospital due to restrictions imposed by the COVID-19 pandemic. During the six months, 13 patients skipped exercises and two patients had worsening disease at the end of training, so they were excluded from the analysis.
To assess the PID, each patient was asked to take as much inspiration as possible and then expel as much air as possible while the nose was blocked with forceps. The MEP was measured after a deep and full inspiration, followed by a forced expiration. Each test was performed three times, and the best value was used in the final analysis. More than a third of the patients were considered overweight (35.3%), according to their body mass index (BMI) and 17.6% were obese; the rest were of normal weight (also 35.3%), with 11.4% underweight.
The analysis therefore included 34 patients with a mean age of 59.29 years (range 44-67). The researchers analyzed patients’ lung volumes, respiratory muscle strength – both maximum inspiratory pressure (PIM) and maximum expiratory pressure (MEP) – and diaphragm amplitude, as assessed by ultrasound. The diaphragm, the main inspiratory muscle, contracts, causing the lungs to fill with air. Each parameter was analyzed at the start and at the end of the study.
Overall, 33 of 34 patients saw an improvement in their respiratory muscle strength after using the Pneumocontrol app, taking MEP values into account. Specifically, the median PEM increased significantly from 83.41 centimeters of water (cmH2O) before rehabilitation to 95.03 cmH2O at the post-rehabilitation stage. The median PMI also showed a significant increase, from 57.91 to 73.21 cmH2O after rehabilitation. The mobility of the diaphragm also increased from 2.81 cm (pre-rehabilitation) to 3.44 cm (post-rehabilitation), a statistically significant difference.
In each pre- and post-rehabilitation assessment, diaphragm mobility showed a significant positive correlation with MIP and MEP. Reduced diaphragm mobility is associated with lower inspiratory and expiratory pressure. Overall, “respiratory muscle training supplemented with a mobile phone app can improve respiratory muscle strength and diaphragmatic mobility,” the researchers concluded.
“In addition, ultrasound assessment could be used as an additional tool for the assessment of the clinical effects of pulmonary rehabilitation in patients with COPD,” they added. Patricia Inacio PhD Patricia holds her doctorate. in Cell Biology from the University of Nova de Lisboa, and has been the author of several research projects and grants, as well as important grant applications for European agencies. She was also a doctoral research assistant in the laboratory of Dr. David A. Fidock, Department of Microbiology and Immunology, Columbia University, New York.
Summary of the news:
- Breathing Exercise Phone App May Help People With COPD, Study Finds
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