Clinical Trial Details
— Status: Recruiting
Administrative data
| NCT number |
NCT04983472 |
| Other study ID # |
AIBU-FTR-CT-01 |
| Secondary ID |
|
| Status |
Recruiting |
| Phase |
|
| First received |
|
| Last updated |
|
| Start date |
July 20, 2021 |
| Est. completion date |
May 20, 2023 |
Study information
| Verified date |
March 2023 |
| Source |
Abant Izzet Baysal University |
| Contact |
Eylem TÜTÜN YÜMIN, Assoc Prof. |
| Phone |
05056763191 |
| Email |
eylemtutun78[@]hotmail.com |
| Is FDA regulated |
No |
| Health authority |
|
| Study type |
Observational
|
Clinical Trial Summary
Chronic and progressive dyspnea is the most characteristic symptom of chronic obstructive
pulmonary disease. There are studies in the literature showing that electromyography
activations of respiratory muscles increase in individuals with chronic obstructive pulmonary
disease and that the severity of the perceived shortness of breath is associated with muscle
activation. However, no study has been found comparing respiratory muscle activations during
pursed lip breathing and normal breathing in the dyspnea reduction positions and supine
position used in the treatment and management of chronic obstructive pulmonary disease. The
aim of this study is to evaluate the effects of different dyspnea reduction positions on
respiratory muscle activations separately, to compare respiratory muscle activation during
normal breathing, respiratory control and pursed lip breathing during these different
positions, and to classify muscle activations according to the severity of chronic
obstructive pulmonary disease.
Description:
Chronic obstructive pulmonary disease is a common, preventable and treatable disease
characterized by persistent respiratory symptoms and airway limitation due to airway and/or
alveolar abnormality, which is affected by many factors that cause abnormal lung development
resulting from exposure to harmful gases or particles. Chronic obstructive pulmonary disease
is known as the fourth most common cause of death in the world and is expected to rise to
third place by the end of 2020. Physiopathological changes such as airflow limitation,
bronchial fibrosis, increased airway resistance, ciliary dysfunction, gas exchange
abnormalities and air trapping occur in chronic obstructive pulmonary disease. While smoking
is the most common risk factor in chronic obstructive pulmonary disease; Occupational dust
and chemicals, air pollution, lung growth and development, genetic predisposition such as age
and gender, and exposure to environmental effects. Symptoms such as shortness of breath
(dyspnea), cough, and sputum are common in chronic obstructive pulmonary disease.
Chronic and progressive dyspnea is the most characteristic symptom of chronic obstructive
pulmonary disease. About 30% of individuals with chronic obstructive pulmonary disease have a
productive cough. These symptoms can vary from day to day and may precede airflow limitation
for years. Significant airflow limitation may also be present without chronic dyspnea, cough,
and sputum production. Although chronic obstructive pulmonary disease is defined based on air
restriction, individuals with chronic obstructive pulmonary disease usually make the decision
to seek treatment based on the effect of symptoms on functional status. Dyspnea, which is the
main symptom of chronic obstructive pulmonary disease, is the main cause of disability and
anxiety associated with the disease. Typical chronic obstructive pulmonary disease patients
define dyspnea as a feeling of increased breathing effort, heaviness in the chest, and air
hunger.
Today, it has been shown that there are many underlying causes of dyspnea. In chronic
obstructive pulmonary disease patients, minute ventilation and dead space ventilation due to
increased workload increase respiratory motor output in association with an increase in
carbon dioxide production. As a result, individuals feel short of breath. Simple mechanical
distention of the airways during exhalation, which is defined as dynamic airway compression,
is another cause of dyspnea in patients with chronic obstructive pulmonary disease. Different
positions and breathing patterns affect the perception of dyspnea in individuals with chronic
obstructive pulmonary disease. In current studies, individuals with chronic obstructive
pulmonary disease have an increased perception of shortness of breath in the supine position
(orthopnea); It was observed that the perception of shortness of breath decreased in pursed
lib (pursed lip) breathing and dyspnea reduction positions. Therefore, pursed lip breathing
and breathlessness reduction positions are frequently used in the treatment of individuals
with chronic obstructive pulmonary disease. Leaning forward, comfortable sitting, leaning
forward, standing with the back leaning, high side lying are the most commonly used positions
to reduce dyspnea.
It has been shown that the forward bending position, one of the dyspnea-reducing positions,
improves the length-tension relationship and function of the diaphragm muscle, decreases the
activity of the sternocleidomastoideus, scalene muscles, improves thoracoabdominal movement,
and helps to reduce shortness of breath. Pursed-lip breathing, on the other hand, increases
tidal volume, leading to increased rib cage movement and accessory muscle recruitment during
inspiration and expiration.
Compared to healthy individuals, individuals with chronic obstructive pulmonary disease have
an increased electromyographic activation of respiratory muscles. In chronic obstructive
pulmonary disease patients, there is an increase in respiratory muscle activation and
shortness of breath due to the imbalance between the workload and capacity of the respiratory
muscles. In current studies, it has been observed that the severity of dyspnea perception and
respiratory muscle activations are related.
There are studies in the literature showing that electromyographic activations of respiratory
muscles increase in individuals with chronic obstructive pulmonary disease and that the
severity of the perceived shortness of breath is associated with muscle activation. However,
no study has been found comparing respiratory muscle activations during pursed lip breathing
and normal breathing in dyspnea reduction positions and supine position used in the treatment
and management of chronic obstructive pulmonary disease. The aim of this study is to evaluate
the effects of different dyspnea reduction positions on respiratory muscle activations
separately, to compare respiratory muscle activation during normal breathing, respiratory
control and pursed lip breathing during these different positions, and to classify muscle
activations according to the severity of chronic obstructive pulmonary disease.
