This randomized, cross-over study aims at describing the effect of pursed lip breathing on exercise-induced dyspnea and exercise capacity in patients with interstitial lung disease.
The use of pursed lip breathing (PLB) to improve exercise tolerance in COPD patients has been widely documented. However, its efficacy in patients with interstitial lung disease (ILD) has yet to be confirmed. This study aims to determine if PLB improves perceived exertion and exercise capacity during a six-minute walk test (6MWT) in patients with ILD. To achieve this, a prospective randomized crossover trial will be performed, in which patients with ILD and restrictive ventilatory defect will be recruited via the ILD clinic of Hôpital Notre-Dame. The study will be performed in a single visit, on the day where patients attend a routine physician-prescribed follow-up 6MWT. Patients will be asked to perform a total of two 6MWT. Patients will be randomized to perform the first test with or without using PLB, and the order will be reversed for the second test, with patients serving as their own control. During tests, ventilatory variables will be continuously measured using a portable metabolic cart. The observed parameters will be: perceived exertion using the Modified-Borg Scale, respiratory rate, minute-ventilation, heart rate, peripheral oxygen saturation, and 6-minute walk distance (6MWD). It is expected that the use of PLB will be associated with a decrease of at least one unit on the Modified Borg Scale, which would be clinically significant. Moreover, it is expected that the decrease in dyspnea with PLB will be related to a decrease in respiratory rate minute ventilation during 6MWT. The clinical impact of this study could be significant as therapies allowing the improvement of dyspnea in patients with ILD are scarce.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
NONE
Enrollment
35
Pursed lip breathing will be taught to the participants following the chronic obstructive pulmonary disease (COPD) Foundation recommendations: 1. Breathe in through your nose (as if you are smelling something) for about 2 seconds. 2. Pucker your lips like you're getting ready to blow out candles on a birthday cake. 3. Breathe out very slowly through pursed-lips, two to three times as long as you breathed in. 4. Repeat.
CHUM (Notre-Dame Hospital)
Montreal, Quebec, Canada
Exertional dyspnea
Patient-reported dyspnea will be measured using the Borg scale
Time frame: On the day of randomization
Six-minute walking distance
Time frame: On the day of randomization
Oxygen uptake (ml/min)
Non-invasive real-time measurements will be performed using a portable metabolic cart system.
Time frame: On the day of randomization, at each minute of the 6-minute walking test
Carbon dioxide output (ml/min)
Non-invasive real-time measurements will be performed using a portable metabolic cart system.
Time frame: On the day of randomization, at each minute of the 6-minute walking test
Respiratory rate (br/min)
Non-invasive real-time measurements will be performed using a portable metabolic cart system.
Time frame: On the day of randomization, at each minute of the 6-minute walking test
Tidal volume (ml)
Non-invasive real-time measurements will be performed using a portable metabolic cart system.
Time frame: On the day of randomization, at each minute of the 6-minute walking test
Minute-ventilation (l/min)
Non-invasive real-time measurements will be performed using a portable metabolic cart system.
Time frame: On the day of randomization, at each minute of the 6-minute walking test
Peripheral oxygen saturation (%)
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Non-invasive real-time measurements will be performed using a portable metabolic cart system.
Time frame: On the day of randomization, at each minute of the 6-minute walking test