Chronic Obstructive Pulmonary Disease (COPD) is the 3rd leading cause of mortality and 7th leading cause of ill-health worldwide. It is characterized by persistent and progressive air flow resistance with expiratory flow more compromised as compared to inspiratory flow leading to CO2 retention and prominent hyperinflation of lungs. The overall effects of COPD on the patient's entire body include pulmonary, followed by extra-pulmonary manifestations in which musculoskeletal derangements are more pronounced and interfere with daily activities, further deteriorating the patient's health. Restricted air flow leads to an increase in shortness of breath on slight exertion and early fatigue or exhaustion of respiratory muscles due to over work. Literature from the past describes how COPD care has advanced and emphasizes the value of pulmonary rehabilitation in addition to medicinal management to treat decadence. Many studies show that Inspiratory muscle training has positive effect on ABG's, some PFT's and diaphragmatic function. Endurance and strength training improve patient activity of daily living and dyspnea. This study intricate the collation of Respiratory Muscle Training and Aerobic Interval Training on functional performance, exertional dyspnea and fatigue level in patients diagnosed with COPD. A randomized controlled trial will be integrated with the sample size of 53 patients which is calculated through epi-tool. Age of selected Patients will fall between 30-55 years and will be randomly assigned into 2 groups. Group A (Experimental group A) will get Inspiratory breather training along-with Aerobic Interval Training, Group B (Experimental group B) will get Expiratory muscle training along-with Aerobic Interval Training (Same Protocol). Data will be gathered from Pulmonology wards and OPD of selected hospital. Clinical Assessment will be incorporated through Karnofsky performance scale, Fatigue Severity Scale, MmRC Dyspnea scale, Digital Spirometer, and 6MWT. Pre-intervention assessment measures and Post-intervention measures will be noted and results will be compared. Study Duration will be of 06 months after approval of synopsis. Data analysis will be done through SPSS. Key words: Aerobic Interval training (AIT), The Breather Device (BD), 6-min walk test (6MWT), Fatigue severity scale (FSS), Modified Medical Research Council dyspnea scale (mMRC), Chronic Obstructive Pulmonary Disease (COPD).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
SINGLE
Enrollment
53
Performed Inspiratory muscle training on a breather device (20), (10 inhales with maximum 3-sec hold), 3 sets with a 1-minute interval between each set, for 6 days a week along with aerobic interval training on alternate days (3 days a week for 20-25 minutes in 1st week, 30-35 minutes in 2nd week, 40 minutes in 3rd week, 45-60 minutes in 4th week each session). (120) Baseline treatment given is Aerobic interval training and COPD medications.
Performed Expiratory muscle training along with aerobic interval training on alternate days (3 days a week for 20-25 minutes in 1st week, 30-35 minutes in 2nd week, 40-45 minutes in 3rd week, 45-60 minutes in 4th week per session). (120) Baseline treatment given is Aerobic interval training and COPD medications.
Al-Zahra Rehabilitation Center, Gulab Devi Teaching Hospital
Lahore, Punjab Province, Pakistan
Modified Medical Research Council (mMRC) Dyspnea Scale
A widely recognized tool for evaluating the level of breathlessness experienced by patients with COPD. It provides a simple and efficient method of assessing the baseline functional disability due to dyspnea. experiencing breathlessness with strenuous exercise. The scale ranges from 0 to 4, with each grade representing a different level of breathlessness, from only experiencing breathlessness with strenuous exercise (Grade 0) to being too breathless to leave the house or experiencing breathlessness when dressing or undressing (Grade 4).
Time frame: 4 Weeks
6 Minute Walk Test
The 6-Minute Walk Test (6MWT) is a sub-maximal exercise test used to assess aerobic capacity and endurance, particularly in patients with COPD. The score of the 6MWT is the distance a patient walks in 6 minutes. The patient may take as many standing rests as they like, but the timer should keep going. The 6MWT measures exercise tolerance in people with various health conditions.
Time frame: 4 Weeks
Karnofsky Performance Scale (KPS)
The Karnofsky Performance Scale (KPS) is an assessment tool used to predict the length of survival in terminally ill patients.It's an 11-point rating scale ranging from normal functioning (100) to dead (0) in ten-point increments. The higher the score, the more independent the person is.
Time frame: 4 Weeks
Fatigue Severity Scale (FSS)
A tool used to measure the severity of fatigue in patients with Chronic Obstructive Pulmonary Disease (COPD). It's a 9-item questionnaire where each item is scored on a 7-point scale, with 1 indicating strong disagreement and 7 indicating strong agreement. The total score ranges from 9 to 63, with higher scores indicating greater fatigue severity.
Time frame: 4 week
FEV1
A Digital Spirometer is a device used to measure the volume and speed of air a person can inhale and exhale. It is often used to diagnose and monitor conditions like COPD. The spirometer measures the Forced Expiratory Volume in 1 second (FEV1), which is how much air you can exhale in the first second after a full inhalation. The FEV1 and FVC values are used to diagnose conditions like COPD.
Time frame: 4 Weeks
FVC
Digital Spirometer will be used to measure the volume and speed of air a person can inhale and exhale. The spirometer measures the Forced Vital Capacity (FVC), which is the largest amount of air that you can forcefully exhale after breathing in as deeply as you can. Pre-post reading will be taken. it is measures in liters.
Time frame: 4 weeks
FEV1/FVC
Digital Spirometer is a device used to measure the volume and speed of air a person can inhale and exhale. The FEV1 and FVC values are used to diagnose conditions like COPD. The ratio of FEV1 to FVC (FEV1/FVC) is calculated and expressed as a percentage. Pre-Post readings will be taken.
Time frame: 4 weeks
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