Effect of Pursed-Lips Breathing on The Symptoms of Depression in Patients with Stable Chronic Obstructive Pulmonary Disease

Abstract

Background: Chronic obstructive pulmonary disease (COPD) can cause a condition called chronic hypoxia that can lead to one of psychological problem, depression. Pursed lips breathing (PLB) is one of pulmonary rehabilitation that can help the oxygen flow in the body. Nowadays, there are several studies about the effect of pulmonary rehabilitation on the quality of life or the improvement of the symptoms of depression, but there are no studies about the effect of PLB on the symptoms of depression. Aims: The aim of this study was analyzed the effect pursed-lips breathing technique on the improvement of the symptoms of depression in patients with stable COPD. Method: Method used in this research was randomized controlled trial design. We conducted open label in COPD outpatient with early symptom of depression by scoring them with Beck Depression Inventory (BDI) questionnaire and then we randomized the result. The subjects were divided into two groups, the study group who went through PLB training and the control group. Standard therapies were maintained. After four weeks, the BDI score was being evaluated. Results: There were 55 subjects consist of 29 subjects in the PLB group and 26 subjects in the control group. The mean age of subjects in the PLB group was 64.31 ± 6.61 years old and the placebo group was 65.65 ± 8.53 years old. There was a decrease of BDI score in the PLB group 4.72±6.39 (p=0.001) compared to the control group 2.19±5.97 (p=0.53). But there was no difference of the mean of data between these two groups (p = 0.136). Conclusion: The improvement of the symptoms of depression were much more to be found in the PLB group. As a result, pursed lips breathing exercise may be considered as an adjunctive therapy for stable COPD patient that already receiving standard medical treatment.