Pursed Lip Breathing Research Articles

Analisis Jenis Pelatihan Pernapasan : Teknik Pernapasan dan Olah Vokal : Pelatihan Voice Over

In doing voice over, several exercises are carried out to support voice over abilities, namely breathing training and vocal training. Each of these trainings has a different type and is important for both breathing and speaking skills. For this reason, this study wanted to find out the analysis of the types of breathing training in the form of breathing techniques as well as vocal training in voice over. The method used in this research is descriptive qualitative with data library research analysis techniques which are at the stages of data reduction, data presentation, and drawing conclusions. Based on the research findings, it was found that the types of breathing techniques or training included several things, namely diaphragmatic breathing exercises, pursed lips breathing, lions breath, equal breathing and deep breathing. Meanwhile, vocal training for voice over includes intonation techniques, breathing techniques, carrying techniques, and articulation techniques. Various types and techniques in breathing and vocal exercises can be carried out as routine exercises to get the right functions and benefits for voice over talent in carrying out their duties and profession.

Effect of Pursed Lips Breathing (PLB) on Increased Oxygen Saturation in Chronic Obstructive Pulmonary Disease (COPD) Patients: Literature Review

Pendahuluan: Pursed-lips breathing (PLB) adalah Latihan pernapasan yang dilakukan pada pasien dengan penyakit paru obstruktif kronik (PPOK) untuk meredakan gejala dispnea sehingga nilai saturasi oksigen pasien meningkat, dan praktiknya diajarkan secara luas sebagai strategi pernapasan untuk meningkatkan toleransi dalam melakukan aktifitas. Tujuan: Penelitian ini bertujuan untuk mengetahui pengaruh PLB terhadap peningkatan saturasi oksigen pada pasien penyakit paru obstruktif kronik (PPOK). Metode: Penelitian ini menggunakan metode studi literatur review. Hasil: Hasil pencarian awal menemukan artikel potensial sebanyak 4011 artikel. Setelah membuang artikel yang teridentifikasi duplikasi dan relavan dengan topik terdapat 6 artikel yang memenuhi tema studi literatur, ke enam jurnal membahas tentang efektifitas PLB pada pasien PPOK. Kesimpulan: PLB mampu untuk meningkatkan nilai saturasi oksigen pasien, sehingga intervensi PLB dianjurkan dilakukan pada pasien PPOK dengan gejala dispnea

Interdialytic Exercise Reduces Fatigue in Chronic Kidney Failure Patients: Systematic Literature Review

Hemodialysis therapy that is carried out for a long time can cause physical stress in the form of fatigue and have an impact on the patient’s quality of life. Giving intradialytic exercise intervention is believed to reduce the level of fatigue. The purpose of this study was to determine the effect of intradialytic exercise on the level of fatigue in chronic kidney failure patients undergoing hemodialysis. This study used a systematic literature review method based on data from Google Schoolar, Garuda, Science Direct, and the Directory of Open Access Journal (DOAJ), by including key words are fatigue, chronic kidney failure, hemodialysisi, and intradialytic exercise. Article were selected through screening according to inclusion criteria, including publications within the last 10 years (2011 – 2022), original articles, Indonesian and English, descriptive analytic study types, and quasi experiments. The results show that Intradialytic exercises applied include breathing exercise, Range of Motion (ROM), slow deep breathing, Progressive Muscle Relaxation (PMR), Pursed Lip Breathing and Physical Exercise. Based on the 9 articles found that intradialytic exercise has an effect on the level of fatigue. The average p-value <0.05, the average post-test fatigue score is smaller than the pre=test, the smaller the average value fatigue score then the level of fatigue decreases. In conclusion, Intradialytic exercise affects the fatigue level of chronic kidney failure patients undergoing hemodialysis. Suggestions are given to HD nurses to be able to implement an intradialytic exercise intervention in patients undergoing hemodialysis to reduce fatigue.

The Influence of Breathing Exercises on Regional Ventilation in Healthy and Patients with Chronic Obstructive Pulmonary Disease

We hypothesized that the respiratory exercises have uniform effects on ventilation in healthy subjects but the effects varied in patients with chronic obstructive pulmonary disease (COPD). In this study, a total of 30 healthy volunteers and 9 patients with COPD were included. Data were recorded continuously during (1) diaphragmatic breathing; (2) pursed lip breathing with full inhalation; (3) pursed lip combining diaphragmatic breathing. The sequence of the three breathing exercises was randomized using machine generated random permutation. Spatial and temporal ventilation distributions were evaluated with electrical impedance tomography. Results showed that, tidal volume was significantly larger during various breathing exercises compared to quiet tidal breathing, in both healthy and COPD (p < 0.01). However, for other EIT-based parameters, statistical significances were only observed in healthy volunteers, not in patients. Diaphragmatic breathing alone might not be able to decrease functional residual capacity in COPD and the effect varied largely from patient to patient (6:3, decrease vs. increase). Ventilation distribution moved toward ventral regions in healthy during breathing exercises (p < 0.0001). Although this trend was observed in the COPD, the differences were not significant. Ventilation became more homogeneous when diaphragmatic breathing technique was implemented (p < 0.0001). Again, the improvements were not significant in COPD. Regional ventilation delay was relatively high in COPD and comparable in various breathing periods. In conclusions, the impact of pursed lip and diaphragmatic breathing varied in different patients with COPD. Breathing exercise may need to be individualized to maximize the training efficacy with help of EIT.

MANAJEMEN NYERI PADA NY. I DENGAN HEPATOMA (HEPATOCELLULAR CARCINOMA) DI RUANG RAWAT INAP PENYAKIT DALAM RSUD KABUPATEN SUMEDANG: STUDI KASUS

Hepatoma is the type of cancer with the fourth highest incidence in Indonesia in 2020. The most common manifestation of Hepatoma patients is pain, 9 out of 10 patients complain of pain with an average pain scale of &gt; 8 (0 – 10 NRS). One of the pain management that can reduce pain level is a combination of pharmacological and non-pharmacological therapy. The purpose of this case study is to provide nursing care for pain management in Hepatoma patients through collaborative interventions providing pharmacological therapy combined with non-pharmacological therapy using the case study approach method through the nursing process. Participants in this case study were one patient who was diagnosed with Hepatoma with a nursing diagnosis of Acute Pain. The instrument used to measure the pain scale is the Numeric Rating Scale (NRS). Intervention was given in collaboration with the administration of opioid therapy combined with non-pharmacological therapy of slow deep pursed lip breathing 3 sessions per day for 3 x 24 hours. The evaluation results showed that before the intervention was given the pain level was on a scale of 9 and after the combined intervention the pain level decreased to a scale of 1. The conclusion of this case study is that a combination of pharmacological and non-pharmacological therapy can significantly reduce pain levels in patients.

EDUKASI KEPERAWATAN PADA PASIEN TUBERKULOSIS DENGAN MENGGUNAKAN PENDEKATAN MODEL SELF-CARE OREM DAN TINDAKAN BERBASIS EVIDANCE BASED EDUKASI AUDIO VISUAL PURSED LIPS BRETHING

Tuberculosis (TB), which is caused by Mycobacterium tuberculosis (MTB), is the leading cause of death from infectious diseases globally. Respiratory symptoms caused by TB are dry cough that gradually becomes productive for more than 3 weeks, sometimes mixed with phlegm, chest pain and dyspnea, for direct training it might be difficult to demonstrate pursed lib breathing practice, so the choice is yes, you can use audio visual media.). Evidence-based nursing that is applied during residency practice is pursed lib breathing education in MDR TB patients who experience dyspnea. The condition of Dipsnea experienced by MDR TB patients will make the patient no longer able to carry out the role they have and need help and support so that the nursing theory approach of the Orem Supportive-educative system self-Care model is very suitable for use in nursing care for MDR TB patients with Dipsnea complaints. The strategy that can be applied is in quadrant I or an aggressive strategy, namely a strategy to maximize the strengths and opportunities possessed by Aji Muhammad Parikesit Hospital. training for 50 new BLUD nurses in independent nursing follow-up Audio Visual Education Pursed Lip Breathing Exercise Audio Visual Education service activities Pursed Lip Breathing Exercise, nurses are able to improve the Pursed Lip Breathing Exercise Audio Visual Education process continuously, and nurses can carry out their duties optimally and professionally safely and comfortably, so nurses can focus on providing nursing care to patients respective rooms.

Pulmonary rehabilitation care: Current perspective

Pulmonary rehabilitation is a program that helps individuals with chronic respiratory diseases improve their physical function, quality of life, and overall well-being. The program typically involves a combination of exercise, education, and support to help patients manage their symptoms and improve their respiratory health.Exercise is a crucial component of pulmonary rehabilitation and can help improve cardiovascular health, increase lung function, and reduce shortness of breath. Aerobic exercise, resistance exercise, and flexibility exercise are all important types of exercise used in pulmonary rehabilitation, with patients gradually increasing the intensity and duration of their workouts over time.Breathing techniques are another essential component of pulmonary rehabilitation and can help patients manage their symptoms and improve their overall respiratory function. Techniques such as diaphragmatic breathing, pursed-lip breathing, and controlled coughing can help improve oxygenation, reduce shortness of breath, and improve overall respiratory function.In addition to exercise and breathing techniques, pulmonary rehabilitation programs may also include education and support to help patients better manage their condition. This may include education on medication management, nutrition, stress management, and other topics relevant to respiratory health.Overall, pulmonary rehabilitation is a comprehensive program that can help individuals with chronic respiratory diseases improve their physical function, reduce symptoms, and improve their overall quality of life. By incorporating exercise, breathing techniques, education, and support, pulmonary rehabilitation can help patients better manage their condition and achieve optimal respiratory health.

Effectiveness of Nonpharmacological Interventions in the Field of Ventilation: An Umbrella Review.

Systematic reviews of the literature published in English, Spanish, French, and Portuguese were used, which included studies in which nonpharmacological interventions were used as a response to impaired ventilation in adults in any given context of the clinical practice. The recommendations given by the Joanna Briggs Institute (JBI) for umbrella reviews were followed. This research took place in several databases such as MEDLINE, CINAHL Complete, CINHAL, MedicLatina, ERIC, Cochrane Reviews (Embase), and PubMed. The Joanna Briggs critical analysis verification list was used for the systematic review. The data extraction was performed independently by two investigators based on the data extraction tools of the Joanna Briggs Institute, and the data were presented in a summary table alongside the support text. Forty-four systematic reviews, thirty randomized clinical essays, and fourteen observational studies were included in this review. The number of participants varied between n = 103 and n = 13,370. Fifteen systematic revisions evaluated the effect of isolated respiratory muscular training; six systematic revisions evaluated, in isolation, breathing control (relaxed breathing, pursed-lip breathing, and diaphragmatic breathing exercises) and thoracic expansion exercises; and one systematic review evaluated, in isolation, the positions that optimize ventilation. Nineteen systematic reviews with combined interventions that reinforced the role of education and capacitation while also aiming for their success were considered. The articles analyzed isolated interventions and presented their efficacy. The interventions based on respiratory exercises and respiratory muscular training were the most common, and one article mentioned the efficacy of positioning in the compromisation of ventilation. Combined interventions in which the educational component was included were found to be effective in improving pulmonary function, diffusion, oxygenation, and functional capacity. The outcomes used in each study were variable, leading to a more difficult analysis of the data. The interventions that were the focus of the review were duly mapped. The results suggest that nonpharmacological interventions used to optimize ventilation are effective, with a moderate to high level of evidence. There is a strong foundation for the use of the chosen interventions. The lack of studies on the intervention of "positioning to optimize ventilation" points out the need for a deeper analysis of its effects and for studies with a clear focus. This study supports the decisions and recommendations for the prescription of these interventions to patients with impaired ventilation.

Distinguishing science from pseudoscience in commercial respiratory interventions: an evidence-based guide for health and exercise professionals.

Respiratory function has become a global health priority. Not only is chronic respiratory disease a leading cause of worldwide morbidity and mortality, but the COVID-19 pandemic hasheightened attention on respiratory health and the means of enhancing it. Subsequently, and inevitably, the respiratory system has become a target of the multi-trillion-dollar health and wellness industry. Numerous commercial, respiratory-related interventions are now coupled to therapeutic and/or ergogenic claims that vary in their plausibility: from the reasonable to the absurd. Moreover, legitimate and illegitimate claims are often conflated in a wellness space that lacks regulation. The abundance of interventions, the range of potential therapeutic targets in the respiratory system, and the wealth of research that varies in quality, all confound the ability for health and exercise professionals to make informed risk-to-benefit assessments with their patients and clients. This review focuses on numerous commercial interventions that purport to improve respiratory health, including nasal dilators, nasal breathing, and systematized breathing interventions (such as pursed-lips breathing), respiratory muscle training, canned oxygen, nutritional supplements, and inhaled L-menthol. For each intervention we describe the premise, examine the plausibility, and systematically contrast commercial claims against the published literature. The overarching aim is to assist health and exercise professionals to distinguish science from pseudoscience and make pragmatic and safe risk-to-benefit decisions.

Effects of Controlled Breathing Maneuver on Exercise Tolerance in Patients with Chronic Obstructive Pulmonary Disease

Background: Chronic obstructive pulmonary disease, which is usually caused by harmful particles or gases, is associated with persistent respiratory symptoms. Aim: To determine effects of controlled breathing techniques for respiratory muscle strengthening and functional capacity. Study Design: Randomized control trial. Methodology: Study was conducted at Services Hospital Lahore for duration of 6months. Patients (n=48) were enrolled through convenient sampling. Participants were divided into two groups 24 in each group. Both groups A and B received baseline treatment for pulmonary rehabilitation. Pursed lip breathing technique was performed to group B, 20 minutes session for 4 days per week. Pre and post treatment readings were taken and the results were analyzed. Informed consent was taken. Data was evaluated by using SPSS vr 23. Before and after comparison was made using paired sample t test considering normality of data. Results: Almost 18.75% were in the age range of (40-49 years), 16(33.33%) in (50-59), 10(20.83%) in (60-69) and 13(27.08%) in (70-75). The pre and post readings showed that there was a mean difference in 6MWT and AQ20 with significant p-value. Conclusion: It was concluded that controlled breathing techniques have been found to be more effective to increase exercise tolerance in people with chronic obstructive pulmonary disease. Keywords: chronic obstructive pulmonary disease, Exercise Tolerance, Controlled Breathing Maneuvers and Pulmonary Functions.

COMBINATION EFFECT AMONG GIVING TRIPOD POSITION AND PURSED LIP BREATHING TO RESPIRATION RATE IN CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) PATIENTS

The purpose of this study was to analyze the effect of a combination of tripod position and pursed lip breathing on respiration rate in COPD patients at Bangil Hospital. In this study, a pre-experimental method was used to determine the effect of giving a combination of tripod position and pursed lip breathing on respiration rate in COPD patients at Bangil Hospital, Pasuruan. The population in this study were all COPD patients at Bangil Hospital Pasuruan in June 2021 as many as 30 people. The sampling technique in this study was consecutive sampling. The sample used in this study were some COPD patients at Bangil Hospital, Pasuruan. From the results of the research above, there are differences in the decrease in respiration rate , this can be caused by differences in the accuracy of respondents when doing pursed lip breathing , respondents who can do it correctly will get better results in reducing respiration rate . It can be concluded that there is an effect of giving a combination of tripod position and pursed lip breathing on respiration rate in COPD patients at Bangil Hospital, Pasuruan.

Penerapan Intervensi Pursed-Lips Breathing Meningkatkan Arus Puncak Ekspirasi pada Pasien Penyakit Paru Obstruksi Kronik

This study aims to determine the magnitude of the effect of pursed-lip breathing (PLB) exercises on increasing the highest flow achieved by maximal expiration peak expiratory flow (APE) in COPD patients at Jakarta Islamic Hospital Cempaka Putih based on the latest research results (evidence-based Nursing Practice). This study uses a quantitative method with a type of quantitative experimental research with a quasi-experimental approach. The results showed that the results of APE measurements before and after PLB breathing exercises to male COPD sufferers at the Jakarta Islamic Hospital showed that, in general, the effects of APE before and after PLB breathing exercises on Day-1 were 278.3 liters or minutes and general after PLB Day-1 breathing exercise was 290.0 greater. From the results of the T-Test experiment, it can be interpreted that there is a significant comparison between APE before and after PLB with the number P = 0.000 or statistically in general APE before and after PLB is smaller than in general in male respondents by (290.0– 278.3 =11.7). In conclusion, age is related to the increased value of pulmonary ventilation function in COPD patients. Age may explain the increased peak expiratory pulmonary flow in COPD patients. Thus there is a significant relationship between age and an increase in the height expiratory flow (APE) value of COPD patients after receiving pursed-lips breathing intervention.&#x0D; &#x0D; Keywords: Peak Expiratory Flow, Chronic Obstructive Pulmonary Disease, Pursed-Lip Breathing&#x0D;

Effect of Pursed lip Breathing Exercise to Reduce Dyspnea in Patient with Asthma Bronchial: Case Study

Asthma causes chronic inflammatory disorders of the respiratory tract resulting in the narrowing of the airways so that asthmatics will complain, shortness of breath, heavy chest, and coughing, especially at night or early in the morning. One effort that can be done to overcome shortness of breath and improve oxygenation status is pursed-lip breathing which is a non-pharmacological therapy. This case study was conducted to analyze the application of pursed-lip breathing exercises to asthmatic patients who experience shortness of breath. This study used an evaluative design, namely a case study in asthmatic patients with shortness of breath. After observing the administration of pursed-lip breathing exercise for 3 days of treatment, there were changes in respiration rate, decreased breathing and shortness of breath. Pursed-lip breathing can reduce shortness of breath in asthma patients.

Mixed reality and sensor real-time feedback to increase muscle engagement during deep core exercising

In lower extremity amputee rehabilitation programs, difficult-to-master targeted activation of deep core muscles and pursed-lip breathing training are prescribed to treat poor movement quality and to improve recovery after amputation. Non-invasive wireless sensors and mixed reality (MR) technologies are proposed as a solution. The main aim was to validate a novel rehabilitation technology by exploring whether a combined verbal and visual mixed reality feedback (VF + MR) will initiate a greater change in muscle electrical activation magnitude compared to verbal feedback only (VF) during exercising. The second objective was to evaluate the effectiveness of specific exercise program targeted to engage specifically deep core muscles. Pre-post-test cross-over study involved electromyographic activity (EMG) analysis from Transversus Abdominis (TA) and Multifidus (MF) muscles and self-reported questionnaires to evaluate the efficiency of MR feedback. Anthropometric data, state of health, subjective low back pain (Oswestry Disability Index), and physical activity level (IPAQ) estimation were analysed. The data from 13 patients following unilateral transtibial and transfemoral amputation showed a significant EMG increase in (VF + MR) for Chair Lean (p = 0.03) and Bent Leg Raise (p = 0.0005) exercises for TA muscle. Even though there was no significant difference in Back Bridge and Side Plank exercises, 6 to 10 participants depending on the exercise, had an increase of EMG in the range of 50–400% for both – TA and MF muscles. The proposed solution has a high potential for increasing motivation, self-awareness, and muscle engagement during exercises, based on EMG and self-reported questionnaire data.

Cesarean section in Swyer-James-Macleod syndrome: Anesthesia implications.

Dear Editor, Swyer-James-MacLeod Syndrome (SJMS) is a rare, acquired postinfectious condition characterized by bronchiectasis or emphysematous changes.[1,2] These patients have a high risk of perioperative pulmonary complications. A 28-year-old primigravida, at 24 weeks of gestation, came with dyspnea on exertion (grade-3) for the 3 months with no history of recurrent infections. On examination, there was diminished breath sounds on the left side. Chest radiograph (done with abdominal shield) showed left hyperlucent lung with reduced vascular markings and slight mediastinal shift. Rest of the investigations were normal. The patient was referred to chest physician for optimization and a diagnosis of Swyer-James syndrome with left lung bulla/pneumothorax was made. The patient was managed with bronchodilators (Metered-Dose Inhaler levosalbutamol and Tiotropium bromide) and breathing exercises (pursed-lip breathing, diaphragmatic breathing). Spirometry was not done since the patient was in the second trimester of pregnancy. The patient got symptomatically better and an elective cesarean section was planned. Blood gas analysis performed a day before surgery showed PH: 7.441, PCO2:25.6, PO2 = 70.6, Bicarbonate = 17, Base excess = 7.21, Oxygen saturation = 94.4%. High-risk written consent was taken and expected complications were explained. On the day of surgery, the patient was taken in the operation theatre after giving inhalational bronchodilators. Ondansetron 4 mg and ranitidine hydrochloride 50 mg were given intravenously 30 min prior to surgery. A 20-G intravenous cannula was secured, Ringer lactate was started and vital parameters were monitored. Spinal anesthesia with 10 mg of heavy bupivacaine and 25 micrograms of fentanyl in the right lateral position was given. The intraoperative period was uneventful. SJMS was first described in 1953 by Swyer and James, and later explained in detail by MacLeod. A chest radiograph demonstrates lobar or unilateral hyperlucent lung and normal or reduced volume of the affected lung. Patients can present with a multitude of symptoms ranging from asymptomatic with incidental radiographical diagnosis to severe symptoms such as dyspnea and repeated pulmonary infections.[1,2] This syndrome is usually diagnosed in childhood after an evaluation for recurrent respiratory infections, but sometimes they are asymptomatic and may be diagnosed in adulthood.[3,4] In a case series by S. S. Hadice et al.,[3] three out of four patients had no history of airway infection in childhood and were diagnosed in adulthood. The clinical incidence of SJMS in pregnancy is 1:2500.[2] The management focuses on early diagnosis, prevention, and treatment of recurrent pulmonary infections and vaccine administration.[2–4] Severe cases of SJMS may require anesthetic care cautiously tailored to significant obstructive pulmonary physiology.[5] Regional anesthesia should be preferred whenever feasible. Chopra S et al.,[2] reported the successful delivery in a case of SJMS under spinal anesthesia in emergency. Labor epidural anesthesia can also be used in electively scheduled patients and supplemented with low-dose spinal anesthesia before surgery, if required. General anesthesia is associated with risk of bulla rupture, worsening of pneumothorax, and other pulmonary complications. Drugs that can cause histamine release and bronchoconstriction should be avoided. Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient and her father have given their consent for his images and other clinical information to be reported in the journal. The patient and father understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.

Early pulmonary rehabilitation of COVID-19 patients in an isolation ward and intensive care unit.

When patient with coronavirus disease 2019 (COVID-19) are hospitalized, the limited space for activity, disease itself causes fever, muscle aches, fatigue, respiratory failure with mechanical ventilation, or medications such as steroids or neuromuscular blocking can cause muscle dysfunction. Pulmonary rehabilitation (PR) should be arranged for these patients with COVID-19. However, the literature on early PR within 1 week of admission on patients with COVID-19 are limited. This review focuses on early PR in COVID-19 patients admitted to isolation wards or intensive care units. The essential components of early PR programs include education, breathing exercise, airway clearance, and physical activity training. Breathing exercises, including diaphragmatic and pursed-lip breathing, are known to improve lung function in chronic obstructive pulmonary disease and are also recommended for COVID-19 patients. Poor airway clearance can further aggravate pneumonia. Airway clearance techniques help patients to clear sputum and prevent the aggravation of pneumonia. Early physical activity training allows patients to maintain limb muscle function during hospitalization. It is recommended to design appropriate indoor exercise training for patients with frequency 1-2 times a day, and intensity should not be too high (dyspnea Borg Scale ≤3) in the acute stage. In order to achieve safe training, criteria for selecting stable patients and training termination are important. Early PR may help reduce the length of hospital stay, maintain functional status, improve symptoms of dyspnea, relieve anxiety, and maintain health-related quality of life in these patients after discharge.

Initial Treatment of High-Altitude Pulmonary Edema: Comparison of Oxygen and Auto-PEEP

Improvement of oxygenation is the aim in the therapy of high-altitude pulmonary edema (HAPE). However, descent is often difficult and hyperbaric chambers, as well as bottled oxygen, are often not available. We compare Auto-PEEP (AP-Pat), a special kind of pursed lips breathing, against the application of bottled oxygen (O2-Pat) in two patients suffering from HAPE. We compare the effect of these two different therapies on oxygen saturation measured by pulse oximetry (SpO2) over time. In both patients SpO2 increased significantly from 65-70% to 95%. Above 80% this increase was slower in AP-Pat compared with O2-Pat. Therapy started immediately in AP-Pat but was delayed in O2-Pat because of organizational and logistic reasons. The well-established therapies of HAPE are always the option of choice, if available, and should be started as soon as possible. The advantage of Auto-PEEP is its all-time availability. It improves SpO2 nearly as well as 3 L/min oxygen and furthermore has a positive effect on oxygenation lasting for approximately 120 min after stopping. Auto-PEEP treatment does not appear inferior to oxygen treatment, at least in this cross-case comparison. Its immediate application after diagnosis probably plays an important role here.

Pulmonary Rehabilitation and Breathing Exercise Effectiveness for Post COVID-19 survivors

<h3>Objective(s)</h3> Residual effects of Covid-19 on respiratory system are often destructive and depilating. Several rehabilitation approach are suggested in literature. This review aims to summarize and compare the available evidence on the current pulmonary rehabilitation therapy following COVID-19. <h3>Data Sources</h3> A computer search was conducted using PubMed, CINAHL, and ERIC using keywords ‘COVID-19',‘respiratory therapy,' OR ‘rehabilitation,' OR ‘physiotherapy,' OR ‘physical therapy,' OR ‘corticosteroid,' OR ‘respiratory rehabilitation,' OR ‘traditional Chinese medicine,' OR ‘aerobic therapy' AND ‘COVID-19 patients'. A narrative synthesis was used to evaluate the selected literature. The search was limited to the English language, human, and the year 2010 to present. <h3>Study Selection</h3> Studies were reviewed independently and those with the focus of COVID-19 and medication, traditional Chinese Medication, respiratory rehabilitation, and aerobic exercise interventions were included. Total of 27 articles were included in the final review. <h3>Data Extraction</h3> An independent extraction of data was performed on demographics, methodology, intervention, and outcomes. <h3>Data Synthesis</h3> Methods of medication (i.e. corticosteroids, antivirals, and Cardiopulmonary [CP] therapy), traditional Chinese Medicine (i.e. herbal medicine and pediatric massage and acupuncture), respiratory rehabilitation (i.e. incentive spirometer use, pursed-lip breathing, diaphragmatic techniques, and airway clearance techniques) and aerobic exercise were reviewed. Although all approaches showed some level of effectiveness, in medication approach, antivirals and CP therapy seems to be most effective for severe cases of COVID-19. Respiratory rehabilitation appears to best benefit inpatient/acute cases of COVID-19. Aerobic exercise is reported to have a promising positive effects, but a clear outline and parameters are yet to be determined. <h3>Conclusions</h3> Post COVID-19 pulmonary rehabilitation appears to vary significantly based on the severity of COVID-19 infection/symptoms and individual responses. There is a limited knowledge of the field due to recent occurrence of the disease and lack of information on the new strains of the virus. <h3>Author(s) Disclosures</h3> There is no conflict of interest associate with this study for any of the authors.

Efektivitas Diafragmatic dan Pursed Lip Breathing Exercise Terhadap Frekuensi Nafas Pasien Asma

Background, bronchial asthma is a type of long-term or chronic disease of the respiratory tract characterized by inflammation and narrowing of the airways which causes shortness of breath or difficulty breathing. Apart from having difficulty breathing, people with asthma can also experience other symptoms such as chest pain, coughing and wheezing. The purpose of this study was to determine the effectiveness of diaphragmatic and pursed lip breathing exercise on respiratory frequency in asthma patients in Public Health Center Jembatan Kecil Bengkulu City. Methods. This type of research is a quantitative study using a Quasy Experiment design with a research design of two groups pre test and post test design. Samples in the study of asthma patients were taken from January-December 2020 and January-April 2021 in Public Health Center Jembatan Kecil Bengkulu City. Results, from the results of statistical tests, it was found that the p-value before and after pursed lip breathing intervention was 0.001, which means that there was an effect on the frequency of breathing in asthmatic patients and the intervention before and after diaphragmatic breathing exercise was p value 0.002, meaning influence on the frequency of breath in asthma patients. Meanwhile, the average difference in frequency reduction in patients with asthma was the most effective diaphragmatic breathing exercise intervention with an average value of 2.750. Conclusion, the most effective intervention between pursed lip breathing and diaphragmatic breathing exercise is the diaphragmatic breathing exercise intervention.

Development and Validation of an Evidence-Based Breathing Exercise Intervention Protocol for Chronic Pain Management in Breast Cancer Survivors

BackgroundBreathing exercise has been utilized as a promising approach to pain management in cancer survivors. However, the development process of the breathing exercise intervention protocol was rarely reported. AimTo develop an evidence-based breathing exercise intervention protocol for chronic pain management in breast cancer survivors and to provide a detailed account of the intervention development process. MethodsThe study design was guided by the Medical Research Council Framework for Developing and Evaluating Complex Intervention. The breathing exercise intervention development process adopted phase one of the Medical Research Council Framework for Developing and Evaluating Complex Intervention framework. The content validity index was applied to determine the consensus of the appropriateness of the breathing exercise intervention protocol among the panel experts. ResultsThe preliminary breathing exercise intervention protocol was developed based on fight-or-flight theory and vagus nerve theory, and the best available research evidence identified from seven systematic reviews, three clinical trials, and four practice recommendations. The breathing exercise intervention was designed as slow deep pursed-lip breathing with a time ratio of inspiration to expiration 1:2-3. The intensity of the breathing exercise was determined as 3 to 5 sessions a day, 5 minutes per session, for 4 weeks. The content validity of the breathing exercise intervention protocol was excellent as consensus was achieved among all panel experts with both the item-level and scale-level CVIs reaching 1.0. ConclusionsThis study developed an evidence-based breathing exercise intervention protocol for chronic pain management in breast cancer survivors. The protocol is well-supported by the relevant theories, research evidence, practice recommendations, and experts’ consensus.