Effects of BBT Versus Diaphragmatic Breathing on Exercise Capacity and Quality of Life in Patients With COPD

Study Overview
=================
Brief Summary
-----------------
Group A will be treated with manual chest physical therapy and Buteyko breathing technique Group-B will be treated with manual chest physical therapy and Diaphragmatic breathing technique. Patients will perform the technique 5 times a weeks for 8weeks and treatment evaluation will be done after 8 weeks

Detailed Description
-----------------
A randomized clinical trial will be conducted at Gulab Devi Hospital, Lahore through convenience sampling technique on 48 patients which will be allocated through simple random sampling through sealed enveloped into group A and group B. Pre-treatment values of patients exercise capacity will be recorded by 6MWT/6MWD- 6 minute walk test/ 6 minutes' walk distance and patients quality of life through St George respiratory questionnaire as primary outcomes while oxygen saturation, heart rate will be measured by pulse oximtery during 6MWT as secondary outcomes. Group A will be treated with manual chest physical therapy and Buteyko breathing technique Group-B will be treated with manual chest physical therapy and Diaphragmatic breathing technique. Patients will perform the technique 5 times a weeks for 8weeks and treatment evaluation will be done after 8 weeks. Data will be analyzed using SPSS software version 25.After assessing normality of data by Shapiro-Wilk test , it will be decidedeither parametric or non-parametric test will be used.

Official Title
-----------------
Effects of BBT Versus Diaphragmatic Breathing on Exercise Capacity and Quality of Life in Patients With COPD

Conditions
-----------------
Breathing Technique

Intervention / Treatment
-----------------
* Other: Buteyko breathing technique
* Other: Diaphragmatic breathing technique.


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Age group : 40-65 years Both males and females Clinical diagnosis of COPD confirmed by smoking history and PFT airflow Patients taking their regular medications e.g bronchodilator Exclusion Criteria: Restrictive lung disease Pneumothorax Resting O2 saturation <90% with room air breathing Recent exacerbations Patients with active viral or bacterial infection Abdominal or thoracic surgery (<3months ago) Cardiologic conditions (<6months ago e.g Myocardial infarction or unstable angina Intubated Patients Orthopedic or urogenital conditions Neurological disorders limiting cognition & mobility

Ages Eligible for Study
-----------------
Minimum Age: 40 Years
Maximum Age: 65 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Group A will be treated with manual chest physical therapy and Buteyko breathing technique Group-B will be treated with manual chest physical therapy and Diaphragmatic breathing technique. Patients will perform the technique 5 times a weeks for 8weeks and treatment evaluation will be done after 8 weeks.
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: manual chest physical therapy and Buteyko breathing technique<br>Group A will be treated with manual chest physical therapy and Buteyko breathing technique | Other: Buteyko breathing technique<br>* Group A : will be treated with manual chest physiotherapy & Buteyko Breathing exercise<br>|
| Experimental: manual chest physical therapy and Diaphragmatic breathing technique.<br>Group-B will be treated with manual chest physical therapy and Diaphragmatic breathing technique. | Other: Diaphragmatic breathing technique.<br>* Group B : will be treated with manual chest physiotherapy & Diaphragmatic Breathing Treatment evaluation will be done after 8 weeks through 6MWT & St George respiratory Questionnaire. Patients will perform technique 5 times a weeks for 8 weeks<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| 6 Minute Walk Distance | Distance will be measured in meter through 6 minute walk test. | 4 weeks. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| St George Respiratory Questionnaire for quality of life : | St George Respiratory Questionnaire/SGRQ is a well established disease specific for health status in asthma and COPD (26).A total three component scores are provided , symptoms (8 items) , activity (16 items) and impacts (26 items), 50 items vary as likert type scale and dichotomus (true/false). In the symptom component , patients are instructed to recall their symptoms in a specific time frame of 1 month , 3 months or 1 year. Other items are not time specific.Scores ranged from 0 ( no impairment ) to 100 ( worst health status) | 4 weeks. | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Chronic obstructive pulmonary disease/COPD, Diaphragmatic breathing technique