Effect of Pursed-lips Breathing Combined With Aerobic Walking Exercise on Oxygenation and Activity Endurance in Lung Cancer Patients After Lobectomy

Study Overview
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Brief Summary
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The effects of pursed-lip breathing or aerobic walking exercise in increasing muscle strength and motility and relieving dyspnea have been proved. However, patients with lung cancer often have decreased lung function and exercise capacity after lobectomy. The aim of this study was to explore the effects of pursed-lip breathing combined with aerobic walking exercise on postoperative oxygenation and exercise tolerance of lung cancer patients underwent lobectomy.

Detailed Description
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An randomized controlled trial was used. Sixty eligible subjects from the Department of Thoracic Surgery of a regional hospital in central Taiwan participate in this study. A total of sixty subjects were randomly and equally assigned to the experimental group, control group I and control group II, to carry out postoperative both pursed lip breathing and aerobic walking exercise, pursed lip breathing, and aerobic walking exercise respectively. All three interventions were conducted 3 times a day, each lasting 15 minutes, from the 1st to 5th day after the operation. Pretests were done before the start of the three interventions on the first postoperative day, and posttests were done after the completion of the three interventions on the 5th postoperative day. Data including 6-minute walking test, Dyspnea Visual Analogue Scale, Rating scale of perceived exertion, peak expiratory flow rate and SpO2 were collected.

Official Title
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Effect of Pursed-lips Breathing Combined With Aerobic Walking Exercise on Oxygenation and Activity Endurance in Lung Cancer Patients After Lobectomy

Conditions
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Complications During Rehabilitation Stay

Intervention / Treatment
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* Behavioral: pursing- lip breathing combined with aerobic walking exercise
* Behavioral: pursing- lip breathing
* Behavioral: aerobic walking exercise


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Participants aged over 20 who have been informed of the research process and are willing to participate and sign consent. Participants with clear consciousness, the ability to communicate in Mandarin or Taiwanese, and the ability to walk independently. Participants diagnosed with lung cancer who have undergone lung lobe resection surgery. Exclusion Criteria: Changes in the surgical plan, not undergoing at least a single lung lobe resection. Deterioration of postoperative condition, making it impossible to correctly perform pursed lip breathing or aerobic walking exercises.

Ages Eligible for Study
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Minimum Age: 20 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: The experimental group was given pursed-mouth breathing training combined with aerobic walking exercise. Control group I was given pursed-mouth breathing training. Control group II was given aerobic walking exercise.
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: experimental group -pursing- lip breathing combined with aerobic walking exercise<br>For the pursed-lip breathing combined with aerobic walking exercise group (experimental group), subjects were taught to coordinate their breathing with their walking. They were instructed to inhale for two steps and exhale with pursed lips for four to five steps. Initially, they were allowed to walk at a pace that felt comfortable to them, and then gradually increase their walking speed until they reached the target aerobic heart rate, calculated using the formula: (220 - age) × 55-65% of maximum heart rate. During the walking exercise, a pulse oximeter was used to monitor their heart rate and blood oxygen saturation. Training sessions were conducted daily from the first day after surgery until the fifth day, with three sessions each day, and each session lasting for 15 minutes. | Behavioral: pursing- lip breathing combined with aerobic walking exercise<br>* pursing- lip breathing combined with aerobic walking exercise<br>|
| Active Comparator: Control group 1-pursed-lip breathing<br>For the group receiving single pursing- lip breathing training (control group 1), subjects were taught to perform deep inhalation through the nose (counting mentally from 1 to 2) while in a seated or standing position. They were then instructed to purse their lips and exhale slowly and steadily (counting mentally from 1 to 4). During the walking exercise, a pulse oximeter was used to monitor their heart rate and blood oxygen saturation. Training sessions were conducted daily from the first day after surgery until the fifth day, with three sessions each day, and each session lasting for 15 minutes. | Behavioral: pursing- lip breathing<br>* pursing- lip breathing<br>|
| Active Comparator: Control group 2 -aerobic walking exercise<br>For the single aerobic walking exercise group (control group 2), subjects were taught to start with their own acceptable stride and pace and then gradually increase their walking speed until they reached the target aerobic heart rate. Pulse oximeters were used to monitor their heart rate and blood oxygen saturation levels during the process. During the walking exercise, a pulse oximeter was used to monitor their heart rate and blood oxygen saturation. Training sessions were conducted daily from the first day after surgery until the fifth day, with three sessions each day, and each session lasting for 15 minutes. | Behavioral: aerobic walking exercise<br>* aerobic walking exercise<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Effect on Postoperative Oxygenation in Lung Cancer Patients | Measurements were taken on the 1st day after surgery, prior to the intervention. The pulse oximeter was placed on the patient's fingertip, and after a 5-second wait, the SpO2 value appeared on the monitor interface, which was then recorded on the data sheet. | pretests(before the start of the three interventions on the post-op day 1) | 
| Effect on Postoperative Oxygenation in Lung Cancer Patients | Measurements were taken on the 5th day after surgery, after three activities. The pulse oximeter was placed on the patient's fingertip, and after a 5-second wait, the SpO2 value appeared on the monitor interface, which was then recorded on the data sheet. | posttests(after the completion of the three interventions on the post-op day 5) | 
| Effect on Postoperative Oxygenation in Lung Cancer Patients | Dyspnea Visual Analogue Scale (DVAS):Draw a vertical 10 cm line on an A4 white paper. Label the top end of the line as Not Breathless and the bottom end as Very Breathless. The longer the distance marked on the line, the more severe the breathlessness. Measurement Method: Measurements were taken on the 1st day after surgery, prior to the intervention. After the patient completes a six-minute walk test, they mark their level of breathlessness on the vertical line to assess the degree of breathlessness. | pretests(before the start of the three interventions on the post-op day 1) | 
| Effect on Postoperative Oxygenation in Lung Cancer Patients | Dyspnea Visual Analogue Scale (DVAS): Draw a vertical 10 cm line on an A4 white paper. Label the top end of the line as Not Breathless and the bottom end as Very Breathless. The longer the distance marked on the line, the more severe the breathlessness. Measurement Method: Measurements were taken on the 5th day after surgery, after three activities. After the patient completes a six-minute walk test, they mark their level of breathlessness on the vertical line to assess the degree of breathlessness. | posttests(after the completion of the three interventions on the post-op day 5) | 
| Effect on Postoperative activity endurance in Lung Cancer Patients | Six-minute walking test (6MWT) : A long, flat, unobstructed hospital corridor is selected as the testing location. The floor is marked every 1 meter, covering a total distance of 30 meters. Patients are instructed to walk back and forth within the marked distance. Before the test, patients are informed to walk at the fastest pace they can tolerate and that they can slow down or pause if they experience any physical discomfort during the test. The test lasts for six minutes, and when the time is up, patients stop walking. The location where patients stop is recorded, corresponding to a marked point on the floor. The distances covered are summed up to determine the test result. | pretests(before the start of the three interventions on the post-op day 1) | 
| Effect on Postoperative activity endurance in Lung Cancer Patients | Six-minute walking test (6MWT) : A long, flat, unobstructed hospital corridor is selected as the testing location. The floor is marked every 1 meter, covering a total distance of 30 meters. Patients are instructed to walk back and forth within the marked distance. Before the test, patients are informed to walk at the fastest pace they can tolerate and that they can slow down or pause if they experience any physical discomfort during the test. The test lasts for six minutes, and when the time is up, patients stop walking. The location where patients stop is recorded, corresponding to a marked point on the floor. The distances covered are summed up to determine the test result. Measurements were taken on the 1st day after surgery before the intervention. | posttests(after the completion of the three interventions on the post-op day 5) | 
| Effect on Postoperative activity endurance in Lung Cancer Patients | Rating scale of perceived exertion (RPE / Borg 6-20):This scale ranges from 6 points (indicating no perceived exertion) to 20 points (indicating maximal exertion). Higher scores indicate a higher level of perceived exertion.Measurements were taken on the 1st day after surgery before the intervention. After the six-minute walking test, patients were asked to circle the score on the scale that corresponds to their perceived level of exertion to assess the level of exertion felt by patients after activity. | pretests(before the start of the three interventions on the post-op day 1) | 
| Effect on Postoperative activity endurance in Lung Cancer Patients | Rating scale of perceived exertion (RPE / Borg 6-20):This scale ranges from 6 points (indicating no perceived exertion) to 20 points (indicating maximal exertion). Higher scores indicate a higher level of perceived exertion.Measurements were taken on the 5th day after surgery after three separate activities. Following the six-minute walking test, patients were asked to circle the score on the scale that corresponds to their perceived level of exertion to assess the level of exertion felt by patients after activity. | posttests(after the completion of the three interventions on the post-op day 5) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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lung cancer, lobectomy, pursed-lip breathing, aerobic walking, oxygenation, exercise tolerance