Seo Yaewon, Yates Bernice, LaFramboise Louise, Pozehl Bunny, Norman Joseph F, Hertzog Melody
University of Nebraska Medical Center, Omaha, USA
University of Nebraska Medical Center, Omaha, USA.
West J Nurs Res. 2016 Mar;38(3):270-91. doi: 10.1177/0193945915584201. Epub 2015 May 8.
Dyspnea limits physical activity and functional status in heart failure patients. This feasibility study examined effects of a diaphragmatic breathing retraining (DBR) intervention delivered over 8 weeks with follow-up at 5 months. The intervention group (n = 18) was trained at baseline and received four telephone calls. An attention control group (n = 18) received four telephone calls with general health information. Results from linear mixed model analysis with effect sizes (η(2)) showed dyspnea improved in both groups, with little difference between groups. Compared with attention alone, the intervention increased physical activity (calories expended; η(2) = .015) and functional status (η(2) = .013) across the 5-month follow-up and increased activity counts at 8 weeks (η(2) = .070). This intervention was feasible and demonstrated promising effects on activity and function but not by reducing dyspnea. Patients may have increased physical activity because of instructions to use DBR during activities of daily living. Further exploration of the intervention's underlying physiological effect is needed.
呼吸困难限制了心力衰竭患者的体力活动和功能状态。这项可行性研究考察了为期8周的膈肌呼吸再训练(DBR)干预措施的效果,并在5个月时进行随访。干预组(n = 18)在基线时接受训练,并接到4次电话。一个注意力控制组(n = 18)接到4次提供一般健康信息的电话。线性混合模型分析结果及效应量(η(2))显示两组的呼吸困难均有所改善,组间差异不大。与仅给予注意力相比,在5个月的随访期间,干预增加了体力活动(消耗的卡路里;η(2) = 0.015)和功能状态(η(2) = 0.013),并在8周时增加了活动计数(η(2) = 0.070)。这项干预措施是可行的,并且对活动和功能显示出有前景的效果,但不是通过减轻呼吸困难来实现。患者可能由于在日常生活活动中使用DBR的指导而增加了体力活动。需要进一步探究该干预措施潜在的生理效应。