The Effect of Deep Respiration and Prone Position on Common Respiratory Symptoms in Patients with COVID 19: A Randomized Clinical Trial

Sima Alipour Nasrabadsofla, Afshin Mansourian, Mohammad Gholamnezhad, Ardashir Afrasiabifar, Asadolah Mosavi, Shahla Najafi Doulatabad1

Abstract


Background: COVID‑19 causes many respiratory problems. The most common clinical manifestation is acute respiratory failure. Respiratory rehabilitation is an important part of treatment, but little is known about it. This study was carried out to determine the effect of deep respiration and prone position on common respiratory symptoms in patients with COVID‑19.

Materials and Methods: In this clinical trial that was conducted in a hospital in Yasuj city, Iran, in 2021, 96 patients with COVID‑19 were selected using a non‑random convenience sampling method and were randomly assigned to three groups of deep respiration, prone position, and deep respiration and prone position. Data were collected using the Borg Rating of Perceived Exertion scale, the Visual Analog Scale, pulse oximetry, and a researcher‑made checklist of patients’ respiratory rates. The interventions were performed for 1 week (2–8 hours daily) based on patient tolerance. Data were collected before and immediately after the intervention.

Results: There was no statistically significant difference (p > 0.05) among the three groups in terms of mean score of shortness of breath, intensity of symptoms, oxygen saturation of blood, and respiration rate before the interventions; however, significant differences were observed after the interventions (p < 0.05) in the three groups.

Conclusions: Deep respiration with prone position could improve respiratory symptoms in patients with COVID‑19 more than deep respiration or prone position alone. Respiratory exercise should be considered as a part of nursing cares and patients with respiratory symptoms should receive education in this regard.


Keywords


Prone position, Respiration, respiratory, Signs and symptoms, COVID 19

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References


. Mahase E. China coronavirus: WHO declares international emergency as death toll exceeds 200. BMJ 2020;368:m408.

Khafaie MA, Rahim F. Cross country comparison of case fatality rates of COVID 19/SARS COV 2. Osong Public Health Res Perspect 2020;11:74 80.

Wang W, Tang J, Wei F. Updated understanding of the outbreak of 2019 novel coronavirus (2019 nCoV) in Wuhan, China. J Med Virol 2020;92:441 7.

Ora J, Liguori C, Puxeddu E, Coppola A, Matino M, Pierantozzi M, et al. Dyspnea perception and neurological symptoms in non severe COVID 19 patients. Neurol Sci 2020;41:2671 4.

Kim ES, Chin BS, Kang CK, Kim NJ, Kang YM, Choi J P, et al. Clinical course and outcomes of patients with severe acute respiratory syndrome coronavirus 2 infection: A preliminary report of the first 28 patients from the Korean cohort study on COVID 19. J Korean Med Sci 2020;35:e142.

Jannat Alipoor Z, Fotokian Z. COVID 19 and the elderly with chronic diseases: Narrative review. Journal Mil Med 2020;22:632 40.

Kallet RH. A comprehensive review of prone position in ARDS. Respir Care 2015;60:1660 87.

Reis MS, Arena R, Archiza B, de Toledo CF, Catai AM, Borghi Silva A. Deep breathing heart rate variability is associated with inspiratory muscle weakness in chronic heart failure. Physiother Res Int. 2014;19:16 24.

Weiss TT, Cerda F, Scott JB, Kaur R, Sungurlu S, Mirza SH, et al. prone positioning for patients intubated for severe acute respiratory distress syndrome (ARDS) secondary to COVID 19: A retrospective observational cohort study. Br J Anaesth 2021;126:48 55.

Gleissman H, Forsgren A, Andersson E, Lindqvist E, Lipka Falck A, Cronhjort M, et al. Prone positioning in mechanically ventilated patients with severe acute respiratory distress syndrome and coronavirus disease 2019. Acta Anaesthesiol Scand 2021;65:360 3.

Alwan MK, Abd Mohsen RI. The effect of deep breathing exercise on oxygen saturation of patients with COVID 19. Mosul J Nurs 2022;10:51 5.

Yokogawa M, Kurebayashi T, Ichimura T, Nishino M, Miaki H, Nakagawa T. Comparison of two instructions for deep breathing exercise: Non specific and diaphragmatic breathing. J Phys Ther Sci 2018;30:614 8.

Heidari M, Fayazi S, Borsi H, Moradbeigi K, Akbari Nassaji N. Effect of a self management program based on 5A model on dyspnea and fatigue severity among patients with chronic obstructive pulmonary disease: A randomized clinical trial. J Hayat 2015;20:89 99.

Daneshmandi H, Choobineh AR, Rajaee Fard A R. Validation of Borg’s RPE 6 20 scale in male industrial workers of Shiraz city based on heart rate. Jundishapur Sci Med J 2012;11:1 10.

Yeung AWK, Wong NSM. The historical roots of visual analog scale in psychology as revealed by reference publication year spectroscopy. Front Hum Neurosci 2019;13:86.

Rezvani Amin M, Siratinayer M, Ebadi A, Moradian T. Correlation between visual analogue scale and short form of McGill questionnaire in patients with chronic low back pain. Qom Univ Med Sci J 2012;6:31 4.

Ashra F, Chen R, Kang XL, Chiang KJ, Pien LC, Jen HJ, et al. Effectiveness of prone position in acute respiratory distress syndrome and moderating factors of obesity class and treatment durations for COVID 19 patients: A meta analysis. Intensive Crit Care Nurs 2022;72:103257.

Öner Cengiz H, Ayhan M, Güner R. Effect of deep breathing exercise with Triflo on dyspnoea, anxiety and quality of life in patients receiving covid 19 treatment: A randomized controlled trial. J Clin Nurs 2022;31:3439 53.

Malik SS, Tassadaq N. Effectiveness of deep breathing exercises and incentive spirometry on arterial blood gases in second degree inhalation burn patients. J Coll Physicians Surg Pak 2019;29:954 7.

Serafim SD, da Ponte FDR, Lima FM, Martins DS, Rosa AR, Kunz M. Effects of deep breathing in patients with bipolar disorder. Perspect Psychiatr Care 2019;55:119 25.

Langer T, Brioni M, Guzzardella A, Carlesso E, Cabrini L, Castelli G, et al. Prone position in intubated, mechanically ventilated patients with COVID 19: A multi centric study of more than 1000 patients. Crit Care 2021;25:1 11.

Carsetti A, Paciarini AD, Marini B, Pantanetti S, Adrario E, Donati A. Prolonged prone position ventilation for SARS CoV 2 patients is feasible and effective. Crit Care 2020;24:1 3.

Lu H, Zhang P, Liu X, Jin L, Zhu H. Effect of prone position ventilation on right heart function in patients with acute respiratory distress syndrome. Clin Respir J 2021;15:1229 38.

Padrão EM, Valente FS, Besen BA, Rahhal H, Mesquita PS, de Alencar JC, et al. Awake prone positioning in COVID‐19 hypoxemic respiratory failure: Exploratory findings in a single‐center retrospective cohort study. Acad Emerg Med 2020;27:1249 59.

Westerdahl E, Wittrin A, Kånåhols M, Gunnarsson M, Nilsagård Y. Deep breathing exercises with positive expiratory pressure in patients with multiple sclerosis–A randomized controlled trial. Clin Respir J 2016;10:698 706.


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