Efficacy of Pulmonary exercise administered in Supine, 45°, or 90° long sitting position on cardiopulmonary parameters and quality of life of patients with chronic obstructive pulmonary disease: A Randomized Control Trial Study Protocol.

Abstract

Background: Pulmonary rehabilitation (PR) is a program commonly structured for the rehabilitation of chronic lung diseases like Chronic Obstructive Pulmonary Disorders (COPD), chronic bronchitis, and emphysema. It aims to increase the patients' quality of life by decreasing the symptoms frequently experienced from respiratory diseases. 

Aim: The overall aim of the study is to compare the effect of pulmonary exercises administered on COPD patients in Supine, 45° or 90° body position on selected cardiopulmonary parameters and quality of life of COPD patients and identify the most efficacious body position during its
administration. 

Methods: Forty-two (42) female and male patients aged forty (40) years and above with COPD of greater than six months duration, diagnosed at the respiratory unit of the Lagos State University Teaching Hospital (LASUTH) will be assessed for eligibility for the study. Patients on hospital admission, recent history of myocardial infarction, and on cardiac pacemakers will be excluded from the study. Eligible participants will be required to attend the study Centre three (3) times per week for a period of 12 weeks, with each session encounter not exceeding 30 minutes. The study design will be a randomized parallel-group design with three intervention groups and three parallel placebo control groups. Active Cycle of Breathing Technique (ACBT), Autogenic drainage (AD), and Reciprocal Pulley Exercise (RPE) will be administered as an intervention in various body position for 5 minutes, respectively. Ten continuous outcomes (FVC, FEV1, PEFR, FEV1/FVC, FEF 25-75%, SP02, HR, RR, SBP, and DBP) will be measured at baseline, before and after every (treatment) procedure. Short Form 36 (SF-36) Health Survey Questionnaire, Medical Research Council (MRC) dyspnea scale, Six Minutes' Walk Test (6MWT), and COPD Assessment Test (CAT) will be assessed fortnightly on a six-time points per subject. Data obtained will be analyzed using descriptive statistics of bar charts and pie charts, while a one-way repeated measures MANOVA will be utilized as inferential statistics to evaluate the normality, variance equality, continuity of data, and a test of statistical significance within and between group interactions at P≤0.05. 

Discussion: The study outcome will determine the efficacy of ACBT, AD, and RPE in supine, 45°, and 90° body positions on selected cardiopulmonary parameters and quality of life of patients with COPD and identify the most efficacious body positioning in the administration of the pulmonary exercises. Trial Registration: www.pactr.org: PACTR202005890624077