Nursing-Based Sleep Promotion Intervention Effectiveness for Post Cardiac Surgery Patients: Systematic Review.

BACKGROUND: Sleep is a fundamental prerequisite for physical and mental health. Poor quality of sleep is common among post-cardiac surgery patients and leads to serious health conditions. OBJECTIVE: To conduct a systematic review that investigates the effectiveness of eye masks, earplugs and deep-breathing exercise on sleep quality among post-cardiac surgery patients. DESIGN: A systematic review of interventional studies was established to meet the PRISMA guidelines. METHODS: PRISMA guidelines were used to assess the findings of 11 selected studies that met the inclusion criteria, published between 2007 and 2023 across four databases: CINAHL, JDNR, MEDLINE and PubMed. The search was conducted on 23 November 2023. RESULTS: The 11 most eligible studies were analysed. All of them were interventional, encompassing a total of 787 participants. Randomised controlled trials were the most common design. Interventions included eye masks, earplugs and deep-breathing exercises. The Richards-Campbell Sleep Questionnaire was the most used assessment scale. Most of the reviewed studies found that the use of non-pharmacological interventions (eye masks, earplugs and deep-breathing exercise) significantly improves the quality of sleep. These interventions were also found to have potentially positive effects on reducing pain and delirium experienced by patients after undergoing cardiac surgery. CONCLUSIONS: Non-pharmacological interventions (eye masks, earplugs and deep-breathing exercise) were found to be cost-effective interventions that could be easily applied in the clinical setting and are effective in improving the quality of sleep among patients after cardiac surgery.

The effect of music therapy and breathing exercise on anxiety and pain in patients undergoing coronary angiography: A randomized controlled study.

BACKGROUND: For over 50 years, music therapy and breathing exercises have been widely utilized as interventions to help individuals cope with fatigue, stress and pain globally. AIM: To analyse the effects of music and breathing exercises on anxiety and pain in patients undergoing coronary angiography. STUDY DESIGN: This is a single-blind, randomized controlled trial. The sample comprised 165 patients: 55 in the control group, 55 in the breathing exercise group and 55 in the music therapy group. Patients in the music group listened to music during angiography, those in the breathing exercise group practised exercises 30 min before the procedure and the control group received standard treatment. Anxiety levels were assessed before and after the procedure, and pain levels were measured post-procedure. The Consolidated Standards of Reporting Trials (CONSORT) checklist for reporting randomized trials was used to guide reporting. RESULTS: Anxiety scores rose significantly in the control group from 33.9 ± 4.2 pre-angiography to 37.7 ± 4.9 post-angiography. Conversely, the breathing group's anxiety scores decreased from 34.3 ± 3.5 before angiography to 31.7 ± 1.5 after angiography, and the music group exhibited a reduction from 32.3 ± 3.6 to 30.8 ± 1.6. Post-angiography, the control group reported a mean pain score of 64 ± 0.8 mm, while the breathing and music groups had significantly lower scores of 35 ± 0.6 and 29 ± 0.8 mm, respectively. Statistical analysis showed a highly significant difference in pain scores between the intervention and control groups. CONCLUSIONS: This study provides support for the beneficial effects of employing breathing exercises and music in alleviating pain and anxiety during coronary angiography procedures. RELEVANCE TO CLINICAL PRACTICE: Integrating these findings into clinical practice could be significant for improving patients' pain experiences and anxiety, enhancing the tolerance of invasive medical procedures.

The Application of Self-Made Disseminating and Descending Breathing Exercises in Home Rehabilitation of Stable COPD.

To investigate the clinical effects and application value of self-made disseminating and descending breathing exercises on home rehabilitation of patients with stable chronic obstructive pulmonary disease (COPD). Seeking to generate concepts for creating novel, convenient, and efficient COPD prognosis rehabilitation exercises aimed at enhancing the well-being and rehabilitation confidence of both COPD patients and their families. A total of 70 COPD patients admitted to our outpatient department from July 2019 to September 2021 were randomly divided into the exercise group (n = 35) and the control group (n = 35). The control group received routine breathing training, while the exercise group was treated with self-made disseminating and descending breathing exercises. The respiratory function, including pulmonary function (FVC, FEV1, FEV1/FVC) and respiratory muscle strength (MIP, MEP), exercise tolerance (6-min walking distance, 6MWT), Modified Medical Research Council Dyspnea Scale (mMRC, Borg), COPD quality of life score (CAT, SGRQ), anxiety and depression scores (HAMA, HAMD) were compared between the two groups after 12-week exercise. After 12-week training, the FEV1, MIP, and MEP in the exercise group were significantly higher than those in the control group (p < 0.001), and the 6MWT was significantly increased in the exercise group compared to the control group (p < 0.001); while the mMRC, Borg score, the scores of CAT, SGRQ, HAMA, and HAMD were found significantly lower than those in the control group (p < 0.001). The self-made disseminating and descending breathing exercises can improve respiratory function and reduce symptoms of dyspnea in COPD patients, while enhancing exercise tolerance and relieving anxiety and depression, and are worthy of clinical application.

Randomized Controlled Trial on the Effects of Home-Based Breathing Exercises on Respiratory Function and Fatigue in COVID-19-Cured Young Patients.

This study investigates the effects of home-based Kakao Healthcare breathing exercises and stretching on respiratory function and fatigue in COVID-19-cured patients. A total of 35 participants performed four movements of home-based breathing exercises and five respiratory muscle stretching exercises four times a week for four weeks. Respiratory function was measured using forced vital capacity(FVC), forced expiratory volume in one second(FEV1), FEV1/FVC ratio, and peak expiratory flow(PEF). Fatigue was assessed using the Fatigue Severity Scale (FSS). Data analysis was performed using independent-sample and paired-sample t-tests in SPSS 24, with the significance level set at p < 0.05. After four weeks of home-based Kakao Healthcare breathing exercises, there were significant increases in respiratory FVC, FEV1, FEV1/FVC, and PEF function values observed in the training group (T.G.) after the exercise intervention (p < 0.05). Such an increase was observed when comparing these values with their corresponding pre-exercise measurements. In contrast, there were no statistically significant differences in respiratory function outcomes before and after exercise in the control group (C.G.) (p > 0.05). The FSS scores were statistically significant within the training group (T.G.) (p > 0.05). The 4-week Kakao Healthcare breathing exercise scheme was found to be capable of improving some respiratory functions in COVID-19-recovered patients, but it showed no significant improvement in fatigue levels.

Effect of Short-term Deep Breathing Exercises on Perioperative Anxiety and Pain in Pediatric Orthopedic Patients: A Randomized Controlled Trial.

PURPOSE: There are currently no pediatric studies examining the effects of deep breathing on perioperative pain and anxiety. This study sought to determine the effect of short-term deep breathing exercises on perioperative anxiety and pain in pediatric patients and their parents. DESIGN: A randomized controlled trial was conducted in the Department of Orthopaedic Surgery where pediatric patients about to undergo surgery were allocated to a control group or a deep breathing group. In the intervention group, patients and their main guardian were guided to practice 10 minutes of deep breathing exercises twice a day for 3 to 4 days prior to surgery. Perioperative anxiety and pain were measured for both the children and parents as outcome indicators. METHODS: Perioperative anxiety was measured using the modified Yale Preoperative Anxiety Scale-Short Form (mYPAS-SF) and state anxiety was measured using the State-Trait Anxiety Inventory (STAI). Patients reported their pain levels daily using the Wong-Baker FACES Pain Rating Scale. The following cutoffs were determined as high levels of anxiety: STAI (adult) > 44, STAI (child) > 36, and mYPAS-SF ≥ 30. FINDINGS: No significant differences were found in the STAI, mYPAS-SF, and Wong-Baker FACES Pain Rating Scale scores of the patients between the intervention and control group. Overall statistics showed that parents had significantly higher postoperative state anxiety levels toward female children (44.93 ± 9.01) compared to male children (40.18 ± 9.89). Preoperative and postoperative parental state anxiety levels were correlated with the child's postoperative anxiety. Furthermore, children's postoperative state anxiety was slightly correlated with postoperative pain. CONCLUSIONS: Short-term use of our deep breathing exercises was ineffective in reducing incidences of perioperative pain and anxiety in pediatric orthopedic patients. A longer period of deep breathing administration may be required for the intervention to be effective. Parental anxiety may have an effect on anxiety levels in children, and postoperative parental anxiety may be affected by the gender of the child.

An evidence-based breathing exercise intervention for chronic pain management in breast cancer survivors: A phase II randomized controlled trial.

OBJECTIVE: Explore the preliminary effects of a breathing exercise (BE) intervention on chronic pain among breast cancer survivors. METHODS: This two-parallel-arm, open-label pilot randomized controlled trial recruited 72 breast cancer survivors who were randomly allocated to either the control or intervention group (n = 36 each). Both groups received usual care and a pain information booklet, while the intervention group received 4 weeks of additional BE. The primary clinical outcome was measured using the Brief Pain Inventory (BPI), with secondary clinical outcomes measured by the Hospital Anxiety and Depression Scale (HADS), Quality of Life Patient/Cancer Survivor Version in Chinese (QOLCSV-C), and Functional Assessment of Cancer Therapy- Breast (FACT-B) immediately post-intervention and at 4-week follow-up. Both adjusted and unadjusted Generalized Estimating Equation models were utilized to assess the BE's potential effects, with safety assessed through participant self-report. RESULTS: Sixty-eight participants completed the study. Statistical significance was observed in BPI in both adjusted and unadjusted models at post-intervention and follow-up (p < 0.05). BE demonstrated positive effects on anxiety, depression and quality of life improvement across all measures and timepoints in both adjusted and unadjusted models (p < 0.05). The effect sizes were smaller in the adjusted model. Three mild transient discomforts were reported associated with BE practice including dizziness, tiredness and yawning, without requirement of medical treatment. No severe adverse events occurred. CONCLUSION: This BE intervention appears effective in alleviating chronic pain, anxiety and depression, and improving quality of life for breast cancer survivors. Fully powered large-scale studies are required to confirm its effects.

The effect of breathing exercises on chemotherapy-induced nausea and vomiting in autologous hematopoietic stem cell transplantation patients: A randomized controlled trial.

PURPOSE: This research was conducted as a randomized controlled study to examine the effect of breathing exercises on managing chemotherapy-related nausea and vomiting in patients who underwent autologous hematopoietic stem cell transplantation. METHODS: A randomized controlled trial design was used, including an intervention group doing breathing exercises and a control group receiving standard care for chemotherapy-induced nausea and vomiting. The sample was selected from patients hospitalized in the bone marrow transplantation unit. A total of 70 autologous hematopoietic stem cell transplantation patients (35 intervention and 35 control participants). Several variables were evaluated, including the frequence and degree of nausea and vomiting, the patient's nutritional status, and the need for antiemetics. Data were analyzed and interpreted using Mann Whitney U, Pearson chi-square test, Independent t-test, Mann Whitney U, and multiple linear regression. RESULTS: It was found that there was a negative relationship between the number of breathing exercises, the number of nausea and vomiting and the severity of nausea. As the number of breathing exercises increased, the number nausea and vomiting, and severity of nausea decreased significantly (p < 0.05). It was found that the use of antiemetics decreased in the intervention group. Furthermore, it was found that the intervention group had higher daily food consumption on the 3rd, 7th, and 9th days (p < 0.05). CONCLUSION: Breathing exercises were a practical approach to managing chemotherapy-related nausea and vomiting.

Neural Respiratory Drive During Different Dyspnea Relief Positions and Breathing Exercises in Individuals With COPD.

BACKGROUND: When the work load of the respiratory muscles increases and/or their capacity decreases in individuals with COPD, respiratory muscle activation increases to maintain gas exchange and respiratory mechanics, and perception of dyspnea occurs. The present study aimed to compare diaphragm and accessory respiratory muscle activation during normal breathing, pursed-lip breathing, and breathing control in different dyspnea relief positions, supine and side lying. METHODS: A cross-sectional study design was used. Sixteen individuals with COPD age between 40-75 y were included. Pulmonary function was evaluated by spirometry, muscle activation by surface electromyography, and dyspnea by the modified Borg scale. Muscle activation was measured in the diaphragm, scalene, sternocleidomastoid, and parasternal muscles. The evaluation was made in the dyspnea relief positions (sitting leaning forward, sitting leaning forward at a table, leaning forward with back against a wall, standing leaning forward, and high lying), seated erect, supine, and side lying. RESULTS: There were significant differences between the 8 positions (P < .001). There was no significant difference in muscle activation between sitting leaning forward and sitting leaning forward at a table position with analyzing post hoc test results (P > .99 for each muscle). However, muscle activation was lower in these 2 positions than in the other positions (P < .001 for each muscle). Muscle activation was greater in the supine position than in the other positions (P < .001 for each muscle). No difference was observed in muscle activation between the seated erect, leaning forward with back against a wall, standing leaning forward, high-lying, or side-lying positions (P > .05 for each muscle with a minimum P value of .09). CONCLUSIONS: The use of sitting leaning forward and sitting leaning forward at a table positions together with breathing control may help people with COPD to achieve more effective dyspnea relief and greater energy efficiency.

Effectiveness of upper arm and breathing exercises to improve inflammatory markers in severe COVID-19 patients.

Studies have suggested associations between inflammatory markers with the severity of coronavirus disease 2019 (COVID-19). Therefore, exercises that could reduce the level of inflammatory markers might be beneficial. The aim of this study was to determine the effect of upper arm and breathing exercises on inflammatory markers such as ferritin, lactate dehydrogenase (LDH), and C-reactive protein (CRP) in severe COVID-19 patients. A quasi-experimental with pre-test and post-test control group design was conducted among severe COVID-19 aged 18-70 years old, with or without comorbidities. Baseline data of inflammatory markers (ferritin, LDH, and CRP) were measured before the exercises and repeated post-exercise. The upper arm and breathing exercises were performed for ten days, twice a day (morning and evening) for ten minutes. A paired Student t-test was used to assess the changes in the inflammatory markers' levels. Our data indicated that levels of ferritin and CRP were not significantly different between pre- and post-exercise. However, the level of LDH decreased significantly from 481.35 U/L to 331.80 U/L (p=0.001). This study highlights that pulmonary rehabilitation exercises might be beneficial to enhance the recovery process in severe COVID-19 patients.

Advocating for Action: Exploring the Potential of Virtual Reality in Breathing Exercise - A Review of The Clinical Applications.

The emergence of virtual reality (VR) technologies is currently shaping the healthcare system and is now being employed in various healthcare interventions. Pulmonary rehabilitation remains one such area in which VR is currently thriving to ensure overall health and well-being. While the importance of these novel technologies is being primarily researched in pulmonary rehabilitation, especially over passive conventional breathing exercise training, there seems to be a limited number of studies that have comprehensively put together these findings. This study utilizes a scoping review methodology to review VR exercises in clinical settings related to pulmonary rehabilitation. To achieve this objective, three electronic databases (Web of Science, PubMed, and Cochrane Library) were searched using a formulated search string related to the research objective. Following the database search, a total of 236 references were retrieved and managed using the reference manager. The screening of references was conducted according to the PRISMA 2020 screening process, and their quality was assessed using the JBI checklist. Ultimately, a total of eight publications of high quality were selected for inclusion in the scoping review. The results of the synthesis validate the importance of utilizing VR in the context of breathing exercise in rehabilitation. The effectiveness and rapid development of VR breathing exercises are primarily attributed to the engaging and immersive experience they provide. The use of biofeedback and self-regulation techniques into VR exercise systems was also seen to have a notable impact on the effectiveness of the breathing exercise system.

Effect of Breathing Exercise During Peripheral Venous Catheterization on Pain, Anxiety, and Patient Satisfaction: A Randomized Controlled Trial.

PURPOSE: This study was carried out to determine the effect of a breathing exercise during peripheral venous cathetererization on pain, anxiety, and patient satisfaction. DESIGN: Randomized Controlled Study. METHODS: The study was completed with a total of 130 individuals. Individuals in the intervention group performed diaphragmatic breathing exercises during catheterization. FINDINGS: The mean pain, anxiety, and satisfaction scores of the individuals in the intervention group were 0.29 ± 0.70, 3.18 ± 2.29, and 7.66 ± 2.20, respectively. In the control group, the mean pain score was 1.30 ± 1.47, the anxiety score was 4.35 ± 2.42, and the satisfaction score was 4.87 ± 1.63. The pain and anxiety levels of the individuals in the intervention group were lower and the satisfaction scores were higher than the control group. CONCLUSIONS: Breathing exercises reduced individuals' pain and anxiety levels and increased individuals' satisfaction. In addition, it reduced the application time, pulse rate, and blood pressure.

The Efficiency of Respiratory Exercises in Rehabilitation of Low Back Pain: A Systematic Review and Meta-Analysis.

BACKGROUND: Low back pain (LBP) is a common musculoskeletal disorder, and respiratory exercise is considered a nonsurgical management method. Therefore, this systematic review and meta-analysis aims to estimate the results of randomized controlled trials on the effect of respiratory training in reducing LBP and its dose relationship. METHODS: The present study was conducted from January 2020 to January 2022, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (2020). Relevant studies were searched in multiple databases including PubMed, Web of Science, the Cochrane Library, EBSCO, Scopus, ScienceDirect, Wan Fang and China Knowledge Network, ClinicalTrials.gov, and Google Scholar, using a combination of MeSH/Emtree terms and free-text words. The heterogeneity of the studies was assessed using the I2 statistic. RESULTS: A total of 14 publications were included in the meta-analysis, with a total sample size of 698 individuals, aged 60-80 years. Respiratory exercise was effective in relieving LBP (standardized mean difference = -0.87, P < .00001) and improving physical disability (standardized mean difference = -0.79, P < .00001). The type of breathing and the total duration of breathing exercises were found to be the source of heterogeneity in this study by subgroup analysis. Subgroup analysis revealed that the most significant effect sizes of breathing resistance exercise to reduce LBP and the most significant effect sizes of breathing relaxation techniques to alleviate physical disability were performed 3 to 5 times per week and period >4 weeks. Respiratory exercise reducing LBP and improving functional disability was most effective when the total duration of the intervention was >500 minutes. Funnel plots showed that the results of the 2 overall studies were reliable without publication bias. CONCLUSIONS: Respiratory exercise can effectively reduce LBP and improve physical disability. Therefore, these exercises can be regarded as a part of a LBP management plan. We recommend an exercise program with 30 to 50 minutes, 3 to 5 times per week, and >4 weeks of breathing resistance exercise program as the most effective for treating LBP.

Mind-Body Therapies in the Management of Otolaryngologic Disease: A State-of-the-Art Review of Randomized Controlled Trials.

OBJECTIVE: To review and assess the peer-reviewed literature on the utility of mind-body therapy (MBT) as an adjunct treatment in the management of otolaryngologic disease. DATA SOURCES: PubMed, Embase, and Cochrane. REVIEW METHODS: Randomized control trials (RCTs) of MBTs in the management of otolaryngologic disease from 2002 to 2022 were identified and included according to predefined criteria. Interventions requiring expensive equipment were excluded because the goal of MBT is to be cost-conscious. All studies were subjected to a two-stage blinded screening, extraction, and appraisal process. The outcomes of the intervention and control groups were compared. CONCLUSION: RCTs of MBTs, including breathing exercises (4), aromatherapy (2), biofeedback (2), meditation, (2), and yoga (2), have been studied in several otolaryngologic conditions, including septoplasty/rhinoplasty (3), head and neck cancer (2), facial palsy (2), and tinnitus (2). Most studies were of moderate risk of bias on appraisal, and each MBT studied was found to significantly reduce subjective and objective distress associated with the otolaryngologic condition in question. IMPLICATIONS FOR PRACTICE: Despite a paucity of strong evidence supporting the universal use of MBTs, our review suggests that MBTs are cost-effective and easily deployable complementary tools in the management of otolaryngologic disease. Future large, methodologically rigorous RCTs are needed to address the limitations of the included studies, such as improper blinding and inappropriate statistical analysis. As MBTs are studied further, a case for their current use can be made because of their low cost and minimal risk to patients.

Effect of comprehensive rehabilitation on apnea hypopnea index in patients with obstructive sleep apnea: a protocol for randomized controlled trial.

PURPOSE: The aim of this study is to investigate the effect of comprehensive rehabilitation on apnea hypopnea index (AHI) in patients with obstructive sleep apnea (OSA). METHODS: Patients diagnosed with OSA and meeting the eligibility criteria will be randomly allocated in the groups. The experimental group will receive comprehensive rehabilitation, and the control group will receive myofunctional therapy. CPAP will be continued by all the participants. Both the groups will receive the interventions for 12 weeks. The primary outcome measures are AHI and Epworth Sleepiness Scale (ESS), and secondary outcomes are Pittsburg Sleep Quality Index (PSQI), Oxygen Desaturation Index (ODI), Snoring Index (SI), Manual Assessment of Respiratory Motion (MARM), Breath Hold Test (BHT), and Self Evaluation of Breathing Questionnaire (SEBQ). The outcomes will be assessed at baseline and at the end of 12 weeks. A follow-up will be taken at the end of 24 weeks. Power analysis suggests that enrollment of 118 patients will required. Repeated measures ANOVA will be used to analyze the effect of the intervention. CONCLUSION: By performing this research, we may develop insights on a novel comprehensive approach for treatment of patients with OSA. TRIAL REGISTRATION: CTRI/2023/10/058486.

Effects of usual yoga practice on the diaphragmatic contractility: A cross-sectional controlled study.

Objectives: The aim of this study is to observe and compare the effects of regular yoga practice on the main inspiratory muscle, the diaphragm, by analyzing its thickness, excursion, velocity and contraction time, using ultrasound. Design: A Cross-Sectional Controlled Study. Participants: 80 healthy subjects (40 habitual yoga practitioners and 40 non-practitioners), without previous respiratory pathology participated in this study. During maximum diaphragmatic breathing, the diaphragmatic thickness (at rest and after maximum inspiration), excursion, velocity and contraction time were measured by ultrasound. Results: in the experimental group, practicing yoga, statistically significant differences (p < 0.001) were observed compared to the control group, not practicing, in the thickness of the diaphragm at rest (0.26 ± 0.02 vs 0.22 ± 0.01 cm); the diaphragmatic thickness in maximum inspiration (0.34 ± 0.03 vs 0.28 ± 0.03 cm); contraction velocity (1.54 ± 0.54 vs 2.23 ± 0.86 cm/s), contraction time (3.28 ± 0.45 vs 2.58 ± 0.49 s) and Borg scale of perceived exertion (1.05 ± 1.6 vs 1.70 ± 1.34), p = 0.05. However, the diaphragmatic excursion was greater in the control group (5.45 ± 1.42 vs 4.87 ± 1.33 cm) with no statistically significant differences (p = 0.06). Conclusions: the regular practice of yoga improves the parameters of diaphragm thickness, speed and contraction time measured in ultrasound and the sensation of perceived exertion during a maximum inspiration. So it can be considered as another method for training the inspiratory muscles in clinical practice.

Algorithm for Predicting Respiratory Motion of Liver Tissue Based on Short-Term Respiratory Monitoring.

In this study, an algorithm for predicting respiratory motion of liver tissue based on the combination of subject-specific external surrogate signals and 2D ultrasound image sequences was investigated to achieve better respiratory monitoring in clinical procedures. To achieve non-invasiveness in clinical procedures, an EM position tracker and a Doppler ultrasound diagnostic system were used as data collectors. Firstly, the mapping relationship between the magnetic sensing surrogate signal and the internal motion of liver tissue was learned by the Ridge regression model to achieve the estimation of the internal motion of liver tissue by the magnetic sensing surrogate signal; then the motion prediction of the estimated internal motion of liver tissue was performed by the artificial neural network (ANN) as the prediction filter; finally, the prediction of the respiratory motion of liver tissue by the magnetic sensing surrogate signal was achieved. Through experimental tests on 16 subject volunteers, the experimental results show that the RMSE of the proposed algorithm for predicting the respiratory motion of liver tissue is 2mm, indicating the potential of this prediction algorithm to achieve the localization of the internal motion position of liver tissue by the human magnetic sensing surrogate signal.

Physical exercise-intervention can be valuable therapy for COVID-19 confinement and post-COVID-19 periods.

PURPOSE: The COVID-19 pandemic and its transition into an endemic phase have profoundly impacted physical health, well-being, mental health, education, and various aspects of society, including the economy and social networks. Home confinement, social distancing, and physical inactivity have exacerbated numerous health issues, including obesity, diabetes mellitus, hypertension, hyperlipidemia, cardiovascular diseases, depression, and poor sleep quality. A systematic review has revealed significant findings: Regular aerobic programs (such as cycling or walking at an intensity of 60-80% of HR max for 20-60 minutes per session, repeated 2-3 times a week) have proven effective in improving both physical and mental health, as well as immune function. This type of physical activity has been shown to increase immunological markers, including lymphocytes, leukocytes, neutrophils, monocytes, and interleukin-6 (IL-6), while reducing low-grade inflammation. Therefore, in this study we aimed to assess the impact of tailored exercise interventions on the physical and mental health of COVID-19 patients. Based on the results, we can establish exercise intervention strategies to mitigate the negative health consequences during and after the COVID-19 pandemic. METHODS: We conducted a search of the PubMed database from January 2020 to August 2023 using predefined search terms such as "COVID-19 and post-COVID-19," "exercise intervention and immunity," and "mental health." By examining references, we explored the links between exercise interventions and the mental and physical health of COVID-19 patients. RESULTS: A tailored, multifaceted exercise intervention should be developed and implemented to address the existing mental challenges and enhance mental health during both the pandemic and the post-COVID-19 periods. CONCLUSION: Breathing exercises and respiratory support techniques, including yoga, thoracic expansion exercises, airway clearance methods, and breathing control, are likely to be beneficial.

Virtual Reality for Pulmonary Rehabilitation: Comprehensive Review.

BACKGROUND: Pulmonary rehabilitation is a vital component of comprehensive care for patients with respiratory conditions, such as lung cancer, chronic obstructive pulmonary disease, and asthma, and those recovering from respiratory diseases like COVID-19. It aims to enhance patients' functional ability and quality of life, and reduce symptoms, such as stress, anxiety, and chronic pain. Virtual reality is a novel technology that offers new opportunities for customized implementation and self-control of pulmonary rehabilitation through patient engagement. OBJECTIVE: This review focused on all types of virtual reality technologies (nonimmersive, semi-immersive, and fully immersive) that witnessed significant development and were released in the field of pulmonary rehabilitation, including breathing exercises, biofeedback systems, virtual environments for exercise, and educational models. METHODS: The review screened 7 electronic libraries from 2010 to 2023. The libraries were ACM Digital Library, Google Scholar, IEEE Xplore, MEDLINE, PubMed, Sage, and ScienceDirect. Thematic analysis was used as an additional methodology to classify our findings based on themes. The themes were virtual reality training, interaction, types of virtual environments, effectiveness, feasibility, design strategies, limitations, and future directions. RESULTS: A total of 2319 articles were identified, and after a detailed screening process, 32 studies were reviewed. Based on the findings of all the studies that were reviewed (29 with a positive label and 3 with a neutral label), virtual reality can be an effective solution for pulmonary rehabilitation in patients with lung cancer, chronic obstructive pulmonary disease, and asthma, and in individuals and children who are dealing with mental health-related disorders, such as anxiety. The outcomes indicated that virtual reality is a reliable and feasible solution for pulmonary rehabilitation. Interventions can provide immersive experiences to patients and offer tailored and engaging rehabilitation that promotes improved functional outcomes of pulmonary rehabilitation, breathing body awareness, and relaxation breathing techniques. CONCLUSIONS: The identified studies on virtual reality in pulmonary rehabilitation showed that virtual reality holds great promise for improving the outcomes and experiences of patients. The immersive and interactive nature of virtual reality interventions offers a new dimension to traditional rehabilitation approaches, providing personalized exercises and addressing psychological well-being. However, additional research is needed to establish standardized protocols, identify the most effective strategies, and evaluate long-term benefits. As virtual reality technology continues to advance, it has the potential to revolutionize pulmonary rehabilitation and significantly improve the lives of patients with chronic lung diseases.

Is preoperative pulmonary rehabilitation effective in the postoperative period after lung resection?

Objective: Investigating the effects of the preoperative short term intensive pulmonary rehabilitation program applied for patients who have undergone lung resection by thoracotomy, on lung functions, complication rates and length of hospital stay during the postoperative period. Methods: A prospective randomized trial of sixty patients were enrolled who would undergo pulmonary resection by thoracotomy and were randomly divided in two groups. Intensive pulmonary rehabilitation was performed on these patients in the study group 3 hours a day throughout 7 days during the preoperative period. Groups were compared with respect to their spirometric pulmonary functions, respiratory parameters, blood gas parameters, complication rates and length of hospital stay. Results: Total incidence rate of complications in the patients from the control group significantly increased(p=0,028). When patients who underwent lobectomy and wedge resection were observed, length of hospital stay of those in the control group was seen to be statistically higher in comparison with the study group(p<0,05). Conclusion: We consider that it will be very beneficial to perform a short term and intensive pulmonary rehabilitation program on every patient possible who is planned to undergo thoracotomy and lobectomy or wedge resection treatment.

Investigation of the effect of breathing exercise on invasive pain associated with arteriovenous fistula cannulation in hemodialysis patients: Randomized controlled, single-blind study.

BACKGROUND: Pain due to puncture during arteriovenous fistula (AVF) cannulation is a very important symptom that affects the quality of life in patients undergoing continuous hemodialysis (HD) therapy. The aim in this study is to examine the effect of breathing exercise applied for long-term on invasive pain experienced during AVF cannulation in HD patients. METHODS: This randomized controlled, single-blind design study was conducted in a private dialysis center in Istanbul between November 2021 and April 2022. The patients in the intervention group were given breathing exercises before fistula cannulation during 12 HD sessions. Before the dialysis nurse performed the cannulation procedure, the patient was told by the researcher to perform breathing exercises and the exercise was completed after intervention for the cannulation. No intervention was made for the patients in the control group. Pain was assessed with the Visual Analog Scale (VAS) by a nurse who is not involved in the study. Mann-Whitney U Test, Chi-Square Test, Fisher's Exact Test, Friedman Test for repeated measurements were used in statistical analysis of data. FINDINGS: The study was completed with a total of 112 patients, 59 in the intervention group and 53 in the control group. It was determined that the VAS scores of the patients in the intervention group were statistically significantly lower than the patients in the control group from the first measurement to the twelfth measurement (p < 0.001). CONCLUSION: It was determined that the breathing exercise applied before the AVF cannulation reduced the invasive pain experienced during cannulation.