Effect of Pursed-lip Breathing Combined with Aerobic Walking Exercise on Oxygenation and Activity Endurance in Lung Cancer Patients after Lobectomy

[[abstract]]背景：噘嘴呼吸或有氧步行運動已被證實可緩解呼吸困難及增加肌肉強度、活動力，肺葉切除術後患者常出現肺功能及運動能力下降，兩者合併運用於肺葉切除術後患者，對於術後氧合及活動耐受力的改善效果是否更佳，則值得進一步研究探討。研究目的：探討噘嘴呼吸合併有氧步行運動對肺癌病人術後氧合及活動耐受力之成效。研究方法：採實驗型研究法，樣本來自中部某區域醫院胸腔外科病房，共60位符合選樣條件之個案參與本研究，隨機分配至實驗組及對照I、II組，實驗組予噘嘴呼吸訓練合併有氧步行運動，對照I組採噘嘴呼吸訓練、對照II組採有氧步行運動，由術後第1至5天，進行每天3次，每次15分鐘的訓練，於術後第1天訓練開始前進行前測，術後第5天3次活動後進行後測，並收集六分鐘走路測試、呼吸困難視覺類比量表及自覺活動費力量表、尖峰呼氣流量、脈搏血氧飽和度等資料。研究結果：實驗組及對照II組之術後六分鐘走路測試、呼吸困難視覺類比量表分數、尖峰呼氣流量、脈搏血氧飽和度及活動後費力感改善程度皆顯著優於對照I組。結論：針對進行肺葉切除術後患者，建議臨床醫護人員可教導噘嘴呼吸合併有氧步行運動或有氧步行運動來增進患者術後氧合及活動耐受力。[[abstract]]Objectives: The effects of pursed-lip breathing or aerobic walking exercise in increasing muscle strength and motility and relieving dyspnea have been proved. After lobectomy, patients often have decreased lung function and exercise capacity. Therefore, the objective of this study is to explore the effects of pursed-lip breathing combined with aerobic walking exercise on postoperative oxygenation and exercise tolerance of lung cancer patients receiving lobectomy, compared to a single intervention of pursed-lip breathing or aerobic walking exercise. Methods: A 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 a 6-minute walking test, Dyspnea Visual Analogue Scale, Rating scale of perceived exertion, peak expiratory flow rate and SpO2 were collected.Results: The 6-minute walking test distance, Dyspnea Visual Analogue Scale scores, Rating scale scores of perceived exertion, peak expiratory flow rate and SpO2 of the experimental group (pursed-lip breathing combined with aerobic walking exercise) and the control group II (only receiving aerobic walking exercise) have significant improvement more than those of the control group I (only receiving pursed-lip breathing).Conclusions: For lung cancer patients undergoing lobectomy, we recommend that medical professionals can provide them with either pursed-lip breathing combined with aerobic walking exercise or aerobic walking exercise to improve their postoperative oxygenation and exercise tolerance