Mind the Breath: Feasibility of Capnography-Assisted Learned Monitored (CALM) Breathing for Dyspnea Treatment.

IF 3.3 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of Cardiopulmonary Rehabilitation and Prevention Pub Date : 2025-03-01 Epub Date: 2025-02-13 DOI:10.1097/HCR.0000000000000939

Anna Norweg, Cheongeun Oh, Angela DiMango, Brittany Hofferber, Michael Spinner, Kimberly Stavrolakes, Marykay Pavol, Peter Lindenauer, Charles G Murphy, Naomi M Simon

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引用次数: 0

Abstract

Purpose: To evaluate the feasibility and acceptability of Capnography-Assisted Learned Monitored (CALM) Breathing, a carbon dioxide (CO 2 ) biofeedback, and motivational interviewing intervention, to treat dyspnea and anxiety together.

Methods: We randomized adults (n = 42) with chronic obstructive pulmonary disease (COPD) to a 4-week, 8-session intervention (CALM Breathing, n = 20) or usual care (n = 22). The CALM Breathing intervention consisted of tailored, slow nasal breathing exercises, capnography biofeedback, motivational interviewing, and a home breathing exercise program. The intervention targeted unlearning dysfunctional breathing behaviors. All participants were offered outpatient pulmonary rehabilitation (PR) in the second phase of the study. The primary outcomes were feasibility and acceptability of CALM Breathing. Exploratory secondary outcomes included respiratory and mood symptoms, physiological and exercise tolerance measures, quality of life, and PR uptake.

Results: Attendance at CALM Breathing sessions was 84%, dropout was 5%, and home exercise completion was 90% and 73% based on paper and device logs, respectively. Satisfaction with CALM Breathing therapy was rated as "good" to "excellent" by 92% of participants. Significantly greater between-group improvements in secondary outcomes-respiratory symptoms, activity avoidance, oxygen saturation (SpO 2 ), end-tidal CO 2 , and breathing self-regulation (interoception)-were found post-intervention at 6 weeks in support of CALM Breathing compared with usual care. At 3 months (after PR initiation), statistically significant between-group differences in Borg dyspnea and SpO 2 post-6-minute walk test were identified also supporting CALM Breathing.

Conclusions: Patient-centered CALM Breathing was feasible and acceptable in adults with COPD and dyspnea anxiety. A CALM Breathing intervention may optimize dyspnea treatment and complement PR.

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注意呼吸：肺活图辅助学习监测（CALM）呼吸治疗呼吸困难的可行性。

目的：评价二氧化碳（CO2）生物反馈和动机性访谈相结合的Capnography-Assisted Learned monitoring (CALM) Breathing干预治疗呼吸困难和焦虑的可行性和可接受性。方法：我们将患有慢性阻塞性肺疾病（COPD）的成人（n = 42）随机分为4周8期干预（CALM Breathing, n = 20）或常规护理（n = 22）。平静呼吸干预包括量身定制的、缓慢的鼻腔呼吸练习、二氧化碳生物反馈、动机性访谈和家庭呼吸练习程序。干预的目标是忘记不正常的呼吸行为。在研究的第二阶段，所有参与者都接受了门诊肺部康复（PR）治疗。主要结局为镇静呼吸的可行性和可接受性。探索性次要结局包括呼吸和情绪症状、生理和运动耐量测量、生活质量和PR摄取。结果：静坐呼吸课程的出勤率为84%，辍学率为5%，基于纸质和设备日志的家庭锻炼完成率分别为90%和73%。92%的参与者将CALM呼吸疗法的满意度评为“良好”至“优秀”。与常规护理相比，在支持CALM呼吸的干预后6周，次要结局-呼吸症状、活动避免、氧饱和度（SpO2）、末潮CO2和呼吸自我调节（内感受）-组间显著改善。在3个月时（PR开始后），6分钟步行测试后Borg呼吸困难和SpO2的组间差异具有统计学意义，也支持CALM呼吸。结论：以患者为中心的CALM呼吸法在COPD合并呼吸困难焦虑的成人患者中是可行且可接受的。平静呼吸干预可以优化呼吸困难的治疗并补充PR。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Cardiopulmonary Rehabilitation and Prevention 医学-心血管系统

CiteScore

5.40

自引率

34.20%

发文量

164

审稿时长

6-12 weeks

期刊介绍： JCRP was the first, and remains the only, professional journal dedicated to improving multidisciplinary clinical practice and expanding research evidence specific to both cardiovascular and pulmonary rehabilitation. This includes exercise testing and prescription, behavioral medicine, and cardiopulmonary risk factor management. In 2007, JCRP expanded its scope to include primary prevention of cardiovascular and pulmonary diseases. JCRP publishes scientific and clinical peer-reviewed Original Investigations, Reviews, and Brief or Case Reports focused on the causes, prevention, and treatment of individuals with cardiovascular or pulmonary diseases in both a print and online-only format. Editorial features include Editorials, Invited Commentaries, Literature Updates, and Clinically-relevant Topical Updates. JCRP is the official Journal of the American Association of Cardiovascular and Pulmonary Rehabilitation and the Canadian Association of Cardiac Rehabilitation.