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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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.