Effect of continuous nursing combined with respiratory exercise nursing on pulmonary function of postoperative patients with lung cancer

BACKGROUND Lung cancer is a malignant tumor with high morbidity and mortality among cancers.Surgery is currently one of the primary methods of treating lung cancer.Although it can slow down the progression of the disease by removing the lesion,this invasive surgery inevitably damages the integrity of the patient’s chest.Moreover,the patient’s pulmonary function may have a low compensatory capacity after surgery,causing various respiratory diseases such as atelectasis,respiratory function decline,and even serious cardiovascular disease.All of these have great negative impacts on the surgical effect and the prognosis of patients.With the continuous exploration and development of nursing,continuous nursing and respiratory exercise nursing have been gradually applied in the nursing of patients after lung cancer surgery,and have achieved good nursing results.AIM To investigate the effect of continuous nursing combined with respiratory exercise nursing on the pulmonary function of postoperative patients with lung cancer.METHODS A total of 80 patients with lung cancer who underwent surgery in our hospital from January 2021 to December 2021 were selected as the study subjects.All subjects were randomly divided into the control group(n=40 cases)and the experimental group(n=40 cases).Patients with lung cancer in the control group were given conventional nursing after surgery,while the experimental group was given continuous nursing combined with respiratory exercise nursing based on conventional nursing.The recovery of pulmonary function and respiratory symptoms was observed before and after 3 mo of intervention in both groups.The pulmonary function parameters,blood gas analysis,MD Anderson Symptom Inventory-lung cancer module(MDASI-LC)scores,incidence of pulmonary complications,and Morisky compliance scores were compared between the two groups before and after 3 mo of intervention.RESULTS There was no significant difference in pulmonary function and blood gas analysis between the two groups before intervention(P>0.05).3 mo after the intervention,the pulmonary function parameters in the experimental group(SpO2,VC,MVV,FEV1,FEV1%pred,and FEV1/FVC)were higher than those in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in blood gas analysis between the two groups before intervention(P>0.05).PaO2 in the experimental group was significantly higher than that in the control group,and PaCO_(2) was significantly lower than that in the control group 3 mo after the intervention.The difference had statistical significance(P<0.05).3 mo after the intervention,the MDASI score of respiratory symptoms in the experimental group was significantly lower than that in the control group(P<0.05),and the incidence of pulmonary complications was lower than that in the control group(P<0.05).In addition,the treatment compliance and nursing satisfaction of patients in the experimental group were higher than those in the control group,and the differences were statistically significant(P<0.05).CONCLUSION Continuous nursing combined with respiratory exercise nursing can significantly accelerate the recovery of respiratory function in postoperative lung cancer patients,reduce the incidence of postoperative complications of lung cancer as well as improve the treatment compliance of patients.

Effectiveness of oral motor respiratory exercise and vocal intonation therapy on respiratory function and vocal quality in patients with spinal cord injury:a randomized controlled trial

Singing,as a method of combining respiratory function exercise and vocal intonation therapy,provides a new direction for respiratory function exercise in patients with spinal cord injury.This randomized controlled trial investigated the effects of oral motor respiratory exercise and vocal intonation therapy on respiratory function and vocal quality in patients with spinal cord injury.Among 31 included patients with spinal cord injury,18 completed the treatment.These 18 patients were randomly assigned to undergo music therapy(intervention group,30 min/d,5 times a week,for a total of 12 weeks;n=9,7 males and 2 females;30.33±11.74 years old)or normal respiratory training(control group,n=9;8 males and 1 female;34.78±11.13 years old).Both patient groups received routine treatment concurrently.Before and at 6 and 12 weeks after intervention,a standard respiratory function test,a voice test,the St.George's Respiratory Questionnaire,and a quality of life questionnaire were administered.The results showed that the inspiratory capacity,forced expiratory volume in 1 second,forced vital capacity,maximal mid-expiratory flow rate,sing-loud pressure level,and sustained note length were significantly increased in the intervention group compared with the control group.The St.George's Respiratory Questionnaire and quality of life results of patients in the intervention group were significantly superior to those in the control group.These findings suggest that oral motor respiratory exercise and vocal intonation therapy,as respiratory training methods in music therapy,are effective and valuable for improving respiratory dysfunction and vocal quality in patients with spinal cord injury.This study was approved by the Ethics Committee of China Rehabilitation Research Center(approval No.2019-78-1)on May 27,2019 and was registered with the Chinese Clinical Trial Registry(registration number:Chi CTR1900026922)on October 26,2019.

Addition of respiratory exercises to conventional rehabilitation for children and adolescents with cerebral palsy:a systematic review and meta-analysis

Background Respiratory dysfunctions are an important cause of morbidity and death in cerebral palsy(CP)populations.Respiratory exercises in addition to conventional rehabilitation have been suggested to improve respiratory status in CP patients.The objective of this systematic review and meta-analysis was to verify the effects of the addition of respiratory exercises to conventional rehabilitation on pulmonary function,functional capacity,respiratory muscle strength,gross motor function and quality of life in children and adolescents with CP.Methods We searched for randomized controlled clinical trials in PubMed/Medline,Lilacs,SciELO,EMBASE and Physi-otheraphy Evidence(PEDro)from their inception until July 2022 without language restrictions.Studies that included respiratory exercises(breathing exercise program;feedback respiratory training;incentive spirometer exercise;inspiratory muscle training;and combination of respiratory exercises+incentive spirometer exercise)in combination with conventional rehabilitation for children and adolescents with CP were evaluated by two independent reviewers.The mean difference(MD)and 95%confidence interval(CI)were estimated by random effect models.Results Ten studies met the eligibility criteria,including 324 children aged from 6 to 16 years.The meta-analysis showed an improvement in inspiratory muscle strength of 22.96 cmH2O(18.63-27.27,n=55)and pulmonary function of 0.60(0.38-0.82,n=98)for forced vital capacity(L);0.22(0.06-0.39,n=98)for forced expiratory volume at 1 second(L);and 0.50(0.05-0.04,n=98)for peak expiratory flow(L/min).Functional skills in daily living activities improved in the intervention group.Caregivers'assistance of daily living activities,functional capacity,gross motor function and expiratory muscle strength showed a nonsignificant improvement.Social well-being and acceptance and functioning domains improved in only one study.Conclusions Emerging data show significant enhancements in inspiratory muscle strength and pulmonary function in CP patients after respiratory training in addition to conventional rehabilitation.There is no consensus on the frequency,type or intensity of respiratory exercises for children with and adolescents with CP.

Effects of Video Combined with the Teach-Back Method on the Respiratory Function Exercise of Patients Undergoing Thoracotomy

Objective: To explore the effect of video combined with the teach-back method on respiratory function exercise in patients undergoing tumor thoracotomy. Methods: Eligible patients undergoing thoracotomy for tumor were selected from the thoracic surgery at a level-A tertiary hospital between August 2021 and December 2021 and included in the control group and the observation group (40 patients in each group). To prevent two groups of patients from interacting with each other, the thoracic surgery ward I was distinguished as the control group, which was adopted by the routine instruction. Based on routine instruction, the thoracic surgery ward II conducted respiratory function exercise instruction by video combined with the teach-back method to compare the two groups’ compliance with respiratory function exercise, complication rates, and patient satisfaction. Results: The patient compliance with respiratory function exercise in the observation group was significantly higher (P < 0.05) and the rate of pulmonary complications in the observation group was lower (P < 0.05) than that in the control group, while the observation group had a high level of satisfaction (P Conclusion: Taking video combined with the teach-back method, an effective health education method, can improve the compliance of the respiratory function exercise of patients undergoing thoracotomy for tumor and promote the recovery of pulmonary function to reduce the incidence of postoperative pulmonary complications so as to improve patient satisfaction.

Clinical experiment of exercise-induced asthma and respiratory impedance asesed with impulse oscilometry to measure exercise response of asthmatics

Objective In order to investigate pathophysiology of exercise induced asthma (EIA), the impedance of the respiratory system was studied using impulse oscillometry (IOS). EIA is a temporary increase in airway resistance, which occurs after several minutes of strenuous exercise. Most asthmatics experience EIA. Patients and methods Respiratory impedance was measured with IOS (MasterScreen, Jaeger, Germany) in 14 healthy volunteers and 14 asthmatics as baseline value at first. The procedure of exercise challenge with an ergometer (Corival 300 Gould Co.) increased heart rate to 90% of predicted maximum values in 3-4 min and maintained for 6 min. After challenge, measurements with IOS were made immediately at 5 min intervals for 5 times. Results The maximal increase of respiratory impedance occurred at 5-10 min after exercise and the increment magnitude of peripheral resistance (99.6%) was more than that of central resistance (13.5%) in asthmatics. After challenge, R5Hz, R5Hz-R20Hz, Zrespir (total impedance), resonance frequency (Fres) and X5Hz from patients changed significantly. The increment value of R5Hz-R20Hz from asthmatics was≥0.032kpa/l·s -1 and the change ratio of X5Hz from 71.4% of asthmatics was ≥41% (2SD beyond the mean response of nonashmatics). Air trapping loop was expressed in V T Zrespir graph in 57.1% patients. All subjects underwent IOS measurement. Conclusion Exercise test can diagnose asthma and evaluate efficacy of treatment for bronchial asthma. Because the patients usually have shortness of breath after exercise challenge, the measurement with spirometry (FEV 1) may not be accurate. IOS is based on measurement of the relationship between an external pressure pulse applied to the respiratory system and the resulting respiratory airflow. The spectral ratio of the amplitude of the pressure wave signal to the resulting flow signal constitutes the impedance of the respiratory system, from which the resistance (R) and the reactance (X, including elastance and inertance) of respiratory system in the frequency range 5Hz to 35Hz can be calculated. Our data showed that the increment value of R5Hz-R20Hz was more sensitive than other indices for detecting exercise induced asthma. The bronchoconstriction took place in peripheral airway mainly after exercise. Because obstruction of small bronchi during expiration and impedance increased abruptly, air trapping loops were expressed in V T Zrespir graph after challenge in asthmatics. Fres is the frequency point where the absolute value of elastance equals to that of inertance. X5Hz reflects the condition of compliance of lungs. Fres shifted right and change ratio of X5Hz increased after exercise were relative to the compliance decrease of lungs. The airway response of exercise challenge may be assessed more accurately and more conveniently with IOS that did not require a maximal inspiration and forced expiration.