Treatment of dyspnea in COPD. A controlled clinical trial of dyspnea management strategies.
We conducted a randomized clinical trial to evaluate a limited pulmonary rehabilitation program focused on coping strategies for shortness of breath but without exercise training. Eighty-nine patients with COPD were randomly assigned to either 6-week treatment or general health education control groups. Treatment consisted of instruction and practice in techniques of progressive muscle relaxation, breathing retraining, pacing, self-talk, and panic control. Tests of 6-min walk distance, quality of well-being, and psychological function as well as six dyspnea measures were administered at baseline, posttreatment, and 6 months after the intervention. Baseline pulmonary function tests also were obtained. At the end of the 6-week treatment, there were no significant differences between the treatment and control groups on any outcome measure. At the 6-month follow-up, a significant group difference was seen on only one variable, Mahler's transition dyspnea index. The results of this evaluation suggest that a treatment program of dyspnea management strategies, without structured exercise training or other components of a comprehensive pulmonary rehabilitation program, is not sufficient to produce significant improvement in dyspnea, exercise tolerance, health-related quality of well-being, anxiety, or depression.
Sassi-Dambron
D E
DE
Division of Pulmonary and Critical Care Medicine, University of California, San Diego.
Eakin
E G
EG
Ries
A L
AL
Kaplan
R M
RM
D000368:Aged; D004417:Dyspnea / Q000150:complications / Q000628:therapy*; D005260:Female; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000150:complications / Q000503:physiopathology* / Q000534:rehabilitation; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D015656:Respiratory Mechanics; D016896:Treatment Outcome