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Updated: Oct 10, 2026
Home-Based Prescribed Pulmonary Exercise in Patients with Stable Chronic Obstructive Pulmonary Disease
Published on: August 24, 2019
Nurse-Led Pursed-Lip and Abdominal Breathing Training Improves Pulmonary Function and Functional Exercise Performance
Changfang Geng1, Quan Gao1, Jia Yu1
1Department of Respiratory and Critical Care Medicine, Liyang People's Hospital, Liyang, Jiangsu, China.
Background:
Chronic obstructive pulmonary disease (COPD) causes dyspnea and impaired function. Evidence for structured nurse-led pursed-lip breathing (PLB) plus abdominal breathing (AB) in stable outpatients is limited.
Methods:
In this single-center randomized controlled trial, 218 adults with Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage II-IV stable COPD were randomized 1:1 to 12 weeks of nurse-led PLB plus AB or routine care. Co-primary outcomes were changes in forced expiratory volume in 1 second (FEV1) and 6-minute walk distance (6MWD). Secondary outcomes were forced vital capacity (FVC), FEV1/FVC, COPD Assessment Test (CAT) score, peripheral oxygen saturation (SaO2), and modified Medical Research Council (mMRC) grade. Intention-to-treat analysis of covariance was performed, adjusting for baseline, age, sex, and GOLD stage, with multiple imputation for missing data.
Results:
At week 12, adjusted differences favored the intervention for FEV1 (0.14 L; 95% CI, 0.11-0.17), 6MWD (37.8 m; 95% CI, 31.5-44.1), FVC (0.16 L; 95% CI, 0.11-0.21), CAT score (-4.22 points; 95% CI, -4.90 to -3.54), and SaO2 (1.33 percentage points; 95% CI, 1.10-1.56) (all P<01). FEV1/FVC change was not significant (P=0.095). Adherence was 87.2%; no intervention-related adverse events were reported.
Conclusion:
Nurse-led PLB plus AB improved spirometric outcomes, functional exercise performance, symptoms, and oxygenation. Multicenter trials with stronger adherence, medication, and mechanistic assessments are needed. Trial registration: Chinese Clinical Trial Registry, ChiCTR2400000218.
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