Controlled Breathing for COPD

(REST Trial)

Overseen By Kristina Kashyap

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: University of Texas at Austin

Disqualifiers: Breathing exercises, Recent hospitalization, Other lung disease, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 2

36 Participants Needed

Trial Summary

Do I have to stop taking my current medications for the trial?

The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the trial coordinators or your doctor.

What data supports the effectiveness of the treatment REST, Controlled Breathing Intervention, REST Program for COPD?

Research shows that controlled breathing can help people with COPD by reducing breathlessness, improving breathing muscle strength, and enhancing quality of life. Techniques like pursed-lips breathing and group breathing exercises have shown benefits in improving symptoms and overall well-being in COPD patients. ^{1 2 3 4 5}

Is controlled breathing safe for humans?

Research on tele-pulmonary rehabilitation, which includes controlled breathing techniques, shows it is safe for people with COPD, as no major adverse events were reported in a study involving 177 participants. ^{6 7 8 9 10}

How is the REST treatment different from other treatments for COPD?

The REST treatment, which involves controlled breathing exercises, is unique because it focuses on improving breathing patterns and reducing breathlessness by strengthening respiratory muscles and optimizing breathing techniques. Unlike standard drug treatments, it is a non-drug approach that can be delivered in group settings, potentially enhancing its benefits for patients with COPD. ^{1 3 4 10 11}

What is the purpose of this trial?

This is a parallel design, randomized, controlled pilot trial comparing a controlled breath intervention (REST) to usual care for reducing stress in individuals with COPD.

Eligibility Criteria

This trial is for people over 40 with confirmed COPD, who experience significant stress and shortness of breath. Participants must have a certain score on the COPD Assessment Test, be able to attend training sessions in person, and communicate in English.

Inclusion Criteria

I can attend 2 in-person sessions.

I can read, write, and speak English.

My COPD symptoms are moderate to severe.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants receive the REST (controlled breath) intervention and COPD education

6 months

2 in-person sessions (1 training, 1 trial)

Follow-up

Participants are monitored for acceptability, feasibility, and stress measures

6 months

Treatment Details

Interventions

• REST

Trial Overview The REST trial compares a controlled breathing technique designed to reduce stress against usual care practices for individuals with COPD. It's a pilot study where participants are randomly assigned to one of the two groups.

Participant Groups

Group I: Behavioral Intervention (REST) Experimental Treatment 1 Intervention

Participants randomized to this group will receive COPD education, research staff support, and the REST (controlled breath) intervention.

Group II: Control Active Control 1 Intervention

Participants randomized to this group will receive COPD education and research staff support.

Who Is Running the Clinical Trial?

University of Texas at Austin

Lead Sponsor

Trials

387

Recruited

86,100+

Findings from Research

Controlled breathing techniques, such as pursed-lips breathing and inspiratory muscle training, have been shown to effectively relieve dyspnea in patients with chronic obstructive pulmonary disease (COPD) by improving gas exchange and respiratory muscle strength.

Despite the benefits of controlled breathing, further research is needed to determine how well these techniques can be applied during daily activities and their overall impact on functional adaptations in COPD patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Controlled breathing and dyspnea in patients with chronic obstructive pulmonary disease (COPD). Gosselink, R.[2022]

Oxygen supplementation and slow breathing techniques have strong and moderate evidence, respectively, for significantly improving baroreceptor sensitivity (BRS) in patients with chronic obstructive pulmonary disease (COPD), based on a systematic review of 18 studies.

Despite the positive effects on BRS, the long-term therapeutic benefits of these interventions on overall autonomic function in COPD patients remain unclear.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of respiratory rehabilitation techniques on the autonomic function in patients with chronic obstructive pulmonary disease: A systematic review. Mohammed, J., Da Silva, H., Van Oosterwijck, J., et al.[2018]

Capnography-assisted respiratory therapy (CART) is a new mind-body approach that effectively integrates real-time CO2 biofeedback with traditional pulmonary rehabilitation (PR) to address dysfunctional breathing behaviors in COPD patients, showing high feasibility with 74% session completion.

Participants in the CART+PR group experienced significant improvements in dyspnea, respiratory rate, and physical function, indicating that this therapy may enhance exercise tolerance and adherence to rehabilitation programs in COPD patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Mind-Body Intervention for Dysfunctional Breathing in Chronic Obstructive Pulmonary Disease: Feasibility Study and Lessons Learned. Norweg, AM., Wu, Y., Troxel, A., et al.[2023]

A randomized controlled trial with 37 patients showed that adding group breathing control exercises to standard rehabilitation significantly improved quality of life and other health measures in those with severe COPD after an acute exacerbation.

The intervention group experienced clinically meaningful improvements in multiple outcomes, including the COPD assessment test and handgrip strength, highlighting the effectiveness of group-based breathing exercises in enhancing recovery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Breathing Control Exercises Delivered in a Group Setting for Patients with Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial. Cazorla, S., Busegnies, Y., D'Ans, P., et al.[2023]

A study involving 40 patients with chronic obstructive pulmonary disease (COPD) found that adding controlled breathing techniques to a standard 4-week pulmonary rehabilitation program did not improve pulmonary function, exercise capacity, or quality of life compared to rehabilitation alone.

The results indicated no significant differences in key measures such as FEV1, 6-minute walking distance, health-related quality of life, or cardiac autonomic function, suggesting that respiratory biofeedback may not provide additional benefits in this context.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effects of controlled breathing during pulmonary rehabilitation in patients with COPD. van Gestel, AJ., Kohler, M., Steier, J., et al.[2012]

The study successfully implemented a province-wide tele-pulmonary rehabilitation (tele-PR) program for individuals with COPD, demonstrating high accessibility and feasibility with over 70% program completion and no major adverse events reported.

Both tele-PR and standard PR showed significant improvements in physical performance and quality of life, with tele-PR participants maintaining better long-term improvements in quality of life scores compared to those in standard PR.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Accessibility, Feasibility, and Safety of a Standardized Community-based Tele-Pulmonary Rehab Program for Chronic Obstructive Pulmonary Disease: A 3-Year Real-World Prospective Study. Alwakeel, AJ., Sicondolfo, A., Robitaille, C., et al.[2022]

In a study involving 25 subjects with stable COPD, both volume assured and pressure preset non-invasive ventilation modes were found to be equally effective in managing long-term ventilatory failure, with no significant differences in daytime blood gas tensions or nocturnal oxygen saturation after 8 weeks of treatment.

The primary outcomes, including arterial oxygen (PaO2) and carbon dioxide (PaCO2) levels, showed no significant variation between the two ventilation modes, indicating that either method can be used effectively for patients with chronic ventilatory failure.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A randomised crossover trial comparing volume assured and pressure preset noninvasive ventilation in stable hypercapnic COPD. Oscroft, NS., Ali, M., Gulati, A., et al.[2010]

An online breathing program with animated diagrams and video guidance significantly improved pulmonary function, exercise capacity, and health-related quality of life in 60 patients with stable COPD over four months.

In contrast, the control group that received conventional education showed no significant improvements, highlighting the effectiveness of web-based interventions for managing COPD symptoms.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of an animated diagram and video-based online breathing program for dyspnea in patients with stable COPD. Liu, F., Cai, H., Tang, Q., et al.[2021]

Pulmonary rehabilitation (PR) is effective for managing chronic obstructive pulmonary disease (COPD), but its benefits typically diminish within 6 to 12 months without a maintenance program.

There is currently no consensus on the optimal structure of maintenance programs for PR, including their duration, location, methods, and intensity, indicating a need for further research to establish clear guidelines.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Easy come, easy go? Current strategies for maintaining the effects of pulmonary rehabilitation in COPD patients]. Spielmanns, M., Ruprecht, M., Schmid-Mohler, G., et al.[2020]

A study involving 116 male patients with moderate COPD showed that a home-based pulmonary rehabilitation program, including pursed lip breathing, diaphragmatic breathing, and lower extremity endurance training, significantly improved oxygenation status, dyspnea, and fatigue after 60 days.

Patients who participated in the pulmonary rehabilitation program experienced less decrease in oxygen saturation and less increase in dyspnea and fatigue levels during a six-minute walk test compared to those who did not undergo the program.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Home Based Pulmonary Rehabilitation on Oxygenation Status, Dyspnea and Fatigue in Stable Patients with COPD. Ahmed, NU., Begum, S., Ali, T., et al.[2020]

In a study of 50 individuals with moderate to severe COPD, practicing pranayam (a set of breathing exercises) for 30 minutes twice a day significantly improved participants' COPD assessment test (CAT) scores, indicating better perceived health and reduced disease severity after 3 months.

While pranayam showed benefits in subjective health measures and exercise capacity, it did not lead to significant improvements in forced expiratory volume (FEV1), highlighting that while pranayam can enhance quality of life, it may not reverse the underlying airflow limitations in COPD.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Pranayam for Treatment of Chronic Obstructive Pulmonary Disease: Results From a Randomized, Controlled Trial. Gupta, A., Gupta, R., Sood, S., et al.[2022]

References

1. United States pubmed.ncbi.nlm.nih.gov

Controlled breathing and dyspnea in patients with chronic obstructive pulmonary disease (COPD). [2022]

2. England pubmed.ncbi.nlm.nih.gov

Effect of respiratory rehabilitation techniques on the autonomic function in patients with chronic obstructive pulmonary disease: A systematic review. [2018]

3. United States pubmed.ncbi.nlm.nih.gov

Mind-Body Intervention for Dysfunctional Breathing in Chronic Obstructive Pulmonary Disease: Feasibility Study and Lessons Learned. [2023]

4. Switzerland pubmed.ncbi.nlm.nih.gov

Breathing Control Exercises Delivered in a Group Setting for Patients with Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial. [2023]

5. Switzerland pubmed.ncbi.nlm.nih.gov

The effects of controlled breathing during pulmonary rehabilitation in patients with COPD. [2012]

6. United States pubmed.ncbi.nlm.nih.gov

The Accessibility, Feasibility, and Safety of a Standardized Community-based Tele-Pulmonary Rehab Program for Chronic Obstructive Pulmonary Disease: A 3-Year Real-World Prospective Study. [2022]

7. England pubmed.ncbi.nlm.nih.gov

A randomised crossover trial comparing volume assured and pressure preset noninvasive ventilation in stable hypercapnic COPD. [2010]

8. New Zealand pubmed.ncbi.nlm.nih.gov

Effects of an animated diagram and video-based online breathing program for dyspnea in patients with stable COPD. [2021]

9. Switzerland pubmed.ncbi.nlm.nih.gov

[Easy come, easy go? Current strategies for maintaining the effects of pulmonary rehabilitation in COPD patients]. [2020]

10. Bangladesh pubmed.ncbi.nlm.nih.gov

Home Based Pulmonary Rehabilitation on Oxygenation Status, Dyspnea and Fatigue in Stable Patients with COPD. [2020]

11. United States pubmed.ncbi.nlm.nih.gov

Pranayam for Treatment of Chronic Obstructive Pulmonary Disease: Results From a Randomized, Controlled Trial. [2022]