Dyspnea, defined as the unpleasant awareness of labored breathing, is a complex phenomenon, and is the primary disabling symptom in chronic obstructive pulmonary disease (COPD). As conceptualized by Haas (1993), dyspneic stimuli are first processed preconsciously. If this information reaches conscious perception, it is interpreted as dyspnea, manifested by breathlessness and anxiety. By occupying attention channels that normally carry dyspneagenic information, distractive auditory stimuli (DAS) may reduce the sensation of dyspnea, promote continued use of exercise, and thereby improve functional performance and health-related quality of life (HRQoL). The purpose of this study is to determine the impact of a home-based exercise program which uses DAS on dyspnea (University of California at San Diego Shortness of Breath Questionnaire), anxiety (Spielberger State-Trait Anxiety Inventory), functional performance (6 Minute Walk), and HRQoL (St. George's Respiratory Questionnaire) in patients with COPD. This study will use a prospective, randomized, repeated measures (baseline, 4 weeks and 8 weeks) design. Subjects will be patients with COPD (FEV1 less than 60 percent predicted) who have completed a pulmonary rehabilitation program. The independent variable will be DAS in the form of music vs. no DAS. The dependent variables will be: dyspnea, anxiety, functional performance, and health-related quality of life. Descriptive variables will include: gender, age, educational level, and pulmonary function indices (FVC, FEV1, FEV1/FVC ratio). The proposed intervention is inexpensive, can be easily implemented with minimal training, and may be a motivator of exercise adherence, given its potential to reduce the sensation of dyspnea.
| Bauldoff, Gerene S; Hoffman, Leslie A; Zullo, Thomas G et al. (2002) Exercise maintenance following pulmonary rehabilitation: effect of distractive stimuli. Chest 122:948-54 |
