Nurse-Led Pursed-Lip and Abdominal Breathing Training Improves Pulmonary Function and Functional Exercise Performance in Patients With Chronic Obstructive Pulmonary Disease: A Prospective Randomized Controlled Trial.

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.