Breathing exercises in people with COPD: A realist review

Abstract

Aims To determine the theoretical framework that explains the mechanisms of the success of breathing exercise interventions in people with chronic obstructive pulmonary disease. Design A realist review. Data sources Seven bibliographic databases and the grey literature were searched from 2015–January 2020 to identify the studies of breathing exercises. Review Methods The evaluation criteria of realist review and the mixed method appraisal tool were both used to evaluate the included studies. We extracted and integrated the context–mechanism–outcome strings of each study to form the theoretical framework. Results Six theoretical mechanisms that affected the success of the intervention were articulated: Wide acceptance of training methods, Integration of the intervention with life, Self‐management of the participants, Confidence in controlling symptoms, Participation and support of practitioners, Motivation for intervention. Conversely, the other two mechanisms including the gap between implementation and training and the duration of the intervention, had negative impacts on the implementation of breathing exercises. Conclusion This review updates and expands the previous literature review on the impact of breathing exercises in people and provides researchers and clinical practitioners with theoretical mechanisms to ensure that the interventions achieve expected effects. Impact When formulating or selecting breathing exercise interventions, our theoretical framework will guide researchers and clinical practitioners to ensure that the intervention will have practical effects.

Advisory groups in realist reviews: Systematically mapping current research and recommendations for practice

“…40% ( n = 37) of the realist reviews cited use of an advisory group at some stage (as per the working definition for this study, notably other terminology was often reported) [14–17, 25–61]. 60% ( n = 56) did not mention the use of an advisory group [62–117]. Of those that did not mention an advisory group, seven reviews [62–64] did report participant involvement that did not fulfill the criteria of an advisory group, i.e., participants were used as data sources but did not advise on the review.…”

BREATHLEssness in INDIA (BREATHE-INDIA)–Study protocol for the co-design of a community breathlessness intervention in India using realist methods and intervention mapping

“…(1) Define review scope, (2) develop initial programme theories, (3) identify evidence through systematic review, (4) study selection (5) data extraction/synthesis. Using Li et al's realist review of COPD breathing exercises [33] as our starting point, we will conduct an expanded realist review to explore all non-pharmacological self-management interventions for NCD-related persistent breathlessness to identify evidence and theory for self-management. Stakeholder Group meetings will be held throughout the review so that the perspectives and insights from healthcare professionals, patients and families, policymakers and community-leaders can inform the interpretation of evidence, critical reflection on emerging theories and decision-making about the focus of the review.…”

Development and Validation of an Evidence-based Home Pursed Lip Breathing Protocol for Improving Health Outcomes in Patients with COPD

“…Additionally, this training method is simple and easy to learn, without the restrictions of equipment and location (Li et al, 2021). It is highly favored by older individuals, such as COPD patients, and has been demonstrated to reduce interference with daily physical activities (Li et al, 2021).…”

“…Additionally, this training method is simple and easy to learn, without the restrictions of equipment and location (Li et al, 2021). It is highly favored by older individuals, such as COPD patients, and has been demonstrated to reduce interference with daily physical activities (Li et al, 2021). Furthermore, COPD patients can experience more significant benefits from conducting PLB at home compared to other types of breathing exercises (Illidi et al, 2023;Sakhaei et al, 2018), although a standardized home-based PLB protocol is still lacking (Weihua Zhang, 2018).…”