Abstract 15524: Diaphragmatic Breathing Retraining Intervention to Improve Dyspnea, Physical Activity, and Functional Status in Heart Failure Patients
Dyspnea and its consequences (decreased physical activity [PA] and functional status) are main contributors to disability in patients with heart failure (HF) and are associated with poorer quality of life and more hospital readmissions. The objective of this feasibility study was to examine the effects of a Deep Breathing Retraining (DBR) intervention vs. attention control (AC) group in improving dyspnea, PA, and functional status in HF patients. We hypothesized that the primary effect of the DBR intervention would be to reduce dyspnea and, in turn, increase PA and improve functional status. We used an experimental, two-group (n=18/group), repeated measures design to recruit rural patients with NYHA functional class II-IV HF. The DBR group received information and practiced DBR for 8 weeks at home, guided by social cognitive theory concepts through 4 telephone calls. The AC group received general health information through 4 telephone calls. Measures were: dyspnea by the Kansas City Cardiomyopathy Questionnaire, and two investigator-developed measures of dyspnea with activities of daily living (ADLs) and physical functioning; PA by the ActiGraph accelerometer; and functional status by the 6-Minute Walk Test. Data were collected at baseline, 8 weeks (post-intervention), and 5 months after baseline and were analyzed using repeated measures analysis of variance controlling for age, gender, comorbidities, and baselines scores for each variable. Effect sizes were used to interpret the results (η2 small effect size=.01, medium=.06, large=.13). In the DBR group, mean adherence rate was 93%. Compared to the AC group, the DBR group reported more daily minutes of PA and kcals expended (ESs>.14), and performed better on the 6-MWT (ES=.11). In contrast, the DBR intervention only had a small effect on reducing dyspnea (ES=.02). In conclusion, the DBR intervention demonstrated promising preliminary results in increasing physical activity and functional status but not by reducing dyspnea as initially hypothesized. DBR patients may have increased their physical activity levels in response to the intervention because they were instructed to use DBR while engaging in all ADLs. Further exploration of the theoretical mechanism of the intervention is needed.
Author Disclosures: Y. Seo: None. B. Yates: None. B. Pozehl: None. J. Norman: None. L. LaFramboise: None. M. Hertzog: None.
This research has received full or partial funding support from the American Heart Association.
- © 2014 by American Heart Association, Inc.