Respiratory Regulation With Biofeedback in COPD
Respiratory Regulation With Biofeedback in COPD
Dyspnea is the main reason that patient with chronic obstructive pulmonary disease(COPD) to
 sedentary. It's a vicious circle of deteriorating lung function. The heart rate
 various(HRV)biofeedback with respiratory regulation training had been reported to reduce
 dyspnea and improve regulatory physical activities in COPD. However, HRV is not available
 with patients in communities persistently, the arm of this study is to explore the effect of
 the pulse oximeter biofeedback with respiratory regulation training to improve physical
 activities in COPD. A 2-group, randomized design study, the subjects are GOLD stage II-IV
 COPD from a medical center hospital of the middle of Taiwan. The experiment cases will be
 taught the skills of evaluating oximeter data and performing correct pursed-lip with
 diaphragmatic breathing. All experiment and controlled patients have to fill out the
 demographic form, the modified British Medical Research Council (mMRC), the international
 physical Activity questionnaire- short form(IPAQ-SF), exercise self-regulation efficacy scale
 (Ex-SRES), COPD assessment test (CAT), and physical activity & respiratory training diary in
 pre-intervention and 12 weeks later. The collective data will analyze with SPSS 22.0.
Before subjects begin participation in any study-specific procedures, the investigators get
 institutional review board approval of the protocol, informed consent form, questionnaires
 and all subject information. A subject is considered enrolled when the investigator decides
 that the subject has met all eligibility criteria. All subjects must personally sign and date
 the IRB approved ICF before commencement of study-specific procedures. Each subject who
 enters the screening period for the study will receive a unique subject identification number
 before any study-related activities are performed. This number will be used to identify the
 subject throughout the study.

 116 subjects will spend 20~30 minutes to fill out based demographic forms, mMRC, CAT, IPAQ,
 Ex-SRES and simple emotion questionnaires, then be randomized by sealed envelope to 1 of 2
 arms. Under routine care, the experiment arm will get educational leaflets to pursed-lip with
 diaphragmatic breathing training and oximetry level evaluation. The controlled arm also has
 education leaflets but without breathing and oximetry level evaluation training. They be
 required to record respiratory regulation and physical activity diary while home care period
 up to first following out-patient department (about 12 weeks later). In the home care period,
 there are three times phone monitors to remind keep recording diary at first, forth and
 eighth week. Finally, mMRC, CAT, IPAQ and Ex-SRES will be finished again when first follow
 visit.
Inclusion Criteria:

 -  1. Diagnosed COPD, pulmonary spirometry test FEV1/FVC<70% and FEV1<80%.

 -  2. At least 20 years old and has communicative capacity.

 -  3. Can walk by self or assistive device prior hospitalization.

 Exclusion Criteria:

 -  1. acute exacerbation attack or recurrent acute exacerbation and SpO2< 90%.

 -  2. Can perform respiratory regulation correctly within exercising regularly.

 -  3. Know cancer.

 -  4. Comorbidity with sever pulmonary and cardiac disease.

 -  5. Diseases of musculoskeletal system.

 -  6. Psychotic or cognitive disorder that likely not be available to complete study
 procedures.

 -  7. the hearing-impaired or visually disabled.