Effect of Active Assisted Range of Motion Exercises in Management of Severe COPD Patients at Nasser Hospital, Gaza: A Study Protocol for Quasi-Experimental Study
DOI:
https://doi.org/10.31436/ijcs.v9i1.543Keywords:
COPD, Dyspnea, Cough, SputumAbstract
ABSTRACT
Background: Chronic obstructive pulmonary disease is a leading cause of morbidity and mortality worldwide, characterized by progressive airflow limitation and respiratory symptoms. The disease burden continues to increase in developing regions, including Palestine, where challenges in healthcare infrastructure limit access to comprehensive management. To examine the effect of active-assisted range of motion exercises combined with standard care on dyspnea, cough, sputum production and pulmonary function among patients with severe chronic obstructive pulmonary disease at Nasser Hospital, Gaza.
Methods: This quasi-experimental study will use a convenience sampling method among severe chronic obstructive pulmonary disease patients admitted to the male and female medical departments at Nasser Hospital in Khan Younis, Southern Gaza Strip. A power analysis has determined an effect size of 0.58, requiring a total sample of 158 participants (79 in each group) to achieve adequate statistical power. Participants diagnosed with severe chronic obstructive pulmonary disease will be allocated into two groups: (1) the intervention group, which will receive active-assisted range of motion exercises in addition to standard treatment, and (2) the control group, which will receive standard treatment only.
Results: The study findings are expected to provide a promising results in advocating the utilisation of active-assisted range of motion exercises into pulmonary rehabilitation programs among patients with severe chronic obstructive pulmonary disease. Conclusion: This study findings will support integrating active-assisted range of motion exercises into severe chronic obstructive pulmonary disease pulmonary rehabilitation in resource-limited settings.
References
WHO. Chronic obstructive pulmonary disease (COPD) [Internet]. World Health Organization. 2022. Available from https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(COPD)
Ur Rehman A, Hassali MA, Muhammad SA, Shakeel S, Chin OS, Ali IBH, et al. Economic Burden of Chronic Obstructive Pulmonary Disease Patients in Malaysia: A Longitudinal Study. PharmacoEconomics. 2020;5(1):35–44. Available from https://doi.org/10.1007/s41669-020-00214-x
Rehman AU, Muhammad SA, Tasleem Z, Alsaedi A, Dar M, Iqbal MO, et al. Humanistic and socioeconomic burden of COPD patients and their caregivers in Malaysia. Scientific Reports. 2021;11(1). Available from https://doi.org/10.1038/s41598-021-01551-5
Torres-Sánchez I, Valenza MC, Sáez-Roca G, Cabrera-Martos I, López-Torres I, Rodríguez-Torres J. Results of a Multimodal Program During Hospitalization in Obese COPD Exacerbated Patients. COPD: Journal of Chronic Obstructive Pulmonary Disease. 2015;13(1):19–25. Available from https://doi.org/10.3109/15412555.2015.1043428
Gondos T, Szabó V, Sárkány G, Sárkány A, Halász G. Estimation of the severity of breathlessness in the emergency department: a dyspnea score. BMC. Emergency Medicine. 2016;17(1). Available from https://doi.org/10.1186/s12873-017-0125-6
Patalano F, Hache C, Pethe A, Kaur H, Leidy NK, Arsiwala T, et al. Performance of the Cough and Sputum Assessment Questionnaire (CASA-Q) in COPD: Evidence from Clinical and Online Patient Interaction Studies. International Journal of Chronic Obstructive Pulmonary Disease. 2022;Volume17:3087–3096. Available from https://doi.org/10.2147/copd.s381131
Deslée G, Burgel P, Escamilla R, Chanez P, Court-Fortune I, Nesme-Meyer P, et al. Impact of current cough on health-related quality of life in patients with COPD. International Journal of Chronic Obstructive Pulmonary Disease. 2016;Volume 11:2091–2097. Available from https://doi.org/10.2147/copd.s106883
Palestinian Central Bureau of Statistics Palestine in Figures 2023; 2023. Available from: https://www.pcbs.gov.ps/Downloads/book2693.pdf
Palestinian Ministry of Health. Chronic obstructive pulmonary disease statistics [Dataset]. In Patient Services Department, Nasser Hospital, Palestine; 2024.
Mosleh M, Aljeesh YI, Dalal K. Burden of Chronic Diseases in the Palestinian Healthcare Sector Using Disability-Adjusted Life Years (DALY), Palestine. Diversity and Equality in Health and Care. 2016;13(3), 261–268. Available from: https://doi.org/10.21767/2049-5471.100061
Massad S, Dalloul H, Ramlaw A, Rayyan I, Salman R, Johansson L. Accuracy of mortality statistics in Palestine: a retrospective cohort study. BMJ Open. 2019;9(4), e026640. Available from: https://doi.org/10.1136/bmjopen-2018-026640
Cleveland Clinic. COPD Guidelines For Exercise & Pulmonary Rehab: Cleveland Clinic. (cited 14 September 2018,). Available from: https://my.clevelandclinic.org/health/articles/9450-copd-exercise--activity-guidelines
Al-Faqawi MS, Abuowda YZ, Elmassry AEM, Böttcher B. Management of Chronic Obstructive Pulmonary Diseases (COPD) Exacerbation. A Clinical Audit in Nasser Hospital, Gaza-Strip, Palestine. Journal of US-China Medical Science. 2017;14(4). Available from https://doi.org/10.17265/1548-6648/2017.04.003
Albarrati AM, Gale NS, Munnery MM, Cockcroft JR, Shale DJ. Daily physical activity and related risk factors in COPD. BMC Pulmonary Medicine. 2020;20(1). Available from: https://doi.org/10.1186/s12890-020-1097-y
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