Desktop Helper 3 - Table 3. Non-pharmacological interventions to address breathlessness and exercise capacity
Table 3. Non-pharmacological interventions to address breathlessness and exercise capacity
|
Intervention |
Purpose/aim |
Supporting references |
|
Pulmonary rehabilitation |
Can relieve breathlessness and fatigue, improves emotional state and enhances person’s sense of control over their condition – moderately large and clinically significant improvements |
|
|
Facial cooling with a fan or cool flannel. |
Good evidence of short-term benefit from using a fan (static or hand held), relieving breathlessness at rest and reducing recovery time after activity. Movement of air over a person’s face is thought to stimulate a vagal response A cool flannel is an alternative |
|
|
Mindfulness/ meditation |
20-minute mindful breathing reduces breathlessness in lung disease, and anxiety/depression in advanced disease; enhances non-evaluative attention and may increase self-efficacy |
|
|
Relaxation techniques |
Some evidence can help anxiety, breathlessness and fatigue in COPD. Guided imagery (‘thinking of a nice place’), progressive muscular relaxation and counting are most acceptable |
|
|
Pacing |
May help breathlessness as a component of an evidence-based complex intervention |
|
|
Walking aids |
Can improve exercise capacity |
|
|
Cognitive behavioural therapy |
Problem-solving approach that challenges unhelpful thoughts/ behaviours; reduces anxiety in COPD in short term; increases pulmonary rehabilitation attendance |
|
|
Breathing techniques |
Most studies do not find this intervention improves breathlessness, although some evidence in lung cancer and pursed lip breathing may help in COPD; however, these are a key component of evidence-based complex interventions for breathlessness |
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|
Acupuncture/ pressure |
Improves breathlessness in advanced disease and may reduce anxiety |
|
|
Inspiratory muscle training |
Conflicting evidence for impact on breathlessness; people need to be carefully selected |
|
What is pulmonary rehabilitation?
“A comprehensive intervention based on thorough patient assessment followed by patient-tailored therapies that include, but are not limited to, exercise training, education, self-management intervention aiming at behaviour change, designed to improve the physical and psychological condition of people with chronic respiratory disease and to promote the long-term adherence to health-enhancing behaviors.” Read more: www.ipcrg.org/PR. |
Resource information
- COPD
- Disease management
- End of Life