The effect of cognition in combination with an active cycle of breathing technique on dyspnea-related kinesiophobia in patients with moderate to severe chronic obstructive pulmonary disease

Abstract

Abstract Background The majority of patients with chronic obstructive pulmonary disease (COPD) have a catastrophic perception of dyspnea and avoid physical activity, with moderate to severe COPD patients exhibiting more pronounced kinesiophobia. The fear-avoidance model suggests that kinesiophobia can be alleviated by reducing dyspnea symptoms and altering the catastrophic perception of dyspnea as an illness. However, we discovered that single inspiratory muscle training and cognitive change have limitations. This study combined cognition and exercise to examine the efficacy of cognitive therapy based on social cognitive theory combined with an active cycle of breathing technique in reducing dyspnea-related kinesiophobia in patients with moderate to severe COPD. Methods This research involved 106 participants. The control group (N = 53) got standard nursing, whereas the intervention group (N = 53) received cognitive combined with active cycle of breathing technology intervention for 8 weeks. Lung function, the breathlessness beliefs questionnaire, and other secondary outcomes were measured before and after the intervention. The breathlessness beliefs questionnaire was administered one, two and three months following the intervention. This study's statistical analysis was conducted using SPSS 22.0 software. Results The between-group effects, within-group effects, and interaction effect of BBQ, BBQ-SF, and BBQ-AA scores in the intervention group were statistically significant (P<0.05) when compared to the control group. At the conclusion of the 8-week intervention, the intervention group's FVC, FEV1, and 6-minute walk distance were considerably greater than the control group's, while the intervention group's mMRC, BODE index, and CAT score were significantly lower (P<0.05). However, no significant change in FEV1% or FEV1/FVC was seen between the two groups (P > 0.05). Conclusion The misconception of dyspnea in COPD patients served as the starting point for this study, which integrated cognitive and exercise training. The combined intervention substantially improved dyspnea-related kinesiophobia in patients with moderate to severe COPD, and the effect remained significant when the intervention duration was extended. Furthermore, it may enhance dyspnea and quality of life, increase exercise capacity, and lower the BODE index. Trial registration: Code: ChiCTR2200058498, Date: 10/04/2022, http://www.chictr.org.cn/showproj.aspx?proj=164225