Deep Breathing Exercise and Active Range of Motion Influence Physiological Response of Congestive Heart Failure Patients

*Novita Nirmalasari  -  Department of Nursing, Faculty of Health, Jenderal Achmad Yani Yogyakarta University, Indonesia
Mardiyono Mardiyono  -  Department of Nursing, Health Polytechnic of Semarang, Indonesia
Edi Dharmana scopus  -  Faculty of Medicine, Universitas Diponegoro, Indonesia
Thohar Arifin  -  Faculty of Medicine, Universitas Diponegoro, Indonesia
Received: 6 Sep 2019; Revised: 9 Mar 2020; Accepted: 12 Apr 2020; Published: 28 Apr 2020.
Open Access Copyright (c) 2020 Nurse Media Journal of Nursing
Creative Commons License This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Citation Format:
Article Info
Section: Articles
Language: EN
Statistics: 1249 794
Abstract

Background: Dyspnea and physiological changes are clinical manifestations of Congestive Heart Failure (CHF) due to respiratory failure. Deep breathing exercise combined with active range of motion increases respiratory muscles and blood circulation. As a result, it reduces breathing effort and decreases blood pressure.

Purpose: This research aimed to analyze the influence of deep breathing exercise and active range of motion (ROM) on physiological response of CHF patients.

Methods: This study used a quasi-experiment with pretest-posttest control group design recruiting 32 respondents by stratified random sampling technique. The intervention was done three times a day for three days. Deep breathing exercise for thirty times and continued with active range of motion for five times each movement was given. Digital sphygmomanometer and digital watch were used as measuring instruments. Data were analyzed using independent and paired t-tests.

Result: The results showed that there were significant differences in the systole (p=0.000), diastole (p=0.000) and respiratory rates (p=0.003) after the intervention compared to the control group. There was also a significant difference in systolic blood pressure between the intervention and the control group (p=0.003). However, no significant difference in diastole and respiratory rates was found.

Conclusion: Deep breathing exercise combined with active range of motion decreases the systole in CHF patients. Further research is expected to lengthen the time of intervention to allow better significance.

Keywords: Active range of motion; CHF; deep breathing exercise; physiological response

Article Metrics:

  1. Adsett, J., Hons, B. & Robbie, M. (2010). Evidence based guidelines for exercise and chronic heart failure: 2010 update. Queensland: Queensland Government. Retrieved from: https://www.health.qld.gov.au/__data/assets/pdf_file/0021/431328/guide_ exercise_chf.pdf
  2. Alvarez, P., Hannawi, B., & Guha, A. (2016). Exercise and heart failure: Advancing knowledge and improving care. Methodist DeBakey Cardiovascular Journal, 12(2), 110-115. doi: 10.14797/mdcj-12-2-110
  3. Arovah, N. I. (2010). Program latihan fisik rehabilitatif pada penderita penyakit jantung [Physical exercise rehabilitation program in congestive heart failure patients]. Medikora, VI(1), 11-22.
  4. Badriyah, F.L., Kadarsih, S., & Permatasari, Y. (2014). Latihan fisik terarah penderita post sindrom koroner akut dalam memperbaiki otot jantung [Directed physical exercise in post-acute coronary syndrome patients to improve myocardiums]. Indonesian Journal of Nursing Practices, 1 (1), 29-40.
  5. Bulechek, G., Butcher, H., Dochterman, J. M., & Wagner C. (2012). Nursing Interventions Classification (NIC) (6th ed.). Mosby: Elsevier.
  6. Cahalin L. P. & Arena R. A. (2015). Breathing exercises and inspiratory muscle training in heart failure. Heart Failure Clinics, 11(1), 149-172.
  7. Herdman, T. H., Kamitsuru, S., & North American Nursing Diagnosis Association. (2014). NANDA International, Inc. Nursing diagnoses: Definitions and classification: 2015-2017. Chichester: Wiley-Blackwell.
  8. Jewiss, D., Ostman, C., & Smart, N. A. (2016). The effect of resistance training on clinical outcomes in heart failure: A systematic review and meta-analysis. International Journal of Cardiology, 221, 674-681.
  9. Joseph, C. N., Porta, C., Casucci, G., Casiraghi, N., Maffeis, M., Rossi, M. B. & Bernardi, L. (2005). Slow breathing improves arterial baroreflex sensitivity and decreases blood pressure in essential hypertension. Hypertension, 46(4), 714-718.
  10. Kupper, N., Bonhof, C., Westerhuis, B., Widdershoven, J., & Denollet, J. (2016). Determinants of dyspnea in chronic heart failure. Journal of Cardiac Failure, 22(3), 201-209.
  11. Lee, J. S., Lee, M. S., Lee, J. Y., Cornelissen, G., Otsuka, K., & Halberg, F. (2003). Effect of diaphragmatic breathing on ambulatory blood pressure and heart rate. Biomedicine & Pharmacotherapy, 57(1), 87-91.
  12. Ministry of Health Republic of Indonesia (MoHRI). (2014). Lingkungan sehat, jantung sehat [Healthy environment, healthy heart]. Jakarta: Depkes RI. Retrieved from: http://www.depkes.go.id/article/view/201410080002/lingkungan-sehat-jantung-sehat.html
  13. Ministry of Health Republic of Indonesia (MoHRI). (2013). Riset kesehatan dasar 2013 [Basic health research 2013]. Jakarta: Badan Penelitian dan Pengembangan Kesehatan Kementerian Kesehatan RI.
  14. Nagaya, S., Hayashi, H., Fujimoto, E., Maruoka, N., & Kobayashi, H. (2015). Passive ankle movement increases cerebral blood oxygenation in the elderly: An experimental study. BMC Nursing, 14 (4), 1-7.
  15. Parati G., Malfatto G., Boarin S., Branzi G., Caldara G., Giglio A., … & Mancia G. (2008). Device-guided paced breathing in the home setting: effect on exercise capacity, pulmonary and ventricular function in patients with chronic heart failure: A pilot study. Circulation Heart Failure, 1(3), 178-183.
  16. Russo, M. A., Santarelli, D. M., & O’Rourke, D. (2017). The physiological effects of slow breathing in the healthy human. Breathe, 13(4), 298-309.
  17. Sagar, V. A., Davies, E. J., Briscoe, S., Coats, A. J., Dalal, H. M., Lough, F., … & Taylor R. S. (2015). Exercise-based rehabilitation for heart failure: Systematic review and meta-analysis. Open Heart, 2(1), e000163.
  18. Sepdianto, T. C. & Maria, D. C. T. (2013). Peningkatan saturasi oksigen melalui latihan deep diaphragmatic breathing pada pasien gagal jantung [Increased oxygen saturation through deep diaphragmatic breathing exercise on heart failure patients]. Jurnal Keperawatan dan Kebidanan, 1(8), 477-84.
  19. Shah, A., Gandhi, D., Srivastava, S., Shah, K. J., & Mansukhani, R. (2017). Heart failure: A class review of pharmacotherapy. P & T: A Peer-Reviewed Journal for Formulary Management, 42(7), 464-472.
  20. Yancy, C. W., Jessup, M., Bozkurt, B., Butler, J., Casey, D. E., Drazner, M. H., … & Wilkoff, B. L. (2013). ACCF/AHA practice guideline 2013 ACCF / AHA guideline for the management of heart failure: A report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines. ACCF/AHA Practice Guideline. Circulation, 128(16), e240-e327.
  21. Ziaeian, B. & Fonarow, G. C. (2016). Epidemiology and aetiology of heart failure. Nature Reviews Cardiology, 13(6), 368-78.