Efficacy of Yoga for Self-Management of Dyspnea in COPD

描述（由申请人提供）：呼吸困难（呼吸急促）的管理是慢性阻塞性肺疾病（COPD）患者的主要问题。传统的有监督的和以家庭为基础的运动项目对减少呼吸困难的有效性已经得到了很好的证实。剩下的知识差距是补充运动的有效性，患者报告他们正在使用这些运动来控制呼吸困难，这可能更符合肺病患者的生活方式和价值观，并且可以适应疾病严重程度和残疾的变化。瑜伽练习是人们用来控制呼吸困难的补充疗法。先前的研究缺乏控制设计、大样本、方案描述或测量呼吸困难的有效工具。本探索性研究的目的是：1)为慢性阻塞性肺病患者制定安全可行的瑜伽计划；2)测试该方案的有效性，同时确定该方案可能预期的呼吸困难的减少；3)确定瑜伽练习是否对身体表现、心理健康和健康相关生活质量（HRQL）的次要结局有积极影响；4)识别和联系社区资源，包括医生、护士、瑜伽练习者和设施，以支持在目标社区对COPD患者进行瑜伽训练的测试。在一项前瞻性随机对照试验中，三组患有中度至重度COPD的受试者（N=36）将被随机分配到实验瑜伽训练组或常规护理对照组，为期12周。结果将在基线、每次训练后和训练项目结束后立即进行测量。如果瑜伽被证明可以影响COPD患者的呼吸困难，那么这项探索性研究的结果将为撰写多中心对照试验奠定基础，以比较瑜伽训练对呼吸困难和多变量结果的影响，与注意对照组和常规护理组比较，该组有更大的中重度COPD患者样本。

DESCRIPTION (provided by applicant): Management of dyspnea (shortness of breath) is a major problem for patients with chronic obstructive lung diseases (COPD). The effectiveness of traditional supervised and home-based exercise programs for decreasing dyspnea is well established. The remaining knowledge gap is the efficacy of complementary exercises that patients report they are using to manage dyspnea, that may be more congruent with pulmonary patients' lifestyles and values, and that can be adapted to changes in illness severity and disability. Yoga practice is a complementary therapy that people use to manage their dyspnea. Previous studies lack controlled designs, large samples, protocol descriptions, or valid instruments for measuring dyspnea. The aims of this exploratory study are: 1) to develop a safe and feasible yoga program for patients with COPD; 2) to test the efficacy of this program, while establishing the decrease in dyspnea that may be expected with such a program; 3) to determine whether secondary outcomes of physical performance, psychological well being, and health related quality of life (HRQL) are positively affected by yoga practice; 4) to identify and contact community resources including physicians, nurses, yoga practitioners and facilities to support the testing of yoga training for patients with COPD in targeted communities. In a prospective randomized controlled trial three cohorts of subjects with moderate to severe COPD (N=36) will be randomly assigned to either an experimental yoga training or a usual care control for12 weeks. Outcomes will be measured at baseline, after each session, and immediately after the training program. If yoga is shown to affect dyspnea in patients with COPD, the findings of this exploratory study will serve as a foundation for the writing of a multi-center controlled trial to compare the effect of yoga training on dyspnea and multivariate outcomes to an attention control group and a usual care group with a larger sample of patients with moderate to severe COPD.