Effect of respiratory biofeedback on effort dyspnea in COPD patients during pulmonary rehabilitation: a pilot study

<bold>Background:</bold> Patients with advanced Chronic Obstructive Pulmonary Disease (COPD) experience effort dyspnea despite maximal drug therapy. Respiratory BF (R-BF) uses sensors for monitoring of electrophysiological parameters and consisted in the patient's progressive education in slow and deep breathing (1). We aim to assess if R-BF training in addition to pulmonary rehabilitation (PR) in patients with optimal pharmacological therapy may determine a benefit on of effort dyspnea. <bold>Methods:</bold> 17 stable COPD patients (all E group) with modified Medical Research Council(mMRC)>3 despite maximal pharmacological therapy were consecutively enrolled for 6 months and randomly divided into two groups: group 1, intervention group(PR+BF); group 2, control group(only PR). The study outcomes were: mMRC, BORG dyspnea, BARTHEL dyspnea, SPPB, 6-minute walk test distance (6MWD), St. George Respiratory Questionnaire (SGRQ), EuroQOL-5 Dimension Questionnaire (EQ-5D™), Montreal Cognitive Assessment (MoCA Test), The Hospital Anxiety and Depression Scale (HADS A and D) <bold>Results:</bold> after rehabilitation, mMRC, BORG D, BARTHEL dyspnea and quality of life questionnarire increased in both groups. In addition, only group 1 showed improvement in 6MWD(p=0.041) and in cognitive domains(p=0.006), specifically in:Executive Functions(p=0.015), Memory(p=0.019), Language(p=0.045), Orientation(p=0.046) <bold>Conclusions:</bold> R-BF does not provide additional benefit on dyspnea, but in combination with PR may promote additional benefits not only on motor but also cognitive outcomes in COPD patients with effort dyspnea despite optimal therapy <bold>Ref:</bold> 1)de Souto Barbosa JV Appl Psychophysiol Biofeedback.2023Dec;48(4):423-432