The Effects of Two Different Breathing Techniques and Forward-Leaning Position on Physiological Parameters

The exercise program will be determined in collaboration with a respiratory physiotherapist and implemented by the researcher. Accordingly, patients with stage II-III COPD (as determined by a physician) who visit the pulmonology outpatient clinic of the relevant hospital and meet the inclusion criteria will be given brief information about respiratory exercises, their benefits, and duration. They will then be instructed on how to perform the exercises through verbal commands for approximately 30 minutes. At the end of the session, the exercise guidelines will be practiced under the supervision of the researcher.

Before starting, the patient will be seated in a chair and allowed to rest for about 15 minutes. The patient will be informed about how to perform the walking test, the expected walking pace, and that they can stop and rest if they feel fatigued. Then, the patient will be asked to walk at a brisk pace for six minutes under the supervision of the researcher. During the walk, the researcher will continuously monitor the patient's oxygen saturation using a handheld pulse oximeter. If the patient exhibits signs of excessive sweating, pallor, or a significant drop in oxygen levels, the test will be terminated early.

Before and after the test, blood pressure, pulse rate, respiratory rate, oxygen saturation [SpO2], and dyspnea score using the Modified Borg Scale will be assessed, and the distance the patient walks in six minutes will be recorded. The six-minute walk test will be repeated at the end of the study. Subsequently, the patient will undergo a pulmonary function test, and the values for FVC, FEV1, FEV1/FVC ratio, and peak expiratory flow will be recorded.

Inclusion criteria

• Patients who have no communication and cooperation problems,
• Can speak and understand Turkish,
• Have a baseline saturation of >90%,
• Have been diagnosed with Stage II and Stage III COPD,
• Have not had any infection or COPD exacerbation for at least 3 months,
• Have not participated in a pulmonary rehabilitation program in the last 3 months,
• Can walk without assistance,
• Do not have serious and/or unstable heart disease, neuromuscular disease, orthopedic disease or mental illness that may impair their physical activities of daily living,
• Willing to participate in the study will be included.

Exclusion criteria

• Patients who have been hospitalized since the start of the study,
• Those receiving continuous oxygen therapy,
• Those who have cooperation problems,
• Those who cannot adapt to exercise,
• Those who have 2-3 or more acute attacks per year,
• Those with a history of pulmonary hypertension, malignancy, pulmonary thromboembolism, obstructive sleep apnea, unstable angina or myocardial infarction,
• Patients with a pulse rate over 120/minute will be excluded from the study.