Effect of Prone Positioning and Alternate Nostril Breathing Technique on Oxygen Saturation and Psychological Status in Patients with COVID-19

Prone Positioning and Alternate Nostril Breathing in Patients with COVID-19

Authors

  • Sahreen Anwar University Institute of Physical Therapy, The University of Lahore, Lahore, Pakistan
  • Wajida Parveen Department of Physical Therapy, Sialkot College of Physical Therapy, Sialkot, Pakistan
  • Muqadas Chaudary Department of Physical Therapy, University of Management and Technology, Lahore, Pakistan
  • Asad Habib Midland Doctors Medical Institute, Muzaffarabad, Pakistan
  • Sohail Khan Raja Department of Pulmonology, Azad Jammu and Kashmir Medical College, Muzaffarabad, Pakistan

DOI:

https://doi.org/10.54393/pbmj.v7i11.1116

Keywords:

Anxiety, Breathing, COVID-19, Prone Position

Abstract

Prone positioning has certain benefits in improving respiratory parameters. Objectives: To study the effects of prone lying position and alternate nostril breathing in patients diagnosed with COVID-19. Methods: This quasi-experimental study was conducted at District Headquarters Hospital Faisalabad, Pakistan. After ethical approval, patients between the ages of 40-80 were recruited with a diagnosis of COVID-19 and received supplemental oxygen. Thirty patients with COVID-19 were divided into two groups, group A opted prone lying alone and group B performed prone lying with alternate nostril breathing. Study outcomes were fractional oxygen concentration in inspired air (FiO2), partial pressure of oxygen (PaO2), and general psychological status recorded at baseline and after one hour of re-supination. A paired sample t-test and ANOVA were applied to find between-group and within-group differences (p≤0.05). Results: Out of 30 patients, 16 (53.3) were male and 14 (46.7%) were female. The mean age ± standard deviation of the participants in group A was 57.58±10.4 and in group B was 59.21±9.589. There was a significant inter-group difference in mean scores for General Anxiety Disorder-7, 9.290±2.355 before and 4.677±2.224 after the treatment. The pretreatment mean value of FiO2 was 1.68±0.475; after treatment, the value was 3.45±2.119. A p-value≤0.05 was found statistically significant for all outcome variables improving respiratory parameters and reducing anxiety. Conclusions: It was concluded that prone positioning with alternate nostril breathing effectively improves (PaO2), (FiO2) and general psychological state in COVID-19 patients.

References

Park M, Cook AR, Lim JT, Sun Y, Dickens BL. A Systematic Review of COVID-19 Epidemiology Based On Current Evidence. Journal of Clinical Medicine. 2020; 9(4): 967. doi: 10.3390/jcm9040967. DOI: https://doi.org/10.3390/jcm9040967

Rana R, Tripathi A, Kumar N, Ganguly NK. A Comprehensive Overview On COVID-19: Future Perspectives. Frontiers in Cellular and Infection Microbiology. 2021; 11: 744903. doi: 10.3389/fcimb.2021.744903. DOI: https://doi.org/10.3389/fcimb.2021.744903

Gattinoni L, Gattarello S, Steinberg I, Busana M, Palermo P, Lazzari S et al. COVID-19 Pneumonia: Pathophysiology and Management. European Respiratory Review. 2021; 30(162). doi: 10.1183/16000617.0138-2021. DOI: https://doi.org/10.1183/16000617.0138-2021

Mehta OP, Bhandari P, Raut A, Kacimi SE, Huy NT. Coronavirus Disease (COVID-19): Comprehensive Review of Clinical Presentation. Frontiers in Public Health. 2021; 8: 582932. doi: 10.3389/fpubh.2020.582932. DOI: https://doi.org/10.3389/fpubh.2020.582932

Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX et al. Clinical Characteristics of Coronavirus Disease 2019 in China. New England Journal of Medicine. 2020; 382(18): 1708-20. doi: 10.1056/NEJMoa2002032. DOI: https://doi.org/10.1056/NEJMoa2002032

Parasher A. COVID-19: Current Understanding of Its Pathophysiology, Clinical Presentation and Treatment. Postgraduate Medical Journal. 2021; 97(1147): 312-20. doi: 10.1136/postgradmedj-2020-138577. DOI: https://doi.org/10.1136/postgradmedj-2020-138577

Zarantonello F, Sella N, Pettenuzzo T, Andreatta G, Calore A, Dotto D et al. Early Physiologic Effects of Prone Positioning in COVID-19 Acute Respiratory Distress Syndrome. Anesthesiology. 2022; 137(3): 327-39. doi: 10.1097/ALN.0000000000004296. DOI: https://doi.org/10.1097/ALN.0000000000004296

Beran A, Mhanna M, Srour O, Ayesh H, Sajdeya O, Ghazaleh S et al. Effect of Prone Positioning on Clinical Outcomes of Non-Intubated Subjects with COVID-19. Respiratory Care. 2022; 67(4): 471-9. doi: 10.4187/respcare.09362. DOI: https://doi.org/10.4187/respcare.09362

Ghiya S. Alternate Nostril Breathing: A Systematic Review of Clinical Trials. International Journal of Research and Medical Sciences. 2017; 5(8): 3273-86. doi: 10.18203/2320-6012.ijrms20173523. DOI: https://doi.org/10.18203/2320-6012.ijrms20173523

Vitacca M, Carone M, Clini EM, Paneroni M, Lazzeri M, Lanza A et al. Joint Statement on the Role of Respiratory Rehabilitation in the COVID-19 Crisis: The Italian Position Paper. Respiration. 2020; 99(6): 493-9. doi: 10.1159/000508399. DOI: https://doi.org/10.1159/000508399

Hantoro AC and Soekiswati S. Respiratory Rehabilitation in COVID-19 Patients with Breathlessness: Literature Review. In Prosiding University Research Colloquium. 2022: 221-236.

Camargo L, Herrera-Pino J, Shelach S, Soto-Añari M, Porto MF, Alonso M et al. GAD-7 Generalized Anxiety Disorder Scale in Colombian Medical Professionals During the COVID-19 Pandemic: Construct Validity and Reliability. Revista Colombiana de psiquiatria (English ed.). 2023; 52(3): 245-50. doi: 10.1016/j.rcpeng.2021.06.011. DOI: https://doi.org/10.1016/j.rcpeng.2021.06.011

Luks AM and Swenson ER. Pulse Oximetry for Monitoring Patients with COVID-19 At Home. Potential Pitfalls and Practical Guidance. Annals of the American Thoracic Society. 2020; 17(9): 1040-6. doi: 10.1513/AnnalsATS.202005-418FR. DOI: https://doi.org/10.1513/AnnalsATS.202005-418FR

Satici MO, Islam MM, Satici C, Uygun CN, Ademoglu E, Altunok İ et al. The Role of a Noninvasive Index ‘Spo2/Fio2’ in Predicting Mortality among Patients with COVID-19 Pneumonia. The American Journal of Emergency Medicine. 2022; 57: 54-9. doi: 10.1016/j.ajem.2022.04.036. DOI: https://doi.org/10.1016/j.ajem.2022.04.036

Shelhamer MC, Wesson PD, Solari IL, Jensen DL, Steele WA, Dimitrov VG et al. Prone Positioning in Moderate to Severe Acute Respiratory Distress Syndrome Due to COVID-19: A Cohort Study and Analysis of Physiology. Journal of Intensive Care Medicine. 2021; 36(2): 241-52. doi: 10.1177/0885066620980399. DOI: https://doi.org/10.1177/0885066620980399

Shukla M, Chauhan D, Raj R. Breathing Exercises and Pranayamas to Decrease Perceived Exertion During Breath-Holding While Locked-Down Due to COVID-19 Online Randomized Study. Complementary Therapies in Clinical Practice. 2020; 41: 101248. doi: 10.1016/j.ctcp.2020.101248. DOI: https://doi.org/10.1016/j.ctcp.2020.101248

Schifino G, De Grauw AJ, Daniele F, Comellini V, Fasano L, Pisani L. Effects of prone and lateral position in non-intubated patients with 2019 Novel Coronavirus (COVID-19) pneumonia. Pulmonology. 2020; 27(2): 167–171. doi: 10.1016/j.pulmoe.2020.10.015. DOI: https://doi.org/10.1016/j.pulmoe.2020.10.015

Wang J, Chen D, Deng P, Zhang C, Zhan X, Lv H, Xie H, Chen D, Wang R. Efficacy and safety of awake prone positioning in the treatment of non-intubated spontaneously breathing patients with COVID-19-related acute respiratory failure: a systematic review and meta-analysis. Journal of Intensive Medicine. 2023; 3(4): 365-72. doi: 10.1016/j.jointm.2023.02.001. DOI: https://doi.org/10.1016/j.jointm.2023.02.001

Siregar MA, Permatasari A, Ariani Y. The Effects of Combination Orthopneic Position and Pursed Lips Breathing On Respiratory Status of COPD Patients. European Journal of Molecular and Clinical Medicine. 2021; 8(3): 4106-4111.

Kader M, Hossain MA, Reddy V, Perera NK, Rashid M. Effects of Short-Term Breathing Exercises On Respiratory Recovery in Patients with COVID-19: A Quasi-Experimental Study. BioMed Central Sports Science, Medicine and Rehabilitation. 2022; 14(1): 60. doi: 10.1186/s13102-022-00451-z. DOI: https://doi.org/10.1186/s13102-022-00451-z

Behesht Aeen F, Pakzad R, Goudarzi Rad M, Abdi F, Zaheri F, Mirzadeh N. Effect of Prone Position on Respiratory Parameters, Intubation and Death Rate in COVID-19 Patients: Systematic Review and Meta-Analysis. Scientific Reports. 2021; 11(1): 14407. doi: 10.1038/s41598-021-93739-y. DOI: https://doi.org/10.1038/s41598-021-93739-y

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Published

2024-11-30
CITATION
DOI: 10.54393/pbmj.v7i11.1116
Published: 2024-11-30

How to Cite

Anwar, S., Parveen, W., Chaudary, M., Habib, A., & Raja, S. K. (2024). Effect of Prone Positioning and Alternate Nostril Breathing Technique on Oxygen Saturation and Psychological Status in Patients with COVID-19: Prone Positioning and Alternate Nostril Breathing in Patients with COVID-19. Pakistan BioMedical Journal, 7(11), 15–19. https://doi.org/10.54393/pbmj.v7i11.1116

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