Effect of Balloon-Blowing on Dyspnea and Oxygenation in Hospitalized COVID-19 Patients: A Pilot Study

  1. Mohammad Bargahi
  2. Nafiseh Rastgoo
  3. Farzane Aryanejad
  4. Sohrab Esmaielzade
  5. Roomina Nemati
  6. Mehdi Ghaebi
  7. Arezoo Bajelan
  8. Soheil Soltani

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Abstract

Dyspnea and decreased O2 saturation are the most common causes of hospitalization in noncritical COVID-19 patients. Breathing exercises and chest physiotherapy are used for managing the patients. These treatments are, however, not well supported by scientific evidence. In a randomized controlled trial, 80 patients were randomly assigned to planned breathing exercises (n=40) and control groups (n=40). The participants in the intervention group were instructed to blow into a balloon five times a day while lying down. Other therapies were similar in both groups. The severity of dyspnea at rest/after activity and peripheral oxygen saturation (SpO2) with/without O2 therapy were compared between the two groups on the first, second, and third days. The study findings showed no statistically significant difference in SpO2 with/without O2 therapy on the first, second, and third days between the two groups. Although the severity of dyspnea showed no significant difference between the two groups, the mean score of dyspnea at rest (2.72±2.25 vs. 1.6±1.21, P=0.007) and after activity (4.53±2.04 vs. 3.52±1.66, P=0.017) improved in the intervention group on the third day. Balloon-blowing exercise improves dyspnea in noncritical Covid-19 patients, but it does not significantly improve oxygenation.

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  1. Version published to 10.18502/acta.v60i6.10038
  2. ScreenIT

    SciScore for 10.1101/2021.07.27.21260398: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsField Sample Permit: This pilot study was conducted to estimate the sample size needed for future studies due to lack of data and the innovation of the method used.
    IRB: Ethical considerations: The Ethics and Research Committee of Qazvin University of Medical Sciences approved this study (IR.QUMS.REC.1399.043).
    Consent: Informed written consent was obtained from all participants following a detailed explanation of the examination and study procedures.
    Sex as a biological variablenot detected.
    RandomizationThis study had a randomized controlled design.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    The patients who met the inclusion criteria were selected and divided into two groups included intervention and control groups based on random number blocks designed by Excel software.
    Excel
    suggested: None
    Statistical analysis: The collected data were analyzed using the IBM SPSS software version 26 in two unlabeled groups.
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    This study had several limitations. Because of the nature of rehabilitation and assessment, neither the executors nor the participants could be blinded. Therefore, it is not possible to rule out the placebo effect, observer bias or experimenter bias in the current study. In addition, the subjects were limited to patients aged 18 years and above, the duration of the intervention was only three days, and the number of participants was insufficient in each group. Eventually, we did not measure other variables such as the respiratory rate, pulse rate, lung capacities, and anxiety score. Therefore, future studies should address these limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2021.07.27.21260398v1 on medRxiv