Using Box Breathing as primary intervention in addition to baseline COPD therapy

Using Wim Hoff breathing technique as primary intervention in addition to baseline COPD therapy

The protocol for box breathing, which is a powerful technique for stress management and relaxation, guided patients through a structured breathing exercise.

The box breathing exercise consisted of the following steps:

• Inhaled Deeply: Patients breathed in slowly through their nose, counting to 4, allowing their lungs to fill fully and gradually.
• Held the Breath: They held their breath for a count of 4, maintaining a sense of calm as they allowed the air to settle.
• Exhaled Slowly: They released the breath through their mouth over a count of 4, focusing on the slow, controlled release of air.
• Paused Again: After exhaling, they held the breath out for a final count of 4, embracing the brief stillness before the next cycle.

Peak Forced Expiratory Rate (PFER) is a vital measure in pulmonary health, assessing the maximum speed of exhalation to gauge lung function, particularly in asthma and COPD patients. It is measured in liters per minute using a peak flow meter, providing instant feedback on airway health. Patients monitor PFER to track airway constriction, adjusting medication as needed. The zone system include Green Zone (80-100%) indicates stable control, Yellow Zone,(50-79%) signals caution, Red Zone (below 50%) requires urgent attention.

Forced Expiratory Volume in 1 Second (FEV1) measures the air exhaled in one second after a deep breath, serving as a critical indicator of lung function and a key diagnostic tool for obstructive lung diseases like asthma and COPD. Measured via spirometry, FEV1 is compared to predicted values and paired with Forced Vital Capacity (FVC) to calculate the FEV1/FVC ratio, differentiating obstructive from restrictive diseases. In COPD classification, FEV1 aids in determining severity: Mild (≥80% of predicted), Moderate (50-79%), Severe (30-49%), and Very Severe (<30%). Tracking FEV1 over time helps clinicians assess progression, adjust treatments, and manage respiratory health effectively .

The State-Trait Anxiety Inventory (STAI) is a psychological tool that assesses anxiety through two scales: State Anxiety (temporary anxiety linked to specific situations) and Trait Anxiety (a general, long-term tendency toward anxiety). With 40 self-report items, it measures how individuals feel at the moment (state) and their baseline anxiety levels over time (trait). Used widely in clinical and research settings, the STAI helps in diagnosing anxiety, tracking treatment progress, and providing insights into situational versus personality-based anxiety. Its dual approach enables a deeper understanding of anxiety, supporting personalized interventions and research into anxiety patterns across populations.