The Effect of Pursed Lip Breathing and Orthopneic Position on Increasing Peak Expiration Flow in Chronic Obstructive Pulmonary Disease Patients
DOI:
https://doi.org/10.31983/jkm.v14i2.13886Keywords:
Chronic Obstructive Pulmonary Disease, Orthopnea Position, Peak Expiratory Flow, Pursed Lip BreathingAbstract
Background: Chronic Obstructive Pulmonary Disease (COPD) is a condition characterized by chronic respiratory symptoms, including shortness of breath and cough, decreased Peak Expiratory Flow (PEF), caused by airway obstruction. Interventions such as Pursed Lip Breathing and orthopnea positioning can potentially improve PEF in COPD patients. Objective: This study aims to analyze the effect of Pursed Lip Breathing and orthopnea position on increasing PEF in COPD patients at Kartini Karanganyar Hospital. Methods: This study used a quasi-experimental design with a pretest-posttest approach. The sample consisted of 64 COPD patients who were divided into two groups: the intervention group who received Pursed Lip Breathing and orthopnea position every morning for 5 minutes for 3 days, and the control group who only received the intervention according to hospital standards. PEF measurements were taken before and after the intervention using a Peak Flow Meter. Results: The results showed that the combination of the two interventions had a significant effect on increasing the patient's PEF indicating an improvement in respiratory function (p=0.00). Conclusion: Pursed Lip Breathing and orthopnea positioning are effective in improving PEF in COPD patients, so it can be recommended as part of respiratory care.
References
PDPI. (2023). Penyakit paru obstruktif kronik (PPOK) perhimpunan dokter paru Indonesia (PDPI) pedoman diagnosis dan penatalaksanaan di Indonesia. 27–31.
Agreta, S. M. N., Rayasari, F., & Kamil, A. R. (2023). Penerapan intervensi pursed-lips breathing meningkatkan arus puncak ekspirasi pada pasien penyakit paru obstruksi kronik. Jurnal Keperawatan Silampari, 6(2), 1078–1092. https://doi.org/10.31539/jks.v6i2.4955
Akbar, Roby, Thohar, Muhamad & Rochana, Nana. (2020). Efek posisi orthopneic terhadap fungsi pernafasan: systematic review. Jurnal Ilmiah Kesehatan.
Amalia, L. Z., Setiawati, E., Isma, R., Putri, A., & Hendrianingtyas, M. (2020). The effect of forward lean position and pursed lip breathing on peak expiratory flow in active smoker. Diponegoro Medical Journal (Jurnal Kedokteran Diponegoro), 9(1), 53–60. http://ejournal3.undip.ac.id/index.php/medico
Amri, N. (2020). Penerapan posisi orthopneic untuk mengatasi ketidakefektifan pola nafas pada pasien dengan asma bronkial di Ruang Paru Mayjen H.A Thalib Kabupaten Kerinci. Jurnal Kesehatan Saintika Meditory, 2(2), 62–72. https://jurnal.syedzasaintika.ac.id
Ayudia, E. I., Miftahurrahmah, & Harahap, H. (2020). Faktor-faktor yang mempengaruhi nilai peak flow meter pada usia produktif di Kelurahan Mayang Mangurai Kota Jambi. JMJ, 115–119.
Buranapuntalug, S., Chaunchaiyakul, R., Ajjimaporn, A., & Pornsuriyasak, P. (2023). Cardiorespiratory and metabolic stresses during repeated pursed-lips breathing in chronic obstructive pulmonary disease. Physiotherapy Quarterly, 31(4), 21–27. https://doi.org/10.5114/pq.2023.117307
Chen, Y., Tan, R., Long, X., & Tu, H. (2024). Applying behavioral change theories to optimize pulmonary rehabilitation in COPD patients: A review. Medicine (United States), 103(22), E38366. https://doi.org/10.1097/MD.0000000000038366
Cheng, S. L., & Lin, C. H. (2021). COPD guidelines in the asia-pacific regions: similarities and differences. Diagnostics, 11(7), 1153.
Devulder, J. V. (2024). Unveiling mechanisms of lung aging in COPD: A promising target for therapeutics development. Chinese Medical Journal Pulmonary and Critical Care Medicine, 2(3), 133–141. https://doi.org/10.1016/j.pccm.2024.08.007
Dewanti, G. P., Kariasa, I. M., & Yona, S. (2024). Efektivitas varian metode terapi komplementer untuk fatigue pada pasien penyakit paru obstruktif kronik ( PPOK ): Tinjauan sistematik. 18(2), 252–265.
Djajalaksana, S., Yudi, A., Wardoyo, P., Listyoko, A. S., Anggraeni, R. D., Amalia, S., Amalia, A. N., Dini, Z., & Christanto, A. (2024). Correlation of brinkman’s index , cat scores , lung function in chronic obstructive pulmonary disease. International Journal for Multidisciplinary Research (IJFMR), 6(5), 1–15. https://www.doi.org/10.36948/ijfmr.2024.v06i05.27383
Emi Nurlaela, D. K. (2021). Pursed lips breathing terhadap peningkatan arus puncak ekspirasi (APE) pasien asma. Nursing Science Journal (NSJ), 2(2), 50–54. https://doi.org/10.53510/nsj.v2i2.87
Endiyono, A. S. (2020). Status respirasi pasien asma yang mendapatkan nebulisasi menggunakan jet nebulizer dibandingkan dengan nebulizer menggunakan oksigen. respirologi Indonesia, 36(4), 1–8. http://www.jurnalrespirologi.org
Fadhilah, M. A. (2024). Chronic obstructive pulmonary disease. Jama, 300(20), 2448. https://doi.org/10.1001/jama.300.20.2448
GOLD. (2024). 2024 GOLD Report - global initiative for chronic obstructive lung disease - gold (pp. 4–22). https://goldcopd.org/2024-gold-report/
Holland, A. E., Singh, S. J., Casaburi, R., Clini, E., Cox, N. S., Galwicki, M., Garvey, C., Goldstein, R. S., Houchen-Wolloff, L., Lareau, S. C., Limberg, T., Nici, L., Rochester, C. L., Steiner, M., Troosters, T., Yawn, B. P., & Zuwallack, R. (2021). Defining modern pulmonary rehabilitation: An official American thoracic society workshop report. Annals of the American Thoracic Society, 18(5), E12–E29. https://doi.org/10.1513/AnnalsATS.202102-146ST
Ikawati, Zullies. (2022). Penatalaksanaan terapi penyakit sistem pernafasan. Yogyakarta: Adipura Book Center.
Janssens, W., & Verleden, G. M. (2023). Nonpharmacological interventions in COPD. European Respiratory Review, 32(167). https://doi.org/10.1183/16000617.0028-2023
Mohammed, H. A., & Hanafy, N. F. (2024). Effect of pursed-lip versus pranayama breathing exercises on selected vital parameters among patients with COPD. Assiut Scientific Nursing Journal, 12(45), 380–394. https://doi.org/10.21608/asnj.2024.306467.1866
Morena, D., Izquierdo, J. L., Rodríguez, J., Cuesta, J., Benavent, M., Perralejo, A., & Rodríguez, J. M. (2023). The clinical profile of patients with COPD is conditioned by age. Journal of Clinical Medicine, 12(24). https://doi.org/10.3390/jcm12247595
Muliase, I. N. (2023). Analisis Patogenesis, Faktor Risiko, dan Pengelolaan Penyakit Paru Obstruktif Kronik: Studi Literatur. Jurnal Sehat Indonesia (JUSINDO), 6(01), 249–255. https://doi.org/10.59141/jsi.v6i01.71
Nielsen, A. O., Lange, P., Hilberg, O., Farver-Vestergaard, I., Ibsen, R., & Løkke, A. (2024). COPD and smoking status – it does matter: characteristics and prognosis of COPD according to smoking status. Chronic Obstructive Pulmonary Diseases, 11(1), 56–67. https://doi.org/10.15326/jcopdf.2023.0433
Novitasari, N., Fitria, N., & Komariah, M. (2024). Asuhan keperawatan pada pasien yang mengalami masalah gangguan pertukaran gas melalui posisi ortopnea pada pasien dengan CAD: Case report. SENTRI: Jurnal Riset Ilmiah, 3(2), 677–686. https://doi.org/10.55681/sentri.v3i2.2307
Nur Imamah, I., & Rahmawatie Ratna Budi Utami, D. (2022). Perbedaan pengaruh kombinasi terapi nebuliser dengan batuk efektif dan pursed lip terhadap sesak nafas pasien PPOK. Profesi (Profesional Islam) : Media Publikasi Penelitian, 20(1), 1–16. https://doi.org/10.26576/profesi.v20i1.98
Parkavi, K., Umarani, R., Anusha, N., & Rashika, R. (2022). Effect of pursed lip breathing on physiological cost index and functional exercise capacity in patients with chronic obstructive pulmonary disease. YMER Digital, 21(03), 247–254. https://doi.org/10.37896/ymer21.03/28
Putra, I. P., & Artika, I. D. M. (2021). Diagnosis dan tatalaksana penyakit paru obstruktif kronis. Ilmu Penyakit Dalam FK UNUD/RSUP Sanglah Denpasar, 1–16. https://ojs.unud.ac.id/index.php/eum/article/download/4872/3658
Rana, M., Tariq, M. I., Syed, A., Zeb, U., Tariq, F., & Tahir, A. (2022). Effects of pursed lip breathing with arm ergometry after chin support position in COPD patients. Pakistan Journal of Medical and Health Sciences, 16(9), 485–488. https://doi.org/10.53350/pjmhs22169485
Ritianingsih, N., Irawaty, D., & Handiyani, H. (2021). Peningkatan fungsi ventilasi paru pada klien penyakit paru obstruksi kronis dengan posisi high fowler dan orthopneic. Jurnal Keperawatan Indonesia, 14(1), 31–36. https://doi.org/10.7454/jki.v14i1.54
Ryan, Cooper, & Tauer. (2023). Efektivitas pursed lips breathing dengan posisi high fowler dan pursed lips breathing dengan posisi ortopnea. Paper Knowledge. Toward a Media History of Documents, 12–26.
Sari, R. P., & Mayasari, D. (2020). Penatalaksanaan holistik penyakit paru obstruktif kronik pada lansia dengan riwayat merokok dan paparan polusi udara. medula, 10(2), 257–266. http://repository.lppm.unila.ac.id/30539/1/Diana_Riska%20PPOK%20polusi%20Julil%202020.pdf
Sharma, G., & Goodwin, J. (2020). Effect of aging on respiratory system physiology and immunology. Clinical Interventions in Aging, 1(3), 253–260. https://doi.org/10.2147/ciia.2006.1.3.253
Soemarwoto, R. A. S., Rusmini, H., Sinaga, F., Susanto, A. D., & Widiyantoro, A. (2021). Comparison between the effect of clove, filter and biomass cigarette smoke to the lung function of COPD patients at Harum Melati Pringsewu Clinic Lampung Province, Period January 2013-January 2020. Jurnal Respirologi Indonesia, 41(1), 40–50. https://doi.org/10.36497/jri.v41i1.153
Suprayitno, E. (2023). Pengaruh pursed lips breathing terhadap peak expiratory flow rate penderita penyakit paru obstruksi kronis. Wiraraja Medika, 7(2), 56–60. https://doi.org/10.24929/fik.v7i2.435
Windartik, E., & Soemah, E. N. (2023). Combination effect among giving tripod position and pursed lip breathing to respiration rate in chronic obstructive pulmonary disease (COPD) patients. International Journal of Nursing and Midwifery Science (IJNMS), 6(3), 282–291. https://doi.org/10.29082/ijnms/2022/vol6/iss3/413
World Health Organization. (2023). Chronic obstructive pulmonary disease (COPD). https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd)
Yari, Y., Rohmah, U. N., & Prawitasari, S. (2023). Pengaruh pursed lips breathing (PLB) terhadap peningkatan saturasi oksigen pada pasien penyakit paru obstruktif kronik (PPOK): Literatur Review. Jurnal Kesehatan Holistic, 7(2), 36–45. https://doi.org/10.33377/jkh.v7i2.163
Downloads
Published
Issue
Section
License
Copyright (c) 2025 JURNAL KEPERAWATAN MERSI
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
