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Effectiveness of Balloon Therapy on Respiratory Status of Patients with Lower

Respiratory Tract Disorders

Article · April 2015

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 International Journal of Science and Research (IJSR)
ISSN (Online): 2319-7064
Index Copernicus Value (2013): 6.14 | Impact Factor (2013): 4.438

Effectiveness of Balloon Therapy on Respiratory

Status of Patients with Lower Respiratory Tract
Disorders
1
Renuka K. , Helen Shaji J. C.2, Kripa Angeline A.3
1
Principal, Kasturba Gandhi Nursing College, Puducherry, India
2
Coordinator of Nursing Department, College of Applied Medical Sciences, Majma’ah University, Kingdom of Saudi Arabia,
3
Associate professor, Kasturba Gandhi Nursing College, Puducherry, India

Abstract: Breathing is the bridge between mind and body, the connection between consciousness and unconsciousness. Chronic
respiratory disease is found to be one of the most distressful conditions, badly affecting the quality of human life in our society. The
main aim of the study was to assess the effectiveness of balloon therapy on respiratory status of patients with lower respiratory tract
disorders. Pre-experimental design was used for this study. Total 20samples were selected using purposive random sampling
technique and balloon therapy was given for two weeks. The data pertaining to respiratory status was collected using structured self
administered questionnaire and respiratory assessment for respiratory rate , dyspnea, and lung capacity were done using incentive
spirometry. Among 20 patients, 15(75%) of patients had poor respiratory rate, 5(25%) patients have poor lung capacity, 15(75%)
patients had poor dyspnea score before the implementation of balloon therapy where as after the implementation of balloon therapy,
18(90%) of patients had normal respiratory rate, 12(60%) of patients had normal score in dyspnea scale and all of them (100%)
attained normal lung capacity. The result of this study proved that regular practice of balloon therapy can improve the respiratory
status to a greater extent among patients with lower respiratory disorders.

Keywords: Effectiveness, balloon therapy, respiratory status, lower respiratory disorders, dyspnea scale.

1. Introduction the respiratory disorders namely asthma, bronchitis, and

tuberculosis (TB) and Pneumonia. In low resource setting
Breath is the key to health and wellness, a function can these diseases are mainly attributed with exposure to indoor
learn to regulate and develop in order to improve our pollution, solid cooking fuels, poor housing, low nutritional
physical, mental and spiritual wellbeing. Breathing is one status and sanitary condition. The association of respiratory
of the most important functions to our body. A person can disorder with geographical region may be relevant with
only live from 5 to 10 seconds without taking another population density, industrial and textile pollutants, and
breath. The main function of breathing is to deliver oxygen tobacco consumption.
to our lungs and to remove carbon-di-oxide when necessary
which is done by respiratory system. Over 35 million people in the United States are living with
lung disease and one in seven people die from it each year.
Respiratory disease is a significant chronic health problem Respiratory disease accounts for 14% of total expenditure
in our society. Chronic respiratory disease is found to be for health care in the United States (Health People, 2010).
one of the most distressful conditions, badly affecting
human life. Flick M.R, Moody LE et.al (2011, Swedan) conducted a
study on effect of nebulization on arterial oxygen saturation
World health organization (2011) shows that by mid- in COPD. 20 patients with mild to severe COPD received
century, morbidity and mortality from respiratory disease ultrasonic nebulization to assess the danger of short term
will reach record at High levels. The report of “WORLD changes in blood gas level during this therapy. The status
HEALTH STATISTICS 2011” Says that, 235 million of arterial oxygenation was monitored during 20 minutes.
people currently suffer from asthma, 90% of COPD deaths In all 20 patients pulse oxymetry studies showed only a
occur in low and middle income countries and > 3 million small mean change at ten minutes of nebulization therapy.
people died of COPD in 2005. The lower respiratory tract
infection pneumonia remains that most common infection Kyndall L Boyle et.al (2010) conducted a study about the
seen in the community and among hospitalized patients. value of blowing up a balloon. A therapeutic exercise that
promotes optimal posture (Diaphragm and lumbar spine
National Disease Statistics (2011) Worldwide shows a high position) and neuromuscular control of the deep
prevalence of respiratory morbidity among patients with abdominals, diaphragm and pelvic floor (lumbar-pelvic
respiratory disorders. It says that COPD is the third leading stabilization).This exercise was designed to optimize
cause of death in America. 12.7 million U.S adults (aged breathing and enhance both posture and stability in order to
18 and above) were estimated to have COPD, 10.1 million improve functions and /or decreases pain.
Americans reported chronic bronchitis and 4.7 million with
emphysema. Most of the disease burden in India is due to
Volume 4 Issue 3, March 2015
www.ijsr.net
Paper ID: SUB151952 496
Licensed Under Creative Commons Attribution CC BY
 International Journal of Science and Research (IJSR)
ISSN (Online): 2319-7064
Index Copernicus Value (2013): 6.14 | Impact Factor (2013): 4.438
Most of the patients in India with chronic lower respiratory 2.6.2 Inclusion Criteria:
disorders used to be on some forms of broncho dilator  Patients who were diagnosed as any form of Lower
therapy, which has its own side effects also. So the respiratory disorders such as asthma, pneumonia,
investigators felt that if this cost effective balloon therapy tuberculosis, bronchitis etc.
is found to be effective in improving the respirtory status of  Patients who were not receiving any forms of
patients, can replace the drug usage or reduce its dosage Bronchodilator therapy.
and thereby can improve the Quality of life of patients with  Patient with age of 20-60 years
Lower respiratory disorders.  Both sexes

1.1Objectives of the Study 2.7 Sampling Technique

 To assess the respiratory status of patients with lower The patients who met the inclusion criteria during the data
respiratory tract disorders during pretest. collection period were selected using purposive sampling
 To evaluate the effectiveness of balloon therapy on technique.
respiratory status of patients with lower respiratory tract
disorders. 2.8 Procedure for Data collection
 To find out the association between respiratory status of
the patient with lower respiratory tract disorders and Before starting data collection, the researcher obtained
selected demographic variables. permission from the Head Of the Department of pulmonary
medicine. The samples were selected based on the criteria
2. Methodology and informed consent was obtained. Pre-test was done on
the first day of data collection using the structured
2.1 Research Approach Questionnaire, Dyspnea scale and incentive spirometry.
Balloon therapy was given for about 14 consecutive days.
Experimental research approach was adopted for the study Commercially available balloons were used for the study.
as it was intended to assess the effectiveness of balloon Patients were encouraged to inflate the balloon to the
therapy on respiratory status of the patient with lower diameter of 7 inches about 8 to 10 times per day. The
respiratory tract disorders. balloon was given with a measuring wire of 7 inches. A
recording sheet was provided to the patients to document
2.2 Research Design the frequency of the therapy and the procedure was
monitored by the investigator. Post-test was done on the 14
Single group pre-test post-test pre experimental design was th day after the balloon therapy. Data was collected using
used. observation and interviewing method focusing on the
improvement of respiratory status and lung capacity of
2.3 Study Setting patients. The data was collected for a period of four weeks.

The study was conducted in Mahatma Gandhi Medical 3. Results

College and Research Institute Puducherry. It is a Multi-
Specialty Hospital situated 15 km away from Puducherry. 3.1 Background Variables
It is a 850 bedded hospital with all speciality Wards.
Considering the age group, 4(20%) of them were in the age
2.4 Study Population group of 20-40 years, 13(65%) were in the age group of 41-
60 years and 3(15%) belong to the age group of 61 &
All the patients in male & female medical ward of above.
MGMC&RI, who met the inclusion criteria.
With respect to the gender, 13(65%) are male & 7(35%)
2.5 Sample and Sample Size are female. With respect to the smoking habit 8(40%) are
smokers and 12(60%) are non smokers (Fig.1). With
Patient who got admitted in female and male medical ward respect to the duration of illness, 10(50%) had this illness
with lower respiratory disorders and those who fulfill the less than 2 years, 8(40%) had illness 2-3 years and only
criteria, were selected as sample. The sample size was 20. 2(10%) had more than 2 years.

2.6 Criteria for Sample Selection

2.6.1 Exclusion Criteria:

 Patient who were not willing to participate
 Patient with oral lesions
 Patient who cannot follow the instruction .e.g., deaf and
dumb, psychiatric patients and blind patients.
 Patient who had chronic diseases like cancer,
congestive cardiac failure etc.

Volume 4 Issue 3, March 2015

www.ijsr.net
Paper ID: SUB151952 497
Licensed Under Creative Commons Attribution CC BY
 International Journal of Science and Research (IJSR)
ISSN (Online): 2319-7064
Index Copernicus Value (2013): 6.14 | Impact Factor (2013): 4.438

Figure 1: Percentage distribution of smoking habit among Figure 3: Percentage distribution of Life style practices
patients with lower respiratory tract disorders among patients with lower respiratory tract disorders:

3.2 Effectiveness of Balloon therapy on respiratory rate,

Table 1: Frequency And Percentage Distribution Of Type dyspnea scale and Lung capacityof patients with lower
of Workers, Presence Of Co-Morbid Illness and alternative respiratory tract disorders
therapy practices among Patients With Lower Respiratory
Tract Disorders The findings of the study depicts that similar number
S.NO Demographic variables Frequency Percentage 15(75%) of patients had poor respiratory rate as well as
1 Types of workers poor dyspnea score and 5(25%) patients had poor lung
a) Sedentary workers 5 25 capacity before the implementation of balloon therapy
b) Moderate workers 12 60
c) Heavy workers 3 15
where as 18(90%) patients had normal respiratory rate
2 Presence of co-morbid illness (Fig.4), 12(60%) patients had normal dyspnea score and
a) Anemia 5 25 20(100%) patients had achieved normal lung capacity
b) Ischemic heart disease 4 20 (Fig.5) after the implementation of balloon therapy. It was
c) Thyroid disorders 1 5 also noted that there was a highly significant improvement
d) None 10 50 in the respiratory rate (P < 0.001), dyspnea score (P<0.01)
3 Alternative therapy practices and lung capacity (P< 0.05) after balloon therapy.
a) Ayurveda 0 0
b) Homeopathy 0 0
c) Naturopathy 0 0
d) Siddha 1 5
e) Unani 0 0
f) None 19 25

Figure 4: Effectiveness of Balloon therapy on respiratory

rate of patients with lower respiratory tract disorders

Figure 2: Percentage distribution of tobacco chewing habit

among patients with lower respiratory tract disorders

Volume 4 Issue 3, March 2015

www.ijsr.net
Paper ID: SUB151952 498
Licensed Under Creative Commons Attribution CC BY
 International Journal of Science and Research (IJSR)
ISSN (Online): 2319-7064
Index Copernicus Value (2013): 6.14 | Impact Factor (2013): 4.438
Others 15 75 5 25
6 Duration of illness X2 =1.467
<2years 8 40 25 10 df=2
2-3 years 5 25 2 10 P=0.48
>2years 2 10 0 0 NS**
7 Types of workers X2 =1.600
Sedentary workers 3 15 2 10 df=2
Moderate workers 9 45 3 15 P=0.449
Heavy workers 3 15 0 0 NS**
8 Co-morbid illness X2 =2..400
Anemia 3 15 2 10 df=3
IHD 4 20 0 0 P=0.494
Thyroid disorder 1 5 0 0 NS**
None 7 35 3 15
9 Smoking Habit X2 =4.444
Yes 8 40 0 0 df=1
No 7 35 5 25 P=0.035
S**
10 Tobacco chewing habit X2 =0.000
Yes 12 60 4 20 df=1
Figure 5: Effectiveness of Balloon therapy on Lung P=1
No 3 15 1 5
capacity of patients with lower respiratory tract disorders NS**
11 Alternative therapies if any X2 =0.351
3.3 Association between respiratory status of patient Ayurveda 0 0 0 0 df=1
with lower respiratory tract disorder and selected Homeopathy 0 0 0 0 P=0.554
demographic variables Naturopathy 0 0 0 0 NS**
Siddha 1 5 0 0
There was no significant association between respiratory Unani 0 0 0 0
rate and selected variables like age, education status, None 14 70 5 25
occupation status, area of work, duration of illness, type of Bronchodilators 10 50 4 20
workers, co-morbid illness, tobacco chewing habit, Antibiotics 4 20 1 5
alternative therapies, and life style practices except Gender NSAIDS
(P < 0.05). The Chi square test revealed that balloon 12 Life style practices X2
therapy was more effective to improve the respiratory Breathing 1 5 0 0 =2.222
Aerobic 0 0 0 0 df=2
status of males than females.
Yoga 4 20 0 0 P=0.32
Meditation 0 0 0 0 9
Table 2: Association between dyspnea scale with selected Others 10 50 5 25
demographic variables NS**
S. Demographic variables Respiratory rate of X2 value
N patient with lower s* significant, NS**-non significant
O respiratory tract
disorder Table:2 describe the association between Dyspnea scale of
Poor Adequate patients with lower respiratory tract disorders and selected
F % F % demographic variables. There was no association of
1 Age X2 =6.188 respiratory rate with selected variables like education
df=2 status, occupation status, area of work, duration of illness,
20-40 2 10 2 10
P=0.045 type of workers, co-morbid illness, tobacco chewing habit,
41-60 12 60 1 5
S** alternative therapies, and life style practices where as there
61 and above 1 5 2 10
2 Gender X2 =3.590
was a significant association between age, gender and
Male 8 40 5 25 df=1 smoking habit at p<0.05. It was clearly evident that there
Female 7 35 0 0 P=0.058 was a significant improvement seen in the dysnea score of
S** non smokers than smokers after ballon therapy.
3 Educational status X2 =4.711
Non literate 3 15 2 10 df=1 3.5 Association between lung capacity of patients with
primary 10 50 2 10 P=0.194 lower respiratory tract disorders and selected
secondary 2 10 0 0 NS** demographic variables
graduate 0 0 1 5
4 Occupational status X2 =1.908 There was no significant association between lung capacity
Un-employed 3 15 2 10 df=2 and selected demographic variables like age, gender,
Self-employed 11 55 2 10 P=0.385
education status, occupation status, area of work, smoking
Employment in public sector 1 5 1 5 NS**
habit, type of workers, co-morbid illness, tobacco chewing
Employment in private sector 0 0 0 0
habit, alternative therapies, and life style practices.
5 Area of work X2 =0
Cotton industry 0 0 0 0 df=0 However there was a significant association found between
Chemical factory 0 0 0 0 P=0 duration of illness at P<0.05 and lung capacity. It was
Mining industry 0 0 0 0 NS** clearly evident from the findings that patients who had
Volume 4 Issue 3, March 2015
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Paper ID: SUB151952 499
Licensed Under Creative Commons Attribution CC BY
 International Journal of Science and Research (IJSR)
ISSN (Online): 2319-7064
Index Copernicus Value (2013): 6.14 | Impact Factor (2013): 4.438
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capacity. This shows improvement in respiratory status of causes of Bronchiectasis; Primary CIliary Dyskinesia”.
patient with lower respiratory tract disorders after balloon Journal of Respiratory Disorders, 72(3), pp253-263,
therapy. 2007.
[13] Benzo R, Kelley G.A., Recchi C Hofman A, Scriurba
The findings of this study was supported by the study F, “Compliations of Lung Resection and Exercise
conducted by Lai Dee et, al (1998) on significance of Capacity; a Meta Analysis” Respire Medical, 101(8),
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asked to inflate one new ordinary balloon to a diameter of 7
inches 40 times a day for 8 weeks. The rest 11 men whose Author Profile
mean age was taken as control group, without treatment.
The study reported a significant reduction in breathlessness Dr. Renuka K pursued her M.Sc (medical surgical
after regular balloon inflation. nursing) in saveetha college of nursing, Chennai,
India and P.hd in Nursing at vinayaga mission
university, salem. She is currently working as a
5. Conclusion Principal at Kasturba college of nursing,
pillaiyarkuppam, pudhucherry, India.
The study findings clearly reveal that regular practice of
balloon therapy improves the respiratory status of patients
as there was a significant improvement in the respiratory Dr. Helen Shaji J.C. pursued her M.Sc (Medical and
status measured in terms of respiratory rate, dyspnea scale surgical nursing) in Saveetha College of Nursing.
and lung capacity in patients with lower respiratory tract Chennai, India and Ph.D in Nursing at The
Tamilnadu Dr. M.G.R. Medical University, Chennai,
disorders who underwent balloon therapy. This simple cost India. She has got 15 years of teaching experience in the field of
effective intervention can also be considered as an Nursing education both India as well as Overseas and currently
alternative measure to improve the lung function among working as a Head of the Department – Nursing (Female section)
patients with respiratory disorders. at College of Applied Medical Sciences, Majma’ah University,
Kingdom of Saudi Arabia
Reference
Mrs. Kripa Angeline pursued her M.Sc (medical
surgical nursing) in kovai medical college and
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[6] P.S.SunderRao, An Introduction to Biostatistics, 3rd
hail of Indira Publications, Prentice.

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