Physical Therapist/Clinical Research Specialist Mayo Clinic Florida St. Johns, Florida, United States
Research Objectives: To investigate if a one-time instruction in a diaphragmatic breathing exercise program, in a primary care setting, performed remotely or in person, was adequate at reducing symptoms of gastro esophageal reflux disease (GERD) and anti reflux medications usage.
Design: This is a prospective before-and-after, interventional study. Follow up surveys were taken at 1, 3 and 6 months via phone or email
Setting: Family practice at Mayo Clinic Florida (MCF) provided the subjects whom were recruited, consented and instructed either virtually and in person due to Covid-19
Participants: 918 individuals were contacted for recruitment. 185 were recruited into the study and 55 completed the study. One withdrew due to increased pain.
Interventions: Subjects were instructed in diaphragmatic breathing, supplemented with both video recorded instruction and by a brochure. Prior to and after Covid lockdown, individuals were instructed in person, also video instruction and pamphlets issuance was used. The prescribed exercise was to be performed 10 times before and after each meal, and as needed for symptoms control for the duration of the study.
Main Outcome Measures: Reflux disease questionaire (RDQ) score changes. Initially anti-reflux medication changes were not addressed but a modification was added to monitor any voluntary medication changes.
Results: A total of 185 patients were included in the analysis, Wilcoxon signed rank test was used to evaluate the change in RDQ score from baseline to 1, 3 and 6 months. All tests were two-sided with p value < 0.05 considered statistically significant. Median changes of RDQ score from baseline to 1, 3 and 6 months were -6, -11 and -12, and all the changes were statistically significant at < 0.0001 level. Of the 55 patients completing the final survey, 11 persons were either able to reduce or stop anti reflux medication.
Conclusions: A one time instruction with supplemental materials was effective at reducing symptoms of reflux progressively at the 1,3 and 6 month follow-up periods
Author(s) Disclosures: No researchers in this study have any conflicts of interest to report.
Learning Objectives:
Upon completion, the participant will be able to describe an effective diaphragmatic breathing program for the control of symptoms of reflux.
Upon completion, the participant will be able to palpate and coach an isolated diaphragmatic contraction.
Upon completion, the participant will be able to visualize demonstrate the appropriate diaphragmatic exercise to recruit diaphragmatic contraction utilized in this study.
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