Graduation Year

2025

Document Type

Dissertation

Degree

Ph.D.

Degree Name

Doctor of Philosophy (Ph.D.)

Degree Granting Department

Nursing

Major Professor

Theresa M. Beckie, Ph.D.

Committee Member

Bini Thomas, Ed.D.

Committee Member

Carmen Rodriguez, Ph.D.

Committee Member

Ayesha Johnson, Ph.D.

Keywords

risk factors, functional capacity, pulmonary function, pulmonary symptoms

Abstract

Severe acute respiratory syndrome 2 coronavirus has resulted in more than 775 million known cases and greater than seven million deaths globally. Up to 25% of patients experience ongoing symptoms three months after the acute illness, and up to 30% of these individuals report persistent dyspnea. The overall aims of this dissertation are to 1) examine the risk factors and predictors for developing persistent dyspnea, 2) measure the effects of respiratory muscle strength training on dyspnea, pulmonary symptoms, quality of life, pulmonary function, and functional capacity, and 3) compare the outcomes of two different respiratory muscle strength training interventions.

In the first aim, a systematic review identified thirty-three studies reporting predictors of persistent dyspnea in post-COVID-19. Female sex, elevated BMI, pulmonary comorbidities, increased age, pre-existing anxiety or depression, pre-existing physical limitations, smoking history, severity of acute COVID, socioeconomic differences, and ethnicity were revealed. In aim two, 25 individuals with persistent dyspnea post-COVID-19 participated in a twelve-week, home-based, respiratory muscle strength training program. Significant improvements were found in dyspnea, pulmonary symptoms, quality of life, pulmonary function, and functional capacity following the intervention. In aim three, the outcomes of two distinct, twelve-week respiratory muscle strength training protocols (inspiratory + expiratory and expiratory only) were compared. The combined inspiratory + expiratory protocol was superior to the expiratory only protocol in improving pulmonary function. This dissertation describes predictors for identifying persistent dyspnea in post-COVID-19, and reports that respiratory muscle strength training may be an effective strategy for reducing dyspnea in the post-COVID-19 population.

Included in

Nursing Commons

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