1116 Bali Medical Journal 2022; 11(3): 1116-1120 | doi: 10.15562/bmj.v11i3.3474 ORIGINAL ARTICLE ABSTRACT The efect of pursed-lips breathing and diaphragm exercises on the quality of life of COPD patient assessed by six-minutes walk test Mulyadi 1* , Ida Muna Junita 2 , Teuku Zulfkar 2 , Nurrahmah Yusuf 2 , Mulkan Azhary 2 , Hotimah Masdan Salim 3 Introduction: Chronic obstructive pulmonary disease (COPD) is a chronic infammation that causes a variety of pulmonary and systemic disorders. Pursed-lip breathing and diaphragmatic breathing exercises are useful techniques for improving ventilation, reducing the degree of breathlessness, enhancing performance, and improving quality of life. The aim of this study was to determine the efect of pursed-lip breathing and diaphragmatic breathing exercise on the value of the 6-min walk test and to improve quality of life by SGRQ in stable COPD patients. Methods: This study was an experimental study using group control before and after examining 60 stable COPD patients at Dr. RSUD Lung Center. Zainoel Abidin from November 2019 to February 2020. Samples were extracted by systematic random sampling and divided into two groups. The intervention group received indacaterol bronchodilator therapy in addition to four weeks of apron and diaphragmatic breathing exercises. The control group received only indacaterol therapy. A 6-minute walk test was administered and a quality of life questionnaire was completed using the SGRQ. A t-test and Wilcoxon test were performed to assess diferences between groups, level of signifcance p < 0.05). Results: There was a signifcant efect on the 6-minute walk test in the intervention group compared with the control group (p = 0.001). There was a signifcant efect in improving quality of life using the SGRQ questionnaire in the intervention group compared with the control group (p = 0.001). Conclusion: There was a signifcant efect on the six-minute walking test in the intervention group compared to the control group. There was a signifcant efect on improving the quality of life using the SGRQ questionnaire in the intervention group compared to the control group. Keywords: COPD, pursed-lips breathing, diaphragmatic breathing exercises, six-minute walk test, SGRQ. Cite This Article: Mulyadi., Junita, I.M., Zulfkar, T., Yusuf, N., Azhary, M., Salim, H.M. 2022. The efect of pursed-lips breathing and diaphragm exercises on the quality of life of COPD patient assessed by six-minutes walk test. Bali Medical Journal 11(3): 1116-1120. DOI: 10.15562/bmj.v11i3.3474 1 Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Nahdlatul Ulama Surabaya, RSIS Jemursari Surabaya, Indonesia Kampus B Jl Raya Jemursari 51-57, Surabaya; 2 Department of Pulmonology and Respiratory Medicine, Universitas Syiah Kuala, RSUD dr. Zainoel Abidin Banda Aceh; 3 Department of Biochemistry and Molecular Biology, Faculty of Medicine, Universitas Nahdlatul Ulama Surabaya, Indonesia Kampus B Jl Raya Jemursari 51-57, Surabaya; *Corresponding author: Mulyadi; Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Nahdlatul Ulama Surabaya, RSIS Jemursari Surabaya, Indonesia Kampus B Jl Raya Jemursari 51-57, Surabaya; mul.0862@gmail.com Received: 2022-07-02 Accepted: 2022-08-11 Published: 2022-09-10 1116 Bali Medical Journal (Bali MedJ) 2022, Volume 11, Number 3: 1116-1120 P-ISSN.2089-1180, E-ISSN: 2302-2914 Open access: www.balimedicaljournal.org INTRODUCTION Chronic Obstructive Pulmonary Disease (COPD) is a complex respiratory disorder characterized by limited airfow and increased response of chronic infammation to the airway. Te pathogenesis of COPD consists of an imbalance of infammation- anti-infammatory, protease-antiprotease, oxidant-antioxidant, and apoptosis as well. Tose basic mechanisms not only occur independently but also interact with one another causing irreversible damage to the airway and lung leading to varied clinical symptoms of pulmonary and systemic events and also impacting many efects like decreased functional capacity and quality of life. 1,2 Te Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines have compiled standard therapy guidelines for COPD comprising pharmacological and non-pharmacological therapies. Pharmacological therapy includes the administration of bronchodilators, anti- infammatory, antibiotics, antioxidants, and mucolytics. Moreover, non- pharmacological therapy consists of education, adequate nutrition, and pulmonary rehabilitation. 3 Currently, non-pharmacological therapy in COPD patients is still not fully applied, although this therapy is efective enough to reduce the severity of breathlessness, to improve lung function and the quality of life among COPD patients so that they do not depend on pharmacological therapy during mild breathlessness. Te Indonesian Pulmonologist Association (PDPI) also recommends rehabilitation in COPD patients comprising of physical and breathing exercises. Tese exercises are efective in COPD like pursed lips breathing and diaphragmatic breathing exercises, which are useful for improving ventilation and synchronizing the thoraco-abdominal muscle for coughing and strengthening limb muscles. 4,5 COPD patients experience weakness due to chronic hypoxia resulting in decreased cardiorespiratory function and functional capacity simply measured by a 6-minute walk test which is one of the tests to measure functional capacity impacting on clinical outcomes on the