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"Fatigue atau CRF ( cancer related fatigue) merupakan salah satu masalah yang sering terjadi pada pasien yang menjalani kemoterapi. Berbagai bentuk terapi komplementer yang dapat diterapkan salah satunya dengan tehnik relaksasi. Tujuan penelitian ini adalah untuk melihat efektifitas relaksasi antara (relaxation breathing exercise) RBE dan (progressive musle relaxation) PMR terhadap fatigue pada pasien kanker payudara yang menjalani kemoterapi. Penelitian ini adalah penelitian kuantitatif dengan menggunakan quasi experiment pre dan post test two groups without control design. Sebanyak 32 responden yang berpastisipasi diperoleh dengan cara consecutive sampling, terdapat dua kelompok yaitu kelompok RBE 16 responden dan kelompok intervensi PMR 16 responden. Fatigue diukur dengan menggunakan kuesioner Piper Fatigue Scale. Data yang diperoleh dianalisis dengan menggunakan uji paired t test dan independent t test. Hasil penelitian ini didapatkan Rerata fatigue menurun setelah dilakukan intervensi RBE dan PMR. Tidak terdapat perbedaan yang signifikan efektifitas antara intervensi RBE dengan intervensi PMR. Hasil penelitian ini direkomendasikan sebagai salah satu terapi non farmakologi untuk mengurangi fatigue pada pasien kanker payudara.

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CRF (cancer-related fatigue) the most symptoms occurs in patients undergoing chemotherapy. Various forms of complementary therapy that can be applied for cancers patient is the relaxation techniques. The purpose of this study is to examine at the effectiveness of relaxation (relaxation breathing exercise) and RBE (musle progressive relaxation) PMR against fatigue in breast cancer patients undergoing chemotherapy.

This is quantitative study using a quasi-experiment with pre and post test two groups without control design. A total of 32 respondents who participates obtained by consecutive sampling. There are two groups RBE 16 respondents and PMR intervention group 16 respondents. Fatigue was measured using the Piper Fatigue Scale questionnaire. The data obtained were analyzed using paired t test and independent t test test.

The results of this study, the mean fatigue decreased after the intervention RBE and PMR. There were no significant differences between intervention effectiveness RBE with PMR intervention. The results of this study is recommended as one of the non-pharmacological therapy to reduce fatigue in breast cancer patients."

"Fatigue adalah salah satu masalah yang paling sering terjadi pada pasien kanker yang menjalani kemoterapi. Berbagai terapi nonfarnakologi disarankan untuk mengurangi fatigue salah satunya adalah Relaxation Breathing Exercise (RBE). Penelitian ini bertujuan untuk mengetahui efektifitas RBE pada fatigue penderita kanker ginekologi yang menjalani kemoterapi. Desain penelitian yang digunakan adalah quasi experiment with pre-post test control group. Sebanyak 42 pasien yang diperoleh secara consecutive berpartisipasi dalam penelitian ini, 21 dimasukkan dalam kelompok RBE 4 kali dan 21 dalam kelompok 2 kali. Skor fatigue pasien akan diukur dengan menggunakan kuesioner Piper Fatigue Scale. Data yang diperoleh dianalisis dengan menggunakan uji Repeated-ANOVA dan Independent t-test dengan tingkat kemaknaan  < 0,01. Penelitian ini menemukan penurunan yang signifikan (p < 0,01) pada skor fatigue rata-rata di kedua kelompok (kelompok RBE 4 kali 3,29 ± 0,59 dan kelompok RBE 2 kali 4,19 ± 0,61) pada hari terakhir intervensi. Namun kelompok 4 kali RBE menunjukkan penurunan yang lebih besar dibandingkan kelompok 2 kali RBE (Selisih mean = 0,91; 99%CI = 0,41 - 1,41; p = 0,001). RBE yang dilakukan 4 kali sehari lebih efektif mengurangi fatigue pada pasien kanker yang menjalani kemoterapi. Peran perawat diperlukan untuk membantu pasien meminimalkan fatigue yang dialami salah satunya dengan mengajarkan terapi nonfarmakologi yang efektif seperti RBE.

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Fatigue is one of the most common problem experienced by patients undergoing chemotherapy. Some non-pharmacological therapies have been suggested to alleviate the problem such as Relaxation Breathing Exercise (RBE). This research aimed to determine the effectiveness of the RBE on the fatigue suffered by gynecological cancer patients undergoing chemotherapy. This study used a quasy randomized-controlled trial with pre- and post-test design. Forty two patients were consecutively sampled, 21 were assigned to RBE four times a day group and 21 to RBE two times a day group. Fatigue score were measured every day for seven days from both groups using Piper Fatigue Scale. The data obtained were analyzed using repeated-ANOVA and independent t-test with significant level α<0.01. This study found significant decreases (p < 0.01) of mean fatigue scores on both groups (RBE four times in a day group = 3.29 ± 0.59 and RBE two times in a day group = 4.19 ± 0.61) after the completion of the intervention. However, the RBE four times a day group shown a larger decrease on fatigue score compared to the RBE two times a day group (Mean Difference = 0.91; 99%CI = 0.41 - 1.41; p=0.001). Four times RBE in a day is more effective in relieving fatigue on cancer patients undergoing chemotherapy. Nurses' role is necessary to help patients in minimizing their fatigue by guiding the patient to perform an effective non-pharmacological therapy such as the RBE."

"Fatigue merupakan keluhan utama pasien yang menjalani hemodialisa jangka panjang, yang memiliki nilai yang tinggi, sehingga akan mempengaruhi kualitas hidup pasien. Tujuan dari penelitian ini adalah mengetahui pengaruh PMR terhadap tingkat fatigue pada pasien gagal ginjal kronis yang menjalani hemodialisa. Penelitian ini menggunakan desain quasi experiment pendekatan pretest-posttest control group. Jumlah responden dalam penelitian adalah 32 pasien dibagi 2 kelompok yaitu 16 kelompok intervensi dan 16 kelompok kontrol.Hasil penelitian menyimpulkan bahwa terdapat perbedaan yang signifikan terhadap tingkat fatigue pada kelompok intervensi antara sebelum dan sesudah dilakukan PMR dengan nilai p = 0,000. Disarankan latihan PMR dapat digunakan sebagai intervensi keperawatan mandiri dalam menurunkan fatigue pada pasien gagal ginjal kronis yang menjalani hemodialisa.

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Fatigue is a major complaint of patients undergoing long-term hemodialysis, which has a high value, so it will affect the quality of life of patients. The purpose of this study was to determine the influence of PMR on the level of fatigue in patients with chronic kidney disease undergoing hemodialysis. This study used a quasi experiment design approach pretest-posttest control group. The number of respondents in the study were 32 patients divided into 2 groups: the 16 intervention group and 16 control group.The research concludes that there are significant differences on the level of fatigue in the intervention group between before and after PMR with p = 0.000. Suggested training PMR can be used as an independent nursing intervention in reducing fatigue in patients with chronic kidney disease undergoing hemodialysis."

"Myalgia dapat terjadi karena efek samping kemoterapi. Tujuan penelitian ini adalah mengetahui pengaruh PMR terhadap myalgia pada pasien kanker paru yang menjalani kemoterapi. Penelitian ini menggunakan desain quasi experiment dengan pre-post test with control group. Sampel penelitian adalah 32 orang, diambil dengan consecutive sampling. Pengukuran intensitas myalgia dilakukan dengan menggunakan numeric rating scale. Kelompok intervensi diberikan tindakan PMR selama 15 menit dengan frekuensi 2x sehari dalam 5 hari berturut-turut pasca kemoterapi. Hasil penelitian didapatkan penurunan intensitas myalgia sebelum dan setelah dilakukan intervensi pada kelompok intervensi (p value 0,001) dan pada kelompok kontrol (p value 0,001). Namun terdapat perbedaan penurunan intensitas myalgia antara kelompok kontrol dan kelompok intervensi setelah diberikan intervensi dengan selisih 0,81 (p value = 0,001). Kesimpulan, PMR dapat membantu menurunkan myalgia pada pasien kanker paru yang menjalani kemoterapi. PMR dapat menjadi salah satu terapi komplementer yang bisa diterapkan perawat di rumah sakit untuk menurunkan myalgia.

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Myalgia can be occured by side effect of chemotherapy. The purpose of this study was to identify the effect of PMR against myalgia in lung cancer patients undergoing chemotherapy. This study design was a quasi experiment, used pre and post test with control group. Samples were 32 patients, recruited by consecutive sampling. Measuring pain assessment used numeric rating scale. The intervention group had been provided PMR fifteen minutes twice a day for five days post chemotherapy.

The results showed significantly different reduction of pain intensity before and after providing PMR in the intervention group and control group as well (p value = 0,001). There was a significantly different reduction of myalgia intensity between both group after giving intervention with mean difference 0,81 (p value = 0,001). It can be concluded that PMR can reduce myalgia in lung cancer patients undergoing chemotherapy. Suggestion, PMR becomes one of the complementary therapies to overcome myalgia"

"Magister Ilmu Keperawatan Universitas IndonesiaJudul:Pengaruh Kombinasi Progressive Muscle Relaxation Terhadap Kejadian Fatigue Klien Kanker yang Menjalani Kemoterapi Kemoterapi pada pasien kanker bertujuan mengendalikan pertumbuhan sel kanker, namun terkadang pemberian terapi tersebut bersifat toksik terhadap sel normal dan memberikan efek terjadinya fatigue. Kombinasis Progressive Muscle Relaxation dan teknik lima jari merupakan terapi komplementer untuk mengurangi kejadian fatigue pada pasien kanker dengan kemoterapi. Tujuan penelitian mengidentifikasi perbedaan pemberian Kombinasi PMR dan Teknik Lima Jari dengan latihan ROM terhadap kejadian fatigue klien kanker yang menjalani kemoterapi di RSAM Bandar Lampung. Penelitian ini merupakan quasi experiment pre-post test with control group. Teknik pengambilan sampel dengan consecutive sampling yang melibatkan 39 responden kelompok intervensi dan kontrol. Uji beda rata-rata skor pretest dan postest pada kelompok kontrol dan intervensi menggunakan uji T berpasangan sedangkan perbedaan rata-rata skor pretest kelompok intervensi dengan kontrol maupun posttest kelompok intervensi dengan kontrol kejadian fatigue menggunakan uji Mann Whitney. Hasil penelitian membuktikan bahwa kombinasi PMR dan Teknik Lima Jari dapat mengurangi kejadian fatigue pada pasien kanker dengan kemoterapi p < 0,05.

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The Effects Combination of progressive muscle relaxation and the five finger techniques on the incidence of fatigue cancer clients undergoing chemotherapy at Abdoel Moeloek Hospital in Bandar Lampung 2017 Chemotherapy performed in cancer patients aims to control the growth of cancer cells, but sometimes the therapy is toxic effect to normal cells and provide side effects suc as fatigue. Combination Progressive Muscle Relaxation and the five finger technique consider as an alternative to decrease the incidence of fatigue in cancer patient with chemotherapy. This study aimed to identify the differences in the provision Combination of progressive muscle relaxation and the five finger techniques with range of motion exercise on the incidence of fatigue cancer clients undergoing chemotherapy at Abdoel Moeloek Hospital in Bandar Lampung. Design research used a quasi experiment pre post test with control group. The sampling technique was concequetive sampling recruited 39 respondents include intervention and control group.. Difference in mean pretest and posttest scores of fatigue incidence in the control and intervention groups using paired T Test while the mean difference of pretest group scores of intervention with control and posttest of intervention and group with fatigue event control using mann whitney test. This study showed that combination of PMR and the five finger technique can be given by nurse to reduce the fatigue incidence of cancer patients who undergoing chemoterapy p 0,05. "

"Pasien post-stroke dipersiapkan menjalani fase rehabilitasi untuk memperoleh kualitas hidup yang baik. Namun masih banyak pasien yang mengalami fatigue dan ini mempengaruhi proses rehabilitasi. Salah satu peran perawat adalah meningkatkan derajat kesehatan dengan cara mempertahankan perilaku adaptif pada pasien, sehingga dibutuhkan sebuah intervensi keperawaatan dalam menurunkan fatigue. Kombinasi intervensi tarik napas dalam dan progressive muscle relaxation (PMR) merupakan salah satu intervensi mandiri keperawatan yang murah dan mudah diterapkan. Tujuan penelitian ini adalah untuk mengetahui pengaruh kombinasi intervensi tarik napas dalam dan PMR terhadap fatigue pada pasien post-stroke. Desain penelitian menggunakan quasi eksperimen pre-post test without control. Sampel dalam penelitian ini berjumah 42 pasien post-stroke dengan teknik pengambilan sampel consecutive sampling. Analisis data menggunakan uji independent t-test dan menunjukkan penurunan tingkat keparahan fatigue yang bermakna pada kelompok intervensi 2 setelah diberikan kombinasi intervensi tarik napas dalam dan PMR  (p value < 0,05). Penelitian ini merekomendasikan kombinasi intervensi tarik napas dalam dan PMR sebagai bentuk intervensi rehabilitatif di unit pelayanan neurorestorasi sebagai aktivitas yang dapat menstimulasi penurunan tingkat keparahan fatiguepada pasien post-stroke dengan stroke murni pada fase rehabilitasi lebih dari 14 hari tanpa underlying disease.

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Post-stroke patients are prepared to undergo a rehabilitation phase to obtain a good quality of life. But there are still many patients who experience fatigue, and this affects the rehabilitation process. One of the roles of nurses is to improve health status by maintaining adaptive behavior in patients so that nursing interventions are needed to reduce fatigue. The combination of deep breathing and progressive muscle relaxation (PMR) interventions is an independent nursing intervention that is cheap and easy to implement. The purpose of this study was to determine the effect of a combination of deep breathing and PMR interventions on fatigue in post-stroke patients. The research design uses a quasi-experimental pre-post test without control. The sample in this study was 42 post-stroke patients using the consecutive sampling technique. An independent t-test was used to analyze the data, which revealed a significant reduction in the severity of fatigue in the intervention group 2 after receiving a combination of deep breathing and PMR intervention, with a p value of 0.001 (p value 0.05). This study recommends a combination of deep breathing and PMR intervention as a form of rehabilitative intervention in the neurorestoration service unit as an activity that can stimulate a decrease in the severity of fatigue in post-stroke patients with pure stroke in the rehabilitation phase of more than 14 days without underlying disease."

"Keluhan sesak napas atau dispnea merupakan gejala umum yang selalu dikeluhkan oleh pasien PPOK. Pengelolaan dispnea pada penderita PPOK di tatanan layanan kesehatan, selain menggunakan terapi farmakologi juga dengan pemberian terapi non farmakologi. Terapi non farmakologi untuk penderita PPOK tersebut meliputi 3 aspek utama, yaitu olah napas/breathing, olah pikiran/thinking dan olah fungsional/functioning. Tatalaksana non farmakologi untuk kasus PPOK sebagian besar berfokus pada upaya kontrol pernapasan melalui teknik Pursed Lip Breathing. Namun belum banyak penelitian yang mengkaji pengaruh kontrol pikiran dalam mengatasi keluhan dispnea pasien PPOK. Penelitian ini menggabungkan antara kontrol pernapasan melalui latihan Pursed Lip Breathing (PLB) dan kontrol pikiran melalui latihan Progressive Muscle Relaxation (PMR). Penelitian ini merupakan penelitian quasy experiment dengan pendekatan pre-post test design pada 20 responden di setiap kelompok intervensi. Kelompok intervensi I diberi kombinasi latihan PLB dan PMR selama 10 menit, 2 kali sehari, selama 7 hari. Sedangkan kelompok intervensi II diberi kombinasi latihan PLB selama 10 menit, 2 kali sehari, selama 7 hari. Hasil penelitian menunjukkan adanya perbedaan yang bermakna pada derajat dispnea setelah pemberian kombinasi latihan PLB dan PMR (p = 0,000; α = 0,05). Dengan demikian, kombinasi latihan PLB dan PMR merupakan salah satu intervensi yang efektif untuk menurunkan derajat dispnea pada pasien PPOK. Rekomendasi pada penelitian ini adalah diperlukannya pengembangan program terapi komplementer di pendidikan dan pelayanan keperawatan untuk modifikasi standar asuhan keperawatan dengan memasukkan terapi komplementer kombinasi latihan PLB dan PMR dalam asuhan keperawatan pasien PPOK. 

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Shortness of breath or dyspnea are common symptoms that are always complained of by Chronic Obstructive Pulmonary Disease (COPD) patients. Management of dyspnea in patients with COPD are pharmacological therapy and non-pharmacological therapy. Non-pharmacological therapy for patients with COPD includes 3 main aspects, namely breathing, mind processing and functional functioning.

Non-pharmacological management for COPD cases focuses mostly on respiratory control efforts through the Pursed Lip Breathing technique. But not many studies have examined the effect of mind control in overcoming complaints of COPD dyspnea patients. This study combines breathing control through Pursed Lip Breathing (PLB) exercise and mind control through Progressive Muscle Relaxation (PMR) exercise.

This research is a quasy experiment with a pre-post test design approach to 20 respondents in each intervention group. The intervention group I was given a combination of PLB and PMR exercises for 10 minutes, 2 times a day, for 7 days. While the intervention group II was given a combination of PLB exercises for 10 minutes, 2 times a day, for 7 days.

The results showed a significant difference in the degree of dyspnea after PLB and PMR exercises (p = 0.000; α = 0.05). The combination of PLB and PMR exercises is an effective intervention to reduce the degree of dyspnea in COPD patients.

The recommendation in this study is the need to develop complementary therapy programs in education and nursing services for modification of nursing care standards by incorporating complementary therapy in combination with PLB and PMR exercises in the nursing care of COPD patients."

"Chemotherapy is one of the cancer treatment that could provide many side effects and decrease the functional status and quality of life cancer patients. Progressive muscle relaxation (PMR) training is one of the nursing intervention that leads to decreased physical and phsycological effect from chemotherapy. The purpose of this study was to identify 'the effect of progressive muscle relaxation training on functional status in the context of the nursing care for cancer patients with chemotherapy'. This study was a quasi experimental using a nonequivalent control group with pretest and posttest design. The sample was cancer patients who received chemotherapy and inpatient in RS Dr. Wahidin Sudirohusodo Makassar. A concecutive sampling was used as the sample collection method and 48 subjects were obtained this study, divided into two groups, each group consisted of twenty four subjects as intervention group who were given PMR training twice a day for seven days, and twenty four subjects as control group who were not given PMR training. The instrument that used in this study were demography form and Functional Living Index-Cancer to measure functional status which consisted 22 questions with 7-point Likert-Type linear analog scale. A T test was used to examine the differences of the mean of functional status scores and each dimension. The finding showed that there was a significant increased of the mean of functional status after PMR training in intervention group (p=0,000). It means that PMR training has an effect in increasing level of functional status in cancer patients with chemotherapy. It is recommended to apply PMR training as a nursing intervention to cancer patients with chemotherapy and suggested to conduct futher research using more samples."

"Praktik keperawatan residensi yang dilakukan di Rumah Sakit Persahabatan dengan kekhususan respirasi diharapkan dapat mengatasi masalah pernapasan. Selama menjalani proses residensi, residen berperan menjadi seorang Clinical Care Manajer (CCM) yang bertugas sebagai konsultan keperawatan bagi staf keperawatan dan pemberi terapi keperawatan kepada pasien, sebagai peneliti dan pendidik dalam rangka pemberi asuhan keperawatan untuk meningkatkan mutu atau kualitas asuhan keperawatan. Dalam memberikan asuhan keperawatan pada kasus kelolaan pasien dengan kanker paru dan 30 kasus resume menggunakan teori Henderson 14 kebutuhan dasar manusia yang menunjukkan peran perawat sebagai pemberi asuhan keperawatan dalam membantu individu baik dalam keadaan sehat maupun sakit, melalui usahanya melakukan berbagai aktivitas guna mendukung kesehatan dan penyembuhan individu atau proses meninggal dengan damai. Masalah keperawatan yang banyak muncul yaitu tentang pemenuhan kebutuhan bernapas normal. Penerapan EBN kombinasi latihan pursed lip breathing dan progressive muscle relaxation terhadap penurunan dyspnea pada pasien PPOK. Pelaksanaan proyek inovasi video sebagai program peningkatan kemampuan perawat dalam melakukan monitoring terhadap pasien yang terpasang Water Seal Drainage (WSD) dan pemberian edukasi kepada pasien yang terpasang WSD di rumah. Hasil analisis praktik residensi keperawatan didapatkan bahwa asuhan keperawatan menggunakan pendekatan teori Henderson bertujuan untuk membantu sesegera mungkin kemandirian pasien. Penerapan kombinasi latihan pursed lip breathing dan progressive muscle relaxation dapat menurunkan dyspnea pada pasien PPOK. Proyek inovasi program peningkatan kemampuan perawat dalam melakukan monitoring WSD dan pemberian edukasi dirumah pada pasien yang terpasang WSD dengan media video dapat meningkatkan kemampuan perawat dalam melakukan monitoring WSD secara sistematis dan terstruktur dan kemampuan melakukan edukasi dirumah pada pasien.

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Residency nursing practice carried out at Persahabatan Hospital with the speciality of respiration was expected to overcome respiratory problems. In addition, during the residency process, the resident perform the role to become a clinical care manager (CCM) who serves as a nursing consultant for nursing staff and nursing therapy providers to patients, researches and educator in the context of providing nursing care to improve the quality of nursing care. In providing nursing care in managed cases of patients with lung cancer and 30 resumed cases used Henderson's theory of 14 basic human needs which showed the role of nurses as nursing care providers in helping individuals both in health and illness, through their efforts to carried out various activities to support individual health and healing or the process of dying peacefully. Many nursing problems that arise were about fulfilling normal breathing needs. Application of EBN combination of pursed lip breathing exercises and progressive muscle relaxation to reduce dyspnea in COPD patients. The implementation of the video innovation project as a program to improve the ability of nurses to monitor patients with watered seal drainage (WSD) and provided education to patients with WSD at home. The results of the analysis of nursing residency practice found that nursing care used the Henderson theory approach aims to help the patient's independence as soon as possible. The application of a combination of progressive muscle relaxation and pursed lip breathing exercises could reduce dyspnea in COPD patients. The program innovation project to improve nurses' ability to monitor WSD and provided home education to patients with WSD installed with video media could improve nurses' ability to monitor WSD systematically and structured and the ability to educate patients at home Keywords: nursing specialist, lung cancer, Henderson nursing theory"

"Pendahuluan Penyakit paru obstruktif kronik merupakan penyakit pernapasan dengan kontribusi signifikan terhadap morbiditas dan mortalitas di seluruh dunia. PPOK mempengaruhi kapasitas latihan dan status kesehatan pasien dari aspek fisik, sosial, dan psikologis. Kecemasan dan dispnea merupakan dua gejala utama pasien penyakit paru obstruktif kronik (PPOK) yang berpengaruh pada kualitas hidup. Untuk itu perlu intervensi yang dapat mengurangi kedua gejala ini. Penelitian ini bertujuan mengidentifikasi efektivitas kombinasi ACBT dan PMR terhadap dispnea dan kecemasan pasien PPOK di ruang rawat inap Paru. Metode Penelitian ini menggunakan design penelitian quasi eksperimen dengan pretest posstest tanpa kelompok kontrol. Jumlah sampel sebanyak 44 responden yang memenuhi kriteria inklusi dan ekslusi. Hasil Terdapat perbedaan selisih pretest-posttest skor dispnea dan kecemasan pada kelompok kombinasi dan kelompok ACBT, dibuktikan dengan nilai selisih pretest-posttest untuk dispnea pada kelompok kombinasi 2 dan 1 pada kelompok ACBT (p value 0,03), sedangkan untuk kecemasan pada kelompok kombinasi 3 dan 2 pada kelompok ACBT (p value 0,000). Sehingga dapat disimpulkan latihan kombinasi ACBT dan PMR lebih efektif dibanding ACBT dalam menurunkan skor dispnea dan kecemasan pada pasien PPOK (p value < 0,05). Kesimpulan Terapi kombinasi ACBT dan PMR maupun ACBT saja efektif menurunkan dispnea dan kecemasan pada pasien PPOK. Akan tetapi kombinasi ACBT dan PMR lebih efektif menurunkan dispnea dan kecemasan.

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Introduction Chronic obstructive pulmonary disease is a disease with a significant contribution to morbidity and mortality worldwide. COPD affects the patient's exercise capacity and health status from physical, social, and psychological aspects. Anxiety and dyspnea are the two main symptoms in patients with chronic obstructive pulmonary disease (COPD) that affect quality of life. For this reason, interventions are needed that can reduce these two symptoms. This study aims to identify the effectiveness of the combination of ACBT and PMR on dyspnea and anxiety in COPD patients in the pulmonary care unit.

Methods This study used a quasi-experimental research design with a pretest posttest without a control group. The number of samples is 44 respondents who meet the inclusion and exclusion criteria.

Results There were differences in pretest-posttest differences in dyspnea and anxiety scores in the combination group and the ACBT group, as evidenced by the pretest-posttest difference values for dyspnea in combination groups 2 and 1 in the ACBT group (p value 0.03), while for anxiety in the combination group 3 and 2 in the ACBT group (p value 0.000). So it can be concluded that the combination of ACBT and PMR exercises is more effective than ACBT in reducing dyspnea and anxiety scores in COPD patients (p value <0.05).

Conclusion Combination therapy of ACBT and PMR as well as ACBT is effective in reducing dyspnea and anxiety in COPD patients. However, the combination of ACBT and PMR is more effective in reducing dyspnea and anxiety."