Effect of Active Assisted Range of Motion Exercises in Management of Severe COPD Patients at Nasser Hospital, Gaza: A Study Protocol for Quasi-Experimental Study

ABSTRACT Background: Chronic obstructive pulmonary disease is a leading cause of morbidity and mortality worldwide, characterized by progressive airflow limitation and respiratory symptoms. The disease burden continues to increase in developing regions, including Palestine, where challenges in healthcare infrastructure limit access to comprehensive management. To examine the effect of active-assisted range of motion exercises combined with standard care on dyspnea, cough, sputum production and pulmonary function among patients with severe chronic obstructive pulmonary disease at Nasser Hospital, Gaza. Methods: This quasi-experimental study will use a convenience sampling method among severe chronic obstructive pulmonary disease patients admitted to the male and female medical departments at Nasser Hospital in Khan Younis, Southern Gaza Strip. A power analysis has determined an effect size of 0.58, requiring a total sample of 158 participants (79 in each group) to achieve adequate statistical power. Participants diagnosed with severe chronic obstructive pulmonary disease will be allocated into two groups: (1) the intervention group, which will receive active-assisted range of motion exercises in addition to standard treatment, and (2) the control group, which will receive standard treatment only. Results: The study findings are expected to provide a promising results in advocating the utilisation of active-assisted range of motion exercises into pulmonary rehabilitation programs among patients with severe chronic obstructive pulmonary disease. Conclusion: This study findings will support integrating active-assisted range of motion exercises into severe chronic obstructive pulmonary disease pulmonary rehabilitation in resource-limited settings.