Effects of diaphragmatic breathing with and without pursed-lips breathing in subjects with COPD

BACKGROUND: Breathing exercises, such as diaphragmatic breathing and pursed-lips breathing, play a role in some individuals with COPD and might be considered for those patients who are unable to exercise. However, in the literature are reports of some adverse effects of diaphragmatic breathing in pa...

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Detalles Bibliográficos
Autores: Liliane Patrícia de Souza Mendes, Karoline Simões Moraes, Mariana Hoffman, Danielle Soares Rocha Vieira, Giane Amorim Ribeiro Samora, Susan Martins Lage, Raquel Rodrigues Britto, Verônica Franco Parreira
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2019
País:Brasil
Institución:Universidade Federal de Minas Gerais (UFMG)
Repositorio:Repositório Institucional da UFMG
Idioma:inglés
OAI Identifier:oai:repositorio.ufmg.br:1843/40266
Acceso en línea:https://doi.org/10.4187/respcare.06319
http://hdl.handle.net/1843/40266
http://orcid.org/0000-0002-2602-3433
https://orcid.org/ 0000-0002-8818-2958
https://orcid.org/0000-0001-6222-6142
http://orcid.org/0000-0001-5102-369X
http://orcid.org/0000-0002-9533-3654
http://orcid.org/0000-0003-0374-9319
Access Level:acceso abierto
Palabra clave:COPD
Diaphragmatic breathing
Pursed-lips
Optoelectronic plethysmography
Breathing pattern
Chest wall motion
Asynchrony
Pulmões - Doenças obstrutivas
Respiração
Exercícios respiratórios
Respiração bucal
Parede torácica
Pulmão - Tratamento
Descripción
Sumario:BACKGROUND: Breathing exercises, such as diaphragmatic breathing and pursed-lips breathing, play a role in some individuals with COPD and might be considered for those patients who are unable to exercise. However, in the literature are reports of some adverse effects of diaphragmatic breathing in patients with COPD. Thus, the purpose of this study was to assess the effects of diaphragmatic breathing and diaphragmatic breathing combined with pursed-lips on chest wall kinematics, breathlessness, and chest wall asynchrony in subjects with COPD, and also to assess whether the combination of both exercises reduces the adverse effects of diaphragmatic breathing while maintaining its benefits. METHODS: Seventeen subjects with COPD, mean ± SD, 65 ± 7 y of age, with a history of smoking and clinical stability without hospitalization or symptoms of exacerbation in the past 4 wk, were evaluated. On day 1, participants' characteristics were collected, and they learned diaphragmatic breathing and its combination with pursed-lips breathing. On day 2, the participants were evaluated by optoelectronic plethysmography with the participants in the seated position while performing breathing exercises. RESULTS: Diaphragmatic breathing and diaphragmatic breathing plus pursed-lips breathing promoted a significant increase in chest wall tidal volume and its compartments as well as a reduction in breathing frequency compared with quiet breathing. No significant changes were observed in dyspnea or end-expiratory volume of the chest wall. A significant increase in asynchrony (inspiratory-expiratory phase ratio) was observed during diaphragmatic breathing and diaphragmatic breathing plus pursed-lips breathing compared with quiet breathing, with no differences observed between the exercises. CONCLUSIONS: Despite the increase in asynchrony, both breathing exercises were able to improve chest wall volumes without affecting dyspnea. The combination of exercises maintained the benefits but did not reduce the adverse effects of diaphragmatic breathing.