![]() ![]() ![]() However, to the best of our knowledge, this was the only study to evaluate the effects of the combination of the techniques for only these 2 outcomes. 5 According to these findings, a combination of these techniques seemed to be more effective than performing the exercises separately. The breathing frequency was significantly lower during diaphragmatic breathing plus pursed-lips breathing, even in relation to each technique in isolation, although there was no difference in oxygen consumption among the 3 exercises. With regard to the combination of these techniques (diaphragmatic breathing plus pursed-lips breathing) in subjects with COPD, Jones et al 5 reported a significant decrease in breathing frequency and oxygen consumption during the combined exercise compared with the spontaneous breathing. 6, 10, 14, 17 However, dyspnea relief remains poorly consistent, because this response is different among subjects. 14– 16 Several studies have shown that the benefits of pursed-lips breathing in subjects with COPD include decreased breathing frequency and lung hyperinflation, improvements in the P CO 2 and oxygen in the blood, and increased tidal volume and oxygen saturation. 6, 10, 14 It is frequently adopted spontaneously and voluntarily by some subjects with COPD to control and relieve dyspnea and can be performed at rest or during exercise. Pursed-lips breathing consists of a soft exhalation performed for 4 to 6 s against the resistance of partially closed lips and clenched teeth. 12, 13 Adverse effects include an increase in the asynchronous and paradoxical movement of the chest wall as well as increased work of breathing and dyspnea in the subjects with the most severe conditions. ![]() 6, 10, 12 For patients with COPD, the immediate benefits of diaphragmatic breathing are an increase in the tidal volume and oxygen saturation, reduction in breathing frequency, and improvements in ventilation and hematosis. 7, 10, 11ĭiaphragmatic breathing consists of a smooth and deep nasal inspiration with anterior displacement of the abdominal region, which emphasizes the action of the diaphragm. 1, 7 These techniques aim to reduce dyspnea, improve ventilation and gas exchange, optimize chest wall motion, and reduce hyperinflation. 2– 4 Breathing exercises, such as diaphragmatic breathing and pursed-lips breathing, which can be performed separately or in combination, 5– 9 have a role in managing breathlessness in patients with COPD and can also be considered for those who are unable to undertake exercise training. 3 Pulmonary rehabilitation has been shown to improve symptoms, exercise tolerance, and health-related quality of life as well as reduce hospitalizations. 1, 2 Pulmonary rehabilitation is a key component of managing COPD and involves exercise training, education and self-management interventions, encouraging behavioral change, and stimulus to physical activity. 1 COPD, as a leading cause of morbidity, is an important public health concern, and clinical exacerbations are responsible for recurrent hospitalizations and an increase in the related economic health-care costs. COPD is a treatable disease characterized by chronic air-flow limitation and persistent symptoms, such as dyspnea, cough, weight loss, and fatigue. ![]()
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