bellarmine university, louisville, ky among persons with copd, is pursed lip breathing or...
TRANSCRIPT
BELLARMINE UNIVERSITY, LOUISVILLE, KY
Among persons with COPD, is pursed lip breathing or
diaphragmatic breathing a more effective technique to
improve symptoms and efficiency of breathing?
Meredith Alvey, Abby Naville, Alex Piedmonte, Lauren Speelman
BELLARMINE UNIVERSITY, LOUISVILLE, KY
Factors Analyzed
• Respiratory rate• Work of breathing• Dyspnea• Oxygen
BELLARMINE UNIVERSITY, LOUISVILLE, KY
Breathing Techniques
www.st-joseph.kramesonline.com
Pursed Lip BreathingDiaphragmatic Breathing
www.my.clevelandclinic.org
BELLARMINE UNIVERSITY, LOUISVILLE, KY
Respiratory Rate
Pursed Lip Breathing
• Slowed breathing frequency from 17.3 to 12.8 (Jones, 2003)
• Lowers oxygen costs (Jones, 2003)
• Increased tidal volume (Gosselink, 2004)
Diaphragmatic Breathing
• Slowed breathing frequency from 17.3 to 15 (Jones, 2003)
• Increase in tidal volume (Vitacca, 1997)
BELLARMINE UNIVERSITY, LOUISVILLE, KY
Work of Breathing
Pursed Lip Breathing
• Often adopted naturally (Dechman, 2004)
• Utilizes the subject’s natural inspiratory breathing pattern (Jones, 2003)
Diaphragmatic Breathing
• Causes respiratory muscle fatigue (Gosselink, 2004)
• Decrease in mechanical efficiency (Dechman, 2004; Gosselink, 1995)
BELLARMINE UNIVERSITY, LOUISVILLE, KY
Oxygen
Pursed Lip Breathing• Improves oxygen
saturation in resting conditions (Gosselink, 2004)
• No improvements in blood gases with exercise (Gosselink, 2004)
• Decreased oxygen consumption compared to spontaneous breathing (Jones, 2003)
– 164.8 mL/min
Diaphragmatic Breathing
• Partial pressure of oxygen increased (Vitacca, 1997)
• Decreased oxygen consumption compared to spontaneous breathing (Jones, 2003)
– 165.8 mL/min
BELLARMINE UNIVERSITY, LOUISVILLE, KY
Dyspnea
Pursed Lip Breathing• Two articles reported
improvements
Diaphragmatic Breathing
• Three studies stated dyspnea increased with this technique
• Visual analog scale (Vitacca, 1997)
– 33 to 54
BELLARMINE UNIVERSITY, LOUISVILLE, KY
Scoreboard
Pursed Lip Breathing
Diaphragmatic Breathing
Resipiratory Rate
Work of Breathing
Oxygen Consumption
Dyspnea
BELLARMINE UNIVERSITY, LOUISVILLE, KY
Conclusion
• Pursed lip breathing is supported over diaphragmatic breathing
• Carryover effect• Future studies needed
BELLARMINE UNIVERSITY, LOUISVILLE, KY
COPD Support Groups
• http://betterbreathers.freeservers.com/groups.htm
BELLARMINE UNIVERSITY, LOUISVILLE, KY
Questions?
www.en.hdyo.org
BELLARMINE UNIVERSITY, LOUISVILLE, KY
References1. Dechman G, Wilson C. Evidence Underlying Breathing Retraining in People With
Stable Chronic Obstructive Pulmonary Disease. Physical Therapy [serial online]. December 2004;84(12):1189-1197. Available from: SPORTDiscus with Full Text, Ipswich, MA. Accessed October 24, 2013
2. Gosselink R. Breathing techniques in patients with chronic obstructive pulmonary disease (COPD). Chronic Respiratory Disease [serial online]. 2004;1(3):163-172. Available from: MEDLINE, Ipswich, MA. Accessed October 24, 2013
3. Gosselink R, Wagenaar R, Rijswijk H, Sargeant A, Decramer M. Diaphragmatic breathing reduces efficiency of breathing in patients with chronic obstructive pulmonary disease. American Journal Of Respiratory And Critical Care Medicine [serial online]. April 1995;151(4):1136-1142. Available from: MEDLINE, Ipswich, MA. Accessed October 24, 2013
4. Jones A, Dean E, Chow C. Comparison of the Oxygen Cost of Breathing Exercises and Spontaneous Breathing in Patients With Stable Chronic Obstructive Pulmonary Disease. Physical Therapy [serial online]. May 2003;83(5):424-431. Available from: SPORTDiscus with Full Text, Ipswich, MA. Accessed October 24, 2013.
5. Vitacca M, Clini E, Bianchi L, Ambrosino N. Acute effects of deep diaphragmatic breathing in COPD patients with chronic respiratory insufficiency. The European Respiratory Journal [serial online]. February 1998;11(2):408-415. Available from: MEDLINE, Ipswich, MA. Accessed October 24, 2013.