Comprehensive directed breathing retraining improves exertional dyspnea for men with spirometry within normal limits

To compare the effects of comprehensive directed breathing retraining with traditional diaphragmatic breathing on male smokers with exertional dyspnea but normal spirometry.

This is a prospective randomized clinical trial in an exercise laboratory at a university hospital. Twenty-four nonmedicated exertional dyspnea subjects were randomly assigned to experimental (comprehensive directed breathing) and control (traditional diaphragmatic breathing) groups. Forty-four physiologic parameters associated with exertional dyspnea were studied before and after interventions for both groups at rest and at 40-W constant exercise for 10 mins. The interventions for both groups included diaphragmatic breathing exercises, walking, and arm exercises for 90 mins, 5 days/wk for 4 wks. In addition, the comprehensive directed breathing group was taught the anatomy and physiology of ventilation; they observed their ventilatory dyssynchrony in a mirror; they were shown their ventilatory rhythm on a spirogram; diaphragmatic movement was demonstrated in an educational movie; and verbal feedback was used to correct respiratory asynchrony.

We compared the relative changes of lung function parameters before and after intervention for each group. The comprehensive directed breathing group improvements were significantly greater (P < 0.05) than those of traditional diaphragmatic breathing for 34 of 44 lung function parameters.

Comprehensive directed breathing training improved exertional dyspnea, Dyspnea Index, and some clinical and functional parameters significantly more than traditional diaphragmatic breathing training.