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Silicosis in sandblasters of shipyard versus silicosis in stone carvers in Brazil: a comparison of imaging findings, lung function variables and cardiopulmonary exercise testing parameters.
Revista portuguesa de pneumologia·2012
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Home-Based Prescribed Pulmonary Exercise in Patients with Stable Chronic Obstructive Pulmonary Disease
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Pursed lip breathing improves exercise tolerance in COPD: a randomized crossover study.
L Ferracini Cabral1, T Da Cunha D'Elia, D De Sousa Marins
1Physical Therapy School, Federal University of Juiz de Fora, Juiz de Fora, Brazil - fguimaraes_pg@yahoo.com.br.
European Journal of Physical and Rehabilitation Medicine
|April 3, 2014
Summary
Pursed-lip breathing (PLB) can improve exercise tolerance and reduce dynamic hyperinflation in COPD patients with low expiratory peak flow. This technique enhances breathing patterns and oxygenation during submaximal exercise.
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Area of Science:
- Pulmonary Rehabilitation
- Respiratory Physiology
- Exercise Science
Background:
- Pursed-lip breathing (PLB) is recommended for managing Chronic Obstructive Pulmonary Disease (COPD) at rest.
- Limited evidence exists on PLB's impact on dynamic hyperinflation (DH) and exercise tolerance in COPD patients.
- High-intensity exercise exacerbates respiratory challenges in COPD patients.
Purpose of the Study:
- To investigate the effects of PLB on exercise tolerance in COPD patients during high-intensity exercise.
- To assess PLB's influence on breathing patterns, dynamic hyperinflation, and arterial oxygenation.
- To identify patient subgroups that may benefit most from PLB.
Main Methods:
- Randomized crossover study involving 40 stable COPD patients (FEV1 < 60%).
- Patients performed PLB and control breathing (CB) during constant work-rate cycloergometer exercise.
- Measurements included dynamic hyperinflation, oxygen saturation, and breathing patterns at rest, isotime, and peak exercise.
Main Results:
- A subgroup of 'Improvers' (n=9) showed significantly increased endurance time with PLB.
- Improvers had lower expiratory peak flow (EPF) and demonstrated improved inspiratory capacity and oxygen saturation at isotime.
- Non-improver patients exhibited thoracoabdominal asynchrony during PLB; PLB improved oxygenation at peak exercise only in Improvers.
Conclusions:
- PLB effectively reduces dynamic hyperinflation and enhances exercise tolerance, breathing patterns, and oxygenation in COPD patients with low PEF during submaximal exercise.
- EPF measurement can identify COPD patients likely to benefit from PLB.
- PLB offers a potential therapeutic application for a selected group of COPD patients to improve exercise capacity.