Chest Wall Kinematics and Breathlessness During Pursed-Lip Breathing in Patients With COPD

Bianchi, Roberto; Gigliotti, Francesco; Romagnoli, Paola; Lanini, Barbara; Castellani, Carla; Grazzini, Maddalena; Scano, Giorgio

doi:10.1378/chest.125.2.459

Cited by 118 publications

(111 citation statements)

References 17 publications

Supporting

Mentioning

100

Contrasting

Unclassified

Order By: Relevance

“…This, in turn, is likely to reduce the sensation of unrewarded inspiration (perceived as dyspnoea) that arises from disequilibrium between the efferent outflow to the inspiratory muscles and the corresponding afferent input from the respiratory system receptors [43]. The reduction in dyspnoea perceived with pursed-lip breathing seems to relate to a slowing of the respiratory rate, which, in people with expiratory airflow obstruction, allows for more complete lung emptying during expiration and less pulmonary hyperinflation [44][45][46]. Finally, the use of a rollator allows people to fix their upper limbs during ambulation and reduces their dyspnoea [47], presumably by facilitating use of the accessory muscles of respiration and minimising reliance on the diaphragm during inspiration.…”

Section: Managing Acute Dyspnoeamentioning

confidence: 99%

The importance of components of pulmonary rehabilitation, other than exercise training, in COPD

Hill¹,

Vogiatzis²,

Burtin³

2013

Eur Respir Rev

View full text Add to dashboard Cite

Comprehensive pulmonary rehabilitation is an important component in the clinical management of people with chronic obstructive pulmonary disease (COPD). Although supervised exercise training is considered the cornerstone of effective pulmonary rehabilitation, there are many other components that should be considered to manage the impairments and symptom burden, as well as the psychosocial and lifestyle changes imposed by COPD. These include approaches designed to: 1) facilitate smoking cessation; 2) optimise pharmacotherapy; 3) assist with early identification and treatment of acute exacerbations; 4) manage acute dyspnoea; 5) increase physical activity; 6) improve body composition; 7) promote mental health; 8) facilitate advance care planning; and 9) establish social support networks. This article will describe these approaches, which may be incorporated within pulmonary rehabilitation, to optimise effective chronic disease self-management. @ERSpublications This paper describes several components of comprehensive pulmonary rehabilitation, other than simply exercise training http://ow.ly/mMNRp Pulmonary rehabilitation for chronic obstructive pulmonary diseaseChronic obstructive pulmonary disease (COPD) is characterised by persistent airflow limitation due to chronic inflammation within the airways and lung in response to noxious particles or gases [1]. People with this condition are limited by dyspnoea and have impaired exercise capacity and health-related quality of life [1]. The prevalence of COPD amongst adults aged o40 years is ,10% [2], and increases to 21% in those with a significant smoking history who are visiting their family physician for any reason [3]. The natural course of COPD is punctuated with episodes of acute worsening, known as exacerbations, which contribute

show abstract

Section: Managing Acute Dyspnoeamentioning

confidence: 99%

The importance of components of pulmonary rehabilitation, other than exercise training, in COPD

Hill¹,

Vogiatzis²,

Burtin³

2013

Eur Respir Rev

View full text Add to dashboard Cite

show abstract

“…Os Quadros 1 e 2 descrevem os dez ensaios clínicos selecionados [11][12][13][14][15][16][17][18][19][20] . As duas revisões bibliográficas encontradas na busca realizada estão apresentadas a seguir de forma descritiva, por não possuírem a formatação estabelecida para a análise dos dados.…”

Section: Características Dos Estudos Selecionadosunclassified

“…A realização da RFL impacta positivamente na mecânica pulmonar de pacientes com DPOC, como verificado em achados recentes da literatura. Bianchi et al 12 estudaram, em repouso, os volumes e as variações dos compartimentos da caixa torácica durante a RFL por meio da pletismografia optoeletrônica. Os resultados demonstraram que a manobra promoveu um decréscimo do volume expiratório final da caixa torácica, principalmente do compartimento abdominal, decorrente do alongamento do tempo expiratório (TE) e do tempo total do ciclo respiratório (T TOT ).…”

Section: Respiração Frenolabial E Mecânica Respiratóriaunclassified

“…Em repouso, a manobra promoveu aumento do VC, TI, TE, T TOT 12,16 e da relação volume corrente/tempo inspiratório, bem como diminuição da f e da relação tempo inspiratório/tempo total 12 . Já em exercício, foram observados prolongamento do T TOT , com aumento do VC, diminuição da f e volume minuto inalterado 14 .…”

Section: Respiração Frenolabial E Mecânica Respiratóriaunclassified

See 1 more Smart Citation

A respiração frenolabial na doença pulmonar obstrutiva crônica: revisão da literatura

et al. 2012

View full text Add to dashboard Cite

interesse: nada a declarar.RESUMO | Esta revisão teve por objetivo destacar os principais achados publicados nos últimos dez anos sobre os efeitos da respiração frenolabial (RFL) em pacientes com doença pulmonar obstrutiva crônica (DPOC). A busca dos artigos foi realizada nas bases de dados Lilacs, IBECS, MEDLINE e SciELO, por meio dos seguintes descritores da área da saúde (DeCS): doença pulmonar obstrutiva crôni-ca, reabilitação, respiração, hiperinsuflação e dispneia, e suas respectivas versões na língua inglesa (MeSH), além do termo pursed-lip breathing. Após a eliminação dos títu-los repetidos, foram selecionados somente os estudos que abordavam a RFL como tema principal, resultando em 12 artigos científicos, 10 ensaios clínicos e 2 revisões bibliográ-ficas. Segundo os achados, a RFL proporciona: alterações sobre a gasometria arterial, caracterizada pelo aumento da saturação e pressão parcial de oxigênio; padrão ventilatório, com diminuição da frequência respiratória e aumento de tempo expiratório e do volume corrente; mecânica ventilatória, por meio do recrutamento de musculatura abdominal expiratória e dos músculos da caixa torácica e acessórios da inspiração; diminuição no consumo de oxigênio; alterações na modulação autonômica cardíaca induzida pelo aumento da atividade parassimpática e, por fim, melhora na qualidade de vida destes pacientes. A RFL é considerada uma manobra de grande importância, por repercutir de forma positiva em diversos sistemas e sobre a qualidade de vida de pacientes portadores da DPOC.Descritores | doença pulmonar obstrutiva crônica; dispneia; respiração.ABSTRACT | This review aimed at standing out the main findings published in the last ten years on the effects of pursed-lip breathing (PLB) in patients with chronic obstructive pulmonary disease (COPD). The search for articles was performed in Lilacs, IBECS, MEDLINE, and SciELO database by using the descriptors of health (DeCS): doença pulmonar obstrutiva crônica, reabilitação, respiração, hiperinsuflação e dispneia, and their respective versions in the English language (MeSH), the term pursed-lip breathing was also in such list. After removing the repeated titles, only studies addressing PLB as the main theme were selected, resulting in 12 papers, 10 clinical trials, and 2 systematic reviews. According to the findings, the PLB provides: changes on arterial gases, which are characterized by increased oxygen saturation and partial pressure of oxygen; ventilatory pattern with decreased respiratory rate and increased expiratory time and tidal volume; respiratory mechanics, by recruiting the expiratory abdominal muscles and muscles of the rib cage and accessories inspired; decrease in oxygen consumption; alterations in cardiac autonomic modulation induced by increase in parasympathetic activity and, ultimately, improved quality of life of these patients. The PLB is considered a maneuver of great importance to have a positive effect on various systems and on the quality of life of patients with COPD.

show abstract

“…Faling 1 described UB as "usually the easiest breathing technique to learn and it is often (but not uniformly) employed instinctively by those who benefit from its use, patients inhale through the nose over several seconds with the mouth closed and then exhale slowly through the mouth." Although several hypotheses [2][3][4][5][6] have been proposed to explain this phenomenon, the exact mechanism associated with the benefits of UB is still not well understood. Many believe that UB creates a PEEP, stabilizing small airways and increasing expiratory flow and tidal volume (V T ) in patients with expiratory obstructive disorders.…”

Section: Introductionmentioning

confidence: 99%

A Unidirectional Breathing Pattern Improves Breathing Efficiency in Subjects With Severe COPD

et al. 2014

View full text Add to dashboard Cite

BACKGROUND: Unidirectional breathing (UB), nose-in mouth-out (NMB) or vice versa, is thought to create PEEP, stabilize small airways, and increase expiratory flow and exhaled tidal volume (V T ) in patients with expiratory obstructive disorders. However, the exact mechanism providing the benefits of UB remains unknown. Our hypothesis was that the benefits of UB are achieved mainly through reduction of upper airway dead space. METHODS: Sixteen stable COPD patients requiring oxygen use at home were enrolled in this prospective study at a tertiary health care center. A nasal mask and a mouthpiece were used, each having a removable one-way valve to direct the breathing pattern.

show abstract

Chest Wall Kinematics and Breathlessness During Pursed-Lip Breathing in Patients With COPD

Cited by 118 publications

References 17 publications

The importance of components of pulmonary rehabilitation, other than exercise training, in COPD

The importance of components of pulmonary rehabilitation, other than exercise training, in COPD

A respiração frenolabial na doença pulmonar obstrutiva crônica: revisão da literatura

A Unidirectional Breathing Pattern Improves Breathing Efficiency in Subjects With Severe COPD

Contact Info

Product

Resources

About