Effect of pursed-lip breathing and forward trunk lean positions on regional chest wall volume and ventilatory pattern in older adults

Abstract

Pursed-lip breathing (PLB) and forward trunk lean posture (FTLP) are commonly used to relieve dyspnea and improve ventilation in a rehabilitation program. However, their effect on chest wall volumes and movements in older adults without chronic obstructive pulmonary disease has never been investigated. This observational study aimed to identify the effect of combined PLB and FTLP on total and regional chest wall volumes, ventilatory pattern, and thoracoabdominal movement using in older adults. It was hypothesized that the combined PLB with FTLP would result in the highest chest wall volumes among the experimental tasks. Twenty older adults performed 2 breathing patterns of quiet breathing (QB) and PLB during a seated upright (UP) position and FTLP. An optoelectronic plethysmography system was used to capture the chest wall movements during the 4 experimental tasks. Tidal volume (V T ) was separated into pulmonary ribcage, abdominal ribcage, and abdomen volume. The changes in anterior–posterior (AP) and medial–lateral (ML) chest wall diameters at 3 levels were measured and used to identify chest wall mechanics to improve chest wall volumes. The PLB significantly improved ventilation and chest wall volumes than the QB ( P < .05). V T of pulmonary ribcage, V T of abdominal ribcage, and V T were significantly higher during the PLB + UP ( P < .05) and during the PLB + FTLP ( P < .01) as compared to those of QB performed in similar body positions. However, there was no significant in total and regional lung volumes between the PLB + UP and the PLB + FTLP. The AP diameter changes at the angle of Louis and xiphoid levels were greater during the PLB + UP than the QB + UP and the QB + FTLP ( P < .01). The AP diameter changes at the umbilical level and the ML diameter changes at the xiphoid level were significantly larger during the PLB + FTLP than the QB + FTLP and the QB + UP ( P < .05). The ML diameter changes at the umbilical level were significantly greater during the PLB + FTLP than the QB + UP ( P < .05). However, no significant difference in the relative regional chest wall volumes and phase angle among the experimental tasks ( P > .05). In conclusion, a combined PLB performed in an FTLP or UP sitting could be used as a strategy to improve chest wall volumes and ventilation in older adults.

The effect of cognition in combination with an active cycle of breathing technique on dyspnea-related kinesiophobia in patients with moderate to severe chronic obstructive pulmonary disease

“…Active cycle of breathing technique (ACBT) is a specialized category of respiratory muscle training methods used to treat respiratory problems, including breathing control, thoracic expansion exercises, and the forceful exhalation technique [20][21][22]. Studies have demonstrated that respiratory control has the same impact as IMT by improving diaphragm strength[21, 23,24], hence reducing exercise-induced dyspnea in patients [25]. COPD patients can train their inspiratory muscle function with deep breathing, inspiration, passive relaxation breathing[26], active exhalation [26,27], and other methods of chest expansion and forceful expiratory technique.…”

The effect of cognition in combination with an ACBT on dyspnea-related kinesiophobia in patients with moderate to severe COPD: Non-randomized controlled trial

“…It is composed of three exercises: breathing control, chest expansion exercise and forced expiratory technique [23]. While focusing on the exercise of inspiratory muscles [24][25][26], it can also signi cantly improve lung function and arterial oxygen saturation, and nally reduce the symptoms of dyspnea and improve daily physical activity [23,27]. However, when only considering the behavior of patients with exercise intervention, we found that the cognitive level of patients could not be changed, and the exercise e cacy of patients could not be stimulated [14], resulting in the initial effect of the intervention, which was generally more signi cant in the 8th week [28].…”