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European journal of physical and rehabilitation medicine (Impa
Factor: 1.95). 04/2014; 51(1).
Source: PubMed
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Pursed lip breathing improves exercise tolerance in
COPD: a randomized crossover study
European journal of physical and rehabilitation medicine (Impa
Factor: 1.95). 04/2014; 51(1).
Source: PubMed
L. Ferracini Cabral T. Da Cunha D'Elia
W. Araujo Zin Fernando S Guimaraes
ABSTRACT Although pursed-lip breathing (PLB) has been
advocated to reduce respiratory rate and improve oxygen
saturation in patients with chronic obstructive pulmonary disea
(COPD) at rest, the evidence of its effects on dynamic
hyperinflation (DH) and exercise tolerance is scarce.
To evaluate the effect of PLB on exercise tolerance, breathing
pattern, dynamic hyperinflation and arterial oxygenation in COP
patients during high-intensity exercise.
Randomized crossover study.
Laboratory of Respiration Physiology, Federal University of Rio
Janeiro. Population: Forty stable COPD patients aged 4075 yea
and with FEV1<60%.
In a randomized order, all patients performed PLB and control
breathing (CB) during constant workrate exercise in an electric
braked cycloergometer. Dynamic hyperinflation, oxygen saturat
and breathing pattern were recorded at rest, in isotime and in p
exercise.
The nine patients who increased their endurance time by more t
25% during PLB (6.422.36 vs. 10.513.83 min; p<0.05) were
considered as the IMPROVER sub-group. Compared to the NON
IMPROVER subgroup, these patients presented a lower expirato
peak flow EPF (40.28.6 vs 53.317.8 % predicted, p<0.05). T
ROC curve analysis of the EPF as a percentage of the predicted
values (%pred) was performed to identify cutoff values that had
greater sensitivity and specificity in differentiating between
IMPROVER and NON-IMPROVER. We observed 61% sensitivity
89% specificity with a 47.7% pred EPF. At isotime, PLB yielded
higher inspiratory capacity (IC) and oxygen saturation (1.190.
to 1.350.39 L; p<0.05 and 93.14.6 to 94.04.1%; p<0.05), a
lower respiratory rate than CB only in IMPROVER. NON-IMPRO
patients showed thoraco-abdominal asynchrony during PLB in
isotime. At peak exercise, PLB improved the arterial oxygenatio
IMPROVER, but there were no changes in the breathing pattern
the analyzed subgroups.
In COPD patients with low PEF, pursedlip breathing reduces
dynamic hyperinflation and improves exercise tolerance, breath
pattern and arterial oxygenation at submaximal intensity exerci
This study points to a possible application of PLB in a selected
group of COPD patients aiming at improving the exercise
tolerance. PEF measurements can help to indicate PLB for COP
patients.
www.researchgate.net/publication/261292410_Pursed_lip_breathing_improves_exerc
ise_tolerance_in_COPD_a_randomized_crossover_study