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PubMed1985

Yoga for bronchial asthma: a controlled study.

Fifty three patients with asthma underwent training for two weeks in an integrated set of yoga exercises, including breathing exercises, suryanamaskar, yogasana (physical postures), pranayama (breath slowing techniques), dhyana (meditation), and a devotional session, and were told to practise these exercises for 65 minutes daily. They were then compared with a control group of 53 patients with asthma matched for age, sex, and type and severity of asthma, who continued to take their usual drugs. There was a significantly greater improvement in the group who practised yoga in the weekly number of attacks of asthma, scores for drug treatment, and peak flow rate. This study shows the efficacy of yoga in the long term management of bronchial asthma, but the physiological basis for this beneficial effect needs to be examined in more detail.

Adolescent↗
PubMed1978

Effects of respiratory exercises on the vital capacity and forced expiratory volume in children with cerebral palsy.

The purpose of this study was to determine if breathing exercises can increase the vital capacity in children with cerebral palsy. Ten children with spastic cerebral palsy, five in the experimental group and five in the control group, were the subjects for the study. A spirometer was used to measure vital capacity and the forced expiratory volume before and after the children performed a breathing exercise program. The pretest values for all 10 youngsters indicated a vital capacity lower than the normal predicted values. The breathing exercises selected emphasized strengthening of the muscles of inspiration and the muscles of expiration. In the breathing exercise program, the physical therapists also attempted to follow the Bobath treatment approach by inhibiting the abnormal breathing patterns and by teaching the child proper ways of breathing control. The results seem to indicate that a breathing exercise program can increase the vital capacity in youngsters with cerebral palsy. The vital capacity of the experimental group was increased by 0.46 liters after exercising for five to seven minutes each day for a period of eight weeks. The mean increase of the vital capacity was 31 percent over the pretest values. The control group showed no change in vital capacity. The pretest and posttest forced expiratory volumes of both groups were within normal limits.

Breathing Exercises↗
PubMed1984

Effect of chest wall vibrations on pulmonary function in chronic bronchitis.

Manual chest wall vibration is one physiotherapeutic technique frequently employed in the management of respiratory disease. A clinical study was undertaken to examine the effects of manual chest wall vibrations on pulmonary function and arterial oxygen saturation in patients with chronic bronchitis. Twelve patients participated in a three-day experimental design where the factors of three different days and three different treatments were randomized and balanced. On one day, deep-breathing exercises were given; on another, deep-breathing exercises with vibrations; and on the remaining day, no treatment was given. Lung volumes were measured before and after each maneuver, and arterial oxygen saturation was monitored continuously. There was a significant decrease in the expiratory reserve volume (ERV) immediately following the deep-breathing exercises alone, which remained constant after the 15-minute rest period (p = 0.032). The remaining outcome parameters do not appear to be significantly affected. Chest wall vibrations do not decrease the ERV in patients with chronic bronchitis.

Aged↗
PubMed1993

Relationship of resting lung mechanics and exercise pattern of breathing in patients with chronic obstructive lung disease.

To investigate the influence of resting pulmonary mechanics on the pattern of breathing during exercise in chronic obstructive pulmonary disease (COPD), we studied 29 patients with moderate to severe COPD (FEV1 50 +/- 20 percent predicted), and 10 normal subjects. Lung mechanics were studied using esophageal balloon technique and body-box. Incremental exercise testing was performed to exhaustion. As minute ventilation (VE) increases, COPD patients with the highest pulmonary resistance (RI) or lowest elastic recoil pressure (PL), used a greater tidal volume/vital capacity ratio (VT/VC) than the COPD patients with more normal RL or lowest PL. To describe the breathing pattern during exercise, an exponential constant (K) describes the rates of increase in VT/VC ratio with increasing VE, calculated according to the equation VT = VC(1-e-KVE). The K values achieved by COPD patients were higher than in normal subjects. In addition, K value correlated negatively with the resting FEV1 and FVC of COPD patients. When COPD patients were grouped according to their K values, it was revealed that patients with high K values generated greater VT/VC ratio and also have the most abnormal resting lung mechanics. These results suggest that the exercise breathing pattern in COPD patients is significantly influenced by the degree of impairment of resting lung mechanics.

Adult↗
PubMed1994

[Influence of physical responses due to controlled frequency breathing during exercise].

The purpose of this study was to examine the influence of respiratory responses due to controlled frequency breathing (CFB) during steady state cycle ergometric exercise (50% of Peak VO2, 60rpm) and to compare their responses between long distance (L), badminton (B), Swimming (S) and untrained (C; Control) group. Twenty-two (n = 6; L, B, C.n = 4; S) female university students were forced to take CFB for 1 min every 3 min during 20 min exercise. The breathing frequencies (BR) were 10, 12, 15, 20 and 30 frequencies in a minute. They were represented by CFB10, CFB12, CFB15, CFB20 and CFB30 respectively. In addition, CFB5, and 40 were given in a separate series. Ventiratory volume (VE) decreased significantly, (P < 0.05) when BR decreased less than about 50% of normal breathing (NB), CFB15 in (B) and (C). It showed to be less than CFB12 in (S), and CFB10 in (L). According to the decrease of VE, tidal volume and O2 pulse increased during CFB10 and 15 in all groups to maintain a constant O2 consumption for a given workload. End tidal partial pressure of O2 (PETO2) significantly decreased during less than CFB15 in (B) and (C), during CFB10 in (L). PETCO2 increased during less than CFB15 in (B), less than CFB12 in (L) and (C). However in (S) during every CFB, neither PETO2 nor PETCO2 changed significantly. Talking about the main differences shown between the four groups, (S) and (L) significantly exceeded (C) in maintaining of VE during CFB. However, in consideration of a ratio of the frequency of CFB to that of NB, (L) could maintain VE against more strictly controlled of breathing than other groups. (B) showed similar tendencies as (C) about some responses. It is considered that these differences in respiratory responses to CFB may result from difference of the duration and the level of breathing control that were forced during their daily training rather than whether their breathing frequency during each exercise is high or low.

Adult↗
PubMed1994

Effects of positive expiratory pressure breathing during exercise in patients with COPD.

The effect of breathing with a positive expiratory pressure of 5 cm H2O was investigated in eight patients with COPD (mean [SD]FEV1 = 54 [13] percent predicted). Specific work of breathing (Wsp) and myoelectrical activity of the following respiratory muscles were measured at rest: scalene muscle, parasternal muscle, and abdominal muscles. Minute ventilation (VE), end-tidal CO2 (FETCO2), physiologic dead space ventilation (VD/VT), oxygen uptake (VO2), and carbon dioxide output (VCO2) were measured at rest and during an incremental bicycle exercise test. Dyspnea sensation during exercise was quantified using the CR10 Borg-scale. All measurements were performed with and without positive expiratory pressure (PEP). During PEP breathing at rest mean (SEM) Wsp increased from 0.54 (0.13) J/L to 1.08 (0.10) J/L. The SEM VE decreased from 12.4 (1.0) L/min to 10.5 (1.1) L/min, and SEM VD/VT decreased from 0.39 (0.03) to 0.34 (0.03). There was a tendency for an increased phasic respiratory muscle activity during PEP breathing of all three muscles as compared with undisturbed breathing, but the changes were not statistically significant. During the exercise test with PEP, VE, VD/VT, VO2, and VCO2 were significantly lower, and FETCO2 was significantly higher as compared with the values obtained during the exercise test with undisturbed breathing. Dyspnea sensation during the exercise test with PEP, however, was higher than during the test with undisturbed breathing. The PEP breathing at rest may be useful in patients with COPD as it increases the efficiency of ventilation by reducing dead space ventilation. This beneficial effect also occurs during exercise, but here it is accompanied by increased dyspnea sensation.

Dyspnea↗
PubMed1985

Effect of 0.25 ppm sulfur dioxide on airway resistance in freely breathing, heavily exercising, asthmatic subjects.

We sought to determine whether 0.25 ppm sulfur dioxide in filtered air causes bronchoconstriction when inhaled by freely breathing, heavily exercising, asthmatic subjects. Nineteen asthmatic volunteers exercised at 750 kilogram meters/min for 5 min in an exposure chamber that contained filtered air at ambient temperature and humidity or, on another day, filtered air plus 0.25 ppm sulfur dioxide. The order of exposure to sulfur dioxide and to filtered air alone was randomized, and the experiments were double-blinded. Specific airway resistance, measured by constant-volume, whole-body plethysmography, increased from 6.38 +/- 2.07 cm H2O X s (mean +/- SD) before exercise to 11.32 +/- 8.97 after exercise on days when subjects breathed filtered air alone and from 5.70 +/- 1.93 to 13.33 +/- 7.54 on days when subjects breathed 0.25 ppm sulfur dioxide in filtered air. The increase in specific airway resistance on days when subjects breathed 0.25 ppm sulfur dioxide was only slightly greater than on days when they breathed filtered air, but the difference was significant. To determine whether 0.25 ppm sulfur dioxide causes greater bronchoconstriction in asthmatic subjects exercising more vigorously, 9 subjects then repeated the experiment exercising at 1,000 instead of 750 kilogram meters/min. Specific airway resistance increased from 6.71 +/- 2.25 to 13.59 +/- 7.57 on days when subjects breathed filtered air alone and from 5.23 +/- 1.23 to 12.54 +/- 6.17 on days they breathed 0.25 ppm sulfur dioxide in filtered air. The increase in specific airway resistance on the 2 days was not significantly different.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Intranasal↗
PubMedDate not supplied

Cardiovascular responses to apnea during dynamic exercise.

Breath holding maneuvers induce hypoxia, hypercapnia, and various cardiovascular responses typically including increases in total peripheral resistance, mean arterial pressure (MAP) and decreases in heart rate (HR). During dynamic exercise these responses may have a generally negative impact on performance. Moreover, they deserve particular attention in cardiovascular risk subjects. In 26 healthy sport students we studied the HR and MAP effects induced by the combination of dynamic exercise (cycle ergometry, 30 W and 250 W) with 20 s of either respiratory arrest (mouth piece pressure held constant at 20 mm Hg), free breathing, or rebreathing, i. e. periods of unimpeded breathing leading to similar levels of hypercapnia and hypoxia as the respiratory arrest. The measurements yielded no major differences between the conditions of rebreathing and free breathing. In contrast, 20 s of apnea led to a marked increase in MAP and a HR depression at both levels of exercise intensity. Additionally, there was a delayed MAP recovery after this stimulus. The present findings show that breath holding has marked effects on MAP and HR during dynamic exercise, which are essentially independent of the resulting hypoxia and of increases in intrathoracic pressure. The key factor seems to be an increase in total peripheral resistance, probably including a vasoconstriction in the exercising muscles.

Adult↗
PubMed1997

Exercise training in COPD patients: the basic questions.

Pulmonary rehabilitation programmes aim at improving exercise capacity, activities of daily living, quality of life and perhaps survival in patients with chronic obstructive pulmonary disease (COPD). Recently, well-designed studies investigated and confirmed the efficacy of comprehensive pulmonary rehabilitation programmes, including exercise training, breathing exercises, optimal medical treatment, psychosocial support and health education. In the present overview, the contribution of exercise training in clinical practice to the demonstrated effects of pulmonary rehabilitation is discussed by means of six basic questions. These include: 1) the significance of exercise training; 2) the optimal intensity for exercise training; 3) prescribing training modalities; 4) the effects of exercise training combined with medication, nutrition or oxygen; 5) how training effects should be maintained; and 6) where the rehabilitation programme should be performed: in-patient, out-patient or homecare? First, exercise training has been proven to be an essential component of pulmonary rehabilitation. Training intensity is of key importance. High-intensity training (>70% maximal workload) is feasible even in patients with more advanced COPD. In addition, the effects on peripheral muscle function and ventilatory adaptations are superior to low-intensity training. There is, however, no consensus on the optimal training modalities. Both walking and cycling improved exercise performance. Since peripheral muscle function has been recognized as an important contributor to exercise performance, specific peripheral muscle training recently gained interest. Improved submaximal exercise performance and increased quality of life were found after muscle training. The optimal training regimen (strength or endurance) and the muscle groups to be trained, remain to be determined. Training of respiratory muscles is recommended in patients with ventilatory limitation during exercise. The additional effects of anabolic-androgenic drugs, oxygen and nutrition are not well-established in COPD patients and need further research. In order to maintain training effects, close attention of the rehabilitation team is required. The continuous training frequency necessary to maintain training effects remains to be defined. At this point in time, out-patient-based programmes show the best results and guarantee the best supervision and a multidisciplinary approach. Future research should focus on the role of homecare programmes to maintain improvements.

Exercise↗
PubMedDate not supplied

Oxygen breathing during exercise in patients with diffuse interstitial fibrosis.

100% oxygen breathing during submaximal exercise in patients with diffuse interstitial lung disease diminishes cardiac output and pulmonary artery hypertension. The pressure drop in the pulmonary artery is most marked in patients with concomitant bronchial obstruction. At rest hyperoxia produced only minimal cardiopulmonary changes. The ventilatory and hemodynamic responses are discussed to find out if differences in these variables during oxygen breathing could be a reliable index for functional classification.

Adult↗
PubMed1986

Evaluation of positive expiratory pressure as an adjunct to chest physiotherapy in the treatment of cystic fibrosis.

It has been suggested that positive expiratory pressure may assist the clearance of bronchial secretions in the treatment of cystic fibrosis. It has been compared with currently used postural drainage techniques. Three treatment regimens were compared in 18 patients with cystic fibrosis. Treatment A consisted of breathing exercises emphasising inspiration, interspersed with the forced expiration technique in gravity assisted positions; treatment B comprised breathing exercises with positive expiratory pressure alternating with the forced expiration technique in the same gravity assisted positions; and treatment C comprised breathing exercises with positive expiratory pressure and the forced expiration technique in the sitting position. During treatment A a significantly greater quantity of sputum was produced than during treatments B and C (p less than 0.025 and p less than 0.001 respectively). Treatment B produced more sputum than treatment C (p less than 0.005). There were no significant differences in arterial oxygen saturation, FEV1 or forced vital capacity. Most adolescent and adult patients are able to carry out their treatment independently using gravity assisted positions, breathing exercises emphasising inspiration, and the forced expiration technique. Sputum clearance was less effective when positive expiratory pressure was included in the treatment regimen.

Adolescent↗
PubMed1994

Neural drives to breathing during exercise.

This article presents the author's views about the neural drives to breathing during exercise. Two hypotheses are developed, the first being that the rapid changes in ventilation at the start and end of exercise are due to a fast neural drive whose magnitude is related to the frequency of limb movement. Experimental data are presented that this drive persists throughout exercise but declines as exercise continues. Second, the excessive increase in ventilation that occurs above the first ventilatory threshold during an incremental exercise test is due to a heavy exercise neural drive whose magnitude is related to the motor commands to the exercising muscles. Using the electromyographical activity of the working muscles as an index of the strength of the motor commands, experimental evidence is presented showing the coincidence of the first ventilatory threshold and that for the electromyographic activity of the working muscles during incremental exercise tests.

Animals↗
PubMed1988

Variability of the perceived sense of effort in breathing during exercise in patients with chronic obstructive pulmonary disease.

The present study examined the reproducibility with which subjects with stable chronic obstructive pulmonary disease (COPD) scale the sense of effort involved in breathing during exercise. The sense of effort was assessed in 6 subjects with COPD during bicycle exercise continued to a symptom-limited maximal work load using a conventional category scale. Reproducibility of the sensory experience was assessed by comparing results obtained from 3 incremental work tests, 2 on the same day and a subsequent test performed within 1 to 10 days. During all trials in all subjects, sensory scores correlated closely with both minute ventilation and oxygen consumption (r greater than or equal to 0.92 for both VE and VO2). The average coefficients of variation for the maximal Borg Score and Borg Score at 2 min of exercise for the group as a whole were 3 +/- 1 and 3 +/- 2% (SE), respectively. Variability in sensory scores was not significantly different on exercise trials performed either within or between days. Furthermore, variability of sensory scores, oxygen consumption, heart rate, or minute ventilation were similar. We conclude that when using a category scale in subjects with COPD, the perceived sense of effort in breathing during exercise is highly reproducible, correlates closely with physiologic measures defining the intensity of exercise, and is no more variable than physiologic parameters typically measured during an exercise test.

Aged↗
PubMed1988

The prevention of pulmonary complications after upper abdominal surgery in patients with noncompromised pulmonary status.

Controversy exists regarding the routine use of breathing exercises in the prevention of pulmonary complications after upper abdominal surgery. We prospectively randomized 153 patients who had noncompromised pulmonary status; the control group (84 patients) engaged in no breathing exercises, and the respiratory therapy group (69 patients) engaged in preoperative and postoperative breathing exercises supervised by the physical therapist. Postoperative pulmonary complications were classified using criteria derived from chest roentgenograms, arterial blood gas samples, and temperature registration. The incidences of postoperative complications in the treatment group and in the control groups were 19% and 60%, respectively. In the present study, preoperative lung function tests had no additional or predictive value. We advise preoperative and postoperative breathing exercises as a prophylactic treatment in all patients scheduled for upper abdominal surgery.

Abdomen↗
PubMed1978

Oronasal breathing during exercise.

The shift from nasal to oronasal breathing (ONBS) has been observed on 73 subjects with two independent methods. A first group of 63 subjects exercising on a bicycle ergometer at increasing work load (98--196 W) has been observed. On 35 subjects the highest value of ventilation attained with nasal breathing was 40.2 +/- 9.41 . min-1 S.D. Ten subjects breathed through the mouth at all loads, while 5 never opened the mouth. On 13 subjects it was not possible to make reliable measurements. On a second group of 10 subjects utilizing a different techniques which did not need a face mask, the ventilation at which one changes the pattern of breathing was found to be 44.2 +/- 13.51 . min-1 S.D. On the same subjects nasal resistance did not show any correlation with ONBS. It is concluded that ONBS is not solely determined by nasal resistance, though an indirect effect due to hypoventilation and hence to changes in alveolar air composition cannot be ruled out. It is likely that ONBS is also influenced by psychological factors.

Adult↗
PubMed1998

Improvement in ejection fraction by hydrotherapy as rehabilitation in patients with chronic pulmonary emphysema.

BACKGROUND AND PURPOSE: It has been reported that breathing exercise by immersion in combination with expiring into water improved pulmonary function and blood-gas exchange in patients with chronic obstructive pulmonary disease (COPD). This effect may result from respiratory muscle exercise against hydraulic pressure and decreased dead space by increased sub-abdominal pressure. Increased cardiac function by bathing is suggested to contribute to the effect. To clarify the effect of the breathing exercise by immersion on cardiac function, a study was made of cardiac function during the exercise in patients with emphysema. METHOD: Echocardiography, respiratory function test and arterial blood gas analysis were performed during a two-month breathing exercise programme in a pool filled with 38 degrees C water for 12 patients (aged 70.9 +/- 9.1 years) with stable chronic pulmonary emphysema who were treated at our hospital between 1993 and 1996. The patients breathed in whilst standing in a pool and breathed out through the mouth while sinking the nose under water. This exercise was repeated for 30 min per day and continued for six days a week for two months. RESULTS: The ejection fraction increased significantly after each 30-minute exercise (N = 12; p < 0.01) as well as after the two-month exercise programme (N = 12, p < 0.05). Left ventricular end-diastolic and systolic dimensions at rest decreased significantly after the two-month exercise programme (N = 12, p < 0.01). The ratio of forced expired volume in one second to forced vital capacity (FEV1:FVC) increased and PaCO2 decreased following this programme (N = 12, p < 0.05). CONCLUSIONS: These results suggest that the breathing exercise by immersion is useful not only in treating emphysema but also in improving cardiac function.

Aged↗
PubMed2026

The Effect of Slow Deep Breathing Relaxation Exercise on Pain and Anxiety Levels During and Post-Chest Tube Removal After CABG.

Chest tube removal after coronary artery bypass graft is frequently reported by patients as stressful and painful, highlighting the need for effective nonpharmacological interventions. Slow deep breathing relaxation exercises (SDBREs) may serve as a simple nursing strategy to reduce discomfort. In this study, we aimed to evaluate the effect of SDBRE on pain and anxiety during and after chest tube removal following coronary artery bypass grafting in Nablus hospitals. An experimental design was used with 80 patients recruited from 2 hospitals. Participants were randomly assigned to either an intervention group (n = 40) that practiced SDBRE or a control group (n = 40) that received standard care. Data were collected through a self-administered questionnaire, the Numeric Pain Scale, and the Visual Anxiety Scale. Data collection occurred from March to October 2024. The intervention group reported significantly lower pain scores during removal (M: 5.325 vs 7.125, P < .001) and after removal (P < .001). Anxiety scores were significantly lower both during and after removal (P < .001). Pain correlated with duration, with more complex operations and prolonged chest tube insertion linked to higher scores. SDBRE significantly reduced pain and anxiety during and after chest tube removal, supporting its integration into routine postoperative nursing care.

Humans↗