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PubMed1990

Hathayogic exercise jalandharabandha in its effect on cardiovascular response to apnoea.

Jalandharabandha (JB) is the important constituent of apnoea (kumbhaka) in hathayogic breathing exercises. It is performed by pressing the chin into the jugular notch and creating thus the positive pressure on the neck region. The influence of JB on the heart rate and vasomotor response was studied in relationship to different lung volumes. The course of R-R intervals is highly significantly different according to the type of apnoea. JB leads to the diminution of bradycardia, but does not change the position of the maximum and minimum in comparison to the apnoea without JB. Application of JB increases the number of vasodilatations and shortens the latencies of vasodilatations, duration and amplitude of reactions. JB during breath holding decreases the vagal reflex changes and may thus work as a stabilizing component in yogic breathing exercises.

Apnea↗
PubMed1980

Physiotherapy in hospitalized medical patients.

Few data on exercise training in hospitalized patients are available, but because exercise may help and it unlikely to harm, some sort of early and maximal mobilization should be attempted. Breathing exercises as practiced currently have little apparent effect beyond the temporary benefit of inducing a slow, deep breathing pattern. New breathing exercises, based on data from physiology laboratories, should be formulated and evaluated. Postural drainage and percussion represent the physiotherapist's mainstay in dealing with exacerbations of chronic obstructive disease. In some patients, these maneuvers increase production of sputum and produce improvements in pulmonary function that, although not large, are significant. Other patients show no acute benefit. Current belief holds that patients with large sputum volumes, notably those with cystic fibrosis and bronchiectasis, are the most likely to be helped by postural drainage and percussion; but definitions vary as to what is a large sputum volume. Two studies have assessed the effect of postural drainage and percussion on the clinical course of patients with pneumonia and patients with exacerbations of chronic bronchitis, and both produced negative results.

Drainage↗
PubMed2001

Breathing-control lowers blood pressure.

We hypothesise that routinely applied short sessions of slow and regular breathing can lower blood pressure (BP). Using a new technology BIM (Breathe with Interactive Music), hypertensive patients were guided towards slow and regular breathing. The present study evaluates the efficacy of the BIM in lowering BP. We studied 33 patients (23M/10F), aged 25-75 years, with uncontrolled BP. Patients were randomised into either active treatment with the BIM (n = 18) or a control treatment with a Walkman (n = 15). Treatment at home included either musically-guided breathing exercises with the BIM or listening to quiet music played by a Walkman for 10 min daily for 8 weeks. BP and heart rate were measured both at the clinic and at home with an Omron IC BP monitor. Clinic BP levels were measured at baseline, and after 4 and 8 weeks of treatment. Home BP measurements were taken daily, morning and evening, throughout the study. The two groups were matched by initial BP, age, gender, body mass index and medication status. The BP change at the clinic was -7.5/-4.0 mm Hg in the active treatment group, vs -2.9/-1.5 mm Hg in the control group (P = 0.001 for systolic BP). Analysis of home-measured data showed an average BP change of -5.0/-2.7 mm Hg in the active treatment group and -1.2/+0.9 mm Hg in the control group. Ten out of 18 (56%) were defined as responders in the active treatment group but only two out of 14 (14%) in the control group (P = 0.02). Thus, breathing exercise guided by the BIM device for 10 min daily is an effective non-pharmacological modality to reduce BP.

Adult↗
PubMed1968

Hypnosis for asthma--a controlled trial. A report to the Research Committee of the British Tuberculosis Association.

An investigation of hypnosis in asthma was made among patients aged 10 to 60 years with paroxysmal attacks of wheezing or tight chest capable of relief by bronchodilators. One group of patients was given hypnosis monthly and used autohypnosis daily for one year. Comparisons were made with a control group prescribed a specially devised set of breathing exercises aimed at progressive relaxation. Treatment was randomly allocated and patients were treated by physicians in nine centres. Results were assessed by daily diary recordings of wheezing and the use of bronchodilators, and by monthly recordings of F.E.V.(1) and vital capacity. At the end of the year independent clinical assessments were made by physicians unaware of the patients' treatment.There were 252 patients (127 hypnosis and 125 controls) accepted for analysis, but a number of them did not continue the prescribed treatment for the whole year: 28 hypnosis and 22 control patients failed to co-operate, left the district, or had family problems; one hypnosis and one control patient died. Seven hypnosis and 17 control patients were withdrawn as treatment failures, the difference between the two groups being statistically significant.As judged by analyses based on the daily "score" of wheezing recorded in patients' diaries, by the number of times bronchodilators were used, and by independent clinical assessors, both treatment groups showed some improvement Among men the assessments of wheezing score and use of bronchodilators showed similar improvement in the two treatment groups; among women, however, those treated by hypnosis showed improvement similar to that observed in the men, but those given breathing exercises made much less progress, the difference between the two treatment groups reaching statistical significance. Changes in F.E.V.(1) and V.C. between the control and hypnosis groups were closely similar.Independent clinical assessors considered the asthma to be "much better" in 59% of the hypnosis group and in 43% of the control group, the difference being significant There was little difference between the sexes. Physicians with previous experience of hypnosis obtained significantly better results than did those without such experience.

Adolescent↗
PubMed2000

Breathing pattern and exercise endurance time after exhausting cycling or breathing.

The aim of the present study was to investigate whether the changes in breathing pattern that frequently occur towards the end of exhaustive exercise (i.e., increased breathing frequency, fb, with or without decreased tidal volume) may be caused by the respiratory work itself rather than by leg muscle work. Eight healthy, trained subjects performed the following three sessions in random order: (A) two sequential cycling endurance tests at 78% peak O2 consumption (VO2peak) to exhaustion (A1, A2); (B) isolated, isocapnic hyperpnea (B1) at a minute ventilation (VE) and an exercise duration similar to that attained during a preliminary cycling endurance test at 78% VO2peak, followed by a cycling endurance test at 78% VO2peak (B2); (C) isolated, isocapnic hyperpnea (C1) at a VE at least 20% higher than that of the preliminary cycling test and the same exercise duration as the preliminary cycling test, followed by a cycling endurance test at 78% VO2peak (C2). Neither of the two isocapnic hyperventilation tasks (B1 or C1) affected either the breathing pattern or the endurance times of the subsequent cycling tests. Only cycling test A2 was significantly shorter [mean (SD) 26.5 (8.3) min] than tests A1 [41.0(9.0) min], B2 [41.9 (6.0) min], and C2 [42.0 (7.5) min]. In addition, compared to test A1, only the breathing pattern of test A2 was significantly different [i.e., VE: + 10.5 (7.6) 1 min(-1), and fb: + 12.1 (8.5) breaths min(-1)], in contrast to the breathing patterns of cycling tests B2 [VE: -2.5 (6.2) 1 min(-1), f(b): +0.2 (3.6) breaths min(-1)] and C2 [VE: -3.0 (7.0) 1 min(-1), fb: +0.6 (6.1) breaths min(-1)]. In summary, these results suggest that the changes in breathing pattern that occur towards the end of an exhaustive exercise test are a result of changes in the leg muscles rather than in the respiratory muscles themselves.

Adult↗
PubMed1999

Breathing during exercise in subjects with mild-to-moderate airflow obstruction: effects of physical training.

In this study we explored the effects of physical training on the response of the respiratory system to exercise. Eight subjects with irreversible mild-to-moderate airflow obstruction [forced expiratory volume in 1 s of 85 +/- 14 (SD) % of predicted and ratio of forced expiratory volume in 1 s to forced vital capacity of 68 +/- 5%] and six normal subjects with similar anthropometric characteristics underwent a 2-mo physical training period on a cycle ergometer three times a week for 31 min at an intensity of approximately 80% of maximum heart rate. At this work intensity, tidal expiratory flow exceeded maximal flow at control functional residual capacity [FRC; expiratory flow limitation (EFL)] in the obstructed but not in the normal subjects. An incremental maximum exercise test was performed on a cycle ergometer before and after training. Training improved exercise capacity in all subjects, as documented by a significant increase in maximum work rate in both groups (P < 0.001). In the obstructed subjects at the same level of ventilation at high workloads, FRC was greater after than before training, and this was associated with an increase in breathing frequency and a tendency to decrease tidal volume. In contrast, in the normal subjects at the same level of ventilation at high workloads, FRC was lower after than before training, so that tidal volume increased and breathing frequency decreased. These findings suggest that adaptation to breathing under EFL conditions does not occur during exercise in humans, in that obstructed subjects tend to increase FRC during exercise after experiencing EFL during a 2-mo strenuous physical training period.

Adult↗
PubMed1989

Effects of peripheral and central chemoreflex activation on the isopnoeic rating of breathing in exercising humans.

1. Respiratory sensation during exercise is generally considered to be related to respiratory mechanical factors which may be manifest as an abnormal relationship between the force applied to the lungs and chest wall and the resulting motion (if any); that is, a 'length-tension' inappropriateness (Campbell & Howell, 1963). This suggests that there should be a direct correlation between ventilation (VE) and the associated intensity of the perceived sensation, such that the sensation associated with a particular level of VE should remain essentially constant regardless of the source of respiratory stimulation. 2. In order to establish whether certain respiratory stimuli might be 'dyspnoeagenic' (i.e. capable of evoking an intensity of respiratory sensation out of proportion to their influence on VE), we investigated the influence of both peripheral chemoreflex activation (induced by isocapnic hypoxia) and central chemoreflex activation (induced by hypercapnic hyperoxia) on the intensity of respiratory sensation in seven healthy adults during moderate cycle ergometer exercise (i.e. below the lactate threshold, theta 1ac). 3. In each test, an 'isopnoea' was established for which a particular level of VE was sustained over a prolonged period (approximately 30 min) while the proportional contributions to the ventilatory drive from either exercise and the peripheral chemoreflex or from exercise and the central chemoreflex were slowly altered to new stable levels, without the subject's knowledge, VE, tidal volume, inspiratory and expiratory durations, mean inspiratory flow, and end-tidal PCO2 and PO2 (PET,CO2, PET,O2) were monitored breath-by-breath. The intensity of respiratory sensation was rated with a visual analogue scale. 4. Isopnoeic ratings of respiratory sensation were systematically greater for peripheral chemoreflex activation by isocapnic hypoxia during exercise at 50% theta 1ac (for which the degree of peripheral chemoreflex activation, estimated by hyperoxic transition or 'Dejours' testing, averaged approximately 23% of the total VE), compared to 90% theta 1ac during isocapnic hyperoxia. Ratings during exercise at 50% theta 1ac for central chemoreflex activation by hypercapnic hyperoxia were not systematically different from 90% theta 1ac during isocapnic hyperoxia, however. 5. As VE was stable throughout each isopnoea and the MVV (maximum voluntary ventilation) was uninfluenced by the test condition, the dyspnoea index (VE x 100/MVV) was not affected. Breathing pattern was also unaffected. 6. We conclude that in normal subjects exercising moderately, activation of the peripheral chemoreceptors by isocapnic hypoxia evokes an intensity of respiratory sensation which is out of proportion to that evoked by an isopnoeic stimulation of the central chemoreceptors with hypercapnic hyperoxia at the same level of exercise.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1982

Preventive geriatrics: an overview from traditional Chinese medicine.

The philosophical tradition of Chinese geriatrics contains a strong preventive element closely tied to the concept of a balanced man-nature relationship and body-mind relationship. It has been emphasized that a sound mind in a sound body is essential to longevity. Moderation in physical and emotional activities is encouraged. There have been a number of approaches to longevity in traditional Chinese medicine. The preventive value of Tai Chi Chuan (a gentle "spiritual" exercise), Chi Kung (a combination of breathing exercise, relaxation and meditation), acupressure and moxibustion on the point of Chu San Li, and tonic herbal medicines like ginseng is discussed in this article. These are regarded to be helpful in improving the general health of the elderly and in promoting longevity.

Acupuncture Therapy↗
PubMed2026

Therapeutic Exercise Protocol During Hospitalization in Pediatric Oncohematological Patients: Randomized Clinical Trial.

BACKGROUND: Leukemias, lymphomas, and central nervous system tumors are among the most common pediatric cancers and may lead to motor deficits, impaired balance, reduced muscle strength, fatigue, and decreased functional capacity. Early physiotherapy during hospitalization may help prevent inactivity and support functional preservation in this population. OBJECTIVE: To evaluate the effects of a therapeutic exercise program on quality of life, muscle strength, fatigue, and functional capacity in hospitalized pediatric oncohematological patients. METHODS: Thirty participants aged 8-17&#xa0;years with oncohematological diseases were randomized to an intervention group (IG) or a minimal active physiotherapy comparator group (CG). Assessments included the 6-min walk test, handgrip dynamometry, the PedsQL Multidimensional Fatigue Scale, and the PedsQL Cancer Module at admission and discharge. The IG performed daily 25-min supervised sessions including aerobic, resistance, and breathing exercises with ambulation guidance, whereas the CG received breathing exercises and ambulation guidance. RESULTS: No significant group&#xa0;&#xd7;&#xa0;time interactions were observed for total fatigue or its domains, overall quality of life or its assessed domains, handgrip strength, or six-minute walk test distance. Time-related changes were observed for some outcomes, but these occurred without evidence of differential change between groups and were not interpreted as effects of the structured exercise protocol. No intervention-related adverse events requiring permanent protocol discontinuation were recorded. CONCLUSION: The structured in-hospital therapeutic exercise protocol could be delivered under close clinical supervision without recorded intervention-related adverse events requiring permanent discontinuation. However, the structured protocol did not demonstrate superiority over the minimal active physiotherapy comparator for fatigue, quality of life, muscle strength, or functional capacity. These findings should be interpreted cautiously because of the small sample size, clinical heterogeneity, variable intervention exposure, and limited intervention-fidelity data. TRIAL REGISTRATION: Brazilian Registry of Clinical Trials (ReBEC), RBR-8sxnfyd.

Humans↗
PubMed1982

Effect of oxygen on breathing during exercise in patients with chronic obstructive lung disease.

In 10 exercising patients with chronic obstructive lung disease (COLD) we measured ventilation (VE), end-tidal CO2 (PETCO2), mean inspiratory flow (VT/TI), the ratio of inspiratory time to total time for one cycle (TI/TTOT), and occlusion pressure at 0.1 s measured at the mouth (P O.1), when they breathed room air and 100% oxygen. Oxygen breathing increased the maximal work load achieved. Furthermore, at the same exercise load, P O.1, VT/TI, VE, heart rate, respiratory frequency (f) decreased significantly in hyperoxia as compared with normoxia. Thoraco-pulmonary impedance assessed by P 0.1/VE and P 0.1/(VT/TI) ratios showed a slight but significant decrease to the respiratory centre. Thus in exercising patients affected by COLD, hyperoxia not only decreases the chemical afferent drive but also may slightly reduce the afferent mechanical drive to the respiratory centre. The decrease in the thoraco-pulmonary impedance may be explained either by an increase in efficiency of the respiratory muscles and/or a decrease in airway resistance.

Adult↗
PubMed1986

Effect of manual percussion on tracheobronchial clearance in patients with chronic airflow obstruction and excessive tracheobronchial secretion.

The effect of manual percussion of the thorax in nine patients with stable chronic airflow obstruction and excessive tracheobronchial secretion has been studied. Tracheobronchial clearance was measured over 50 minutes on three different days. On the first day manual percussion was applied for 10 minutes. In the period when percussion was applied the mucus clearance was slightly but significantly greater than in the periods when no percussion was applied. On the second day manual percussion was applied in combination with postural drainage, coughing, and breathing exercises for 20 minutes. This resulted in a much greater clearance than on the first day. On the third day postural drainage, coughing, and breathing exercises, but no manual percussion, were carried out for 20 minutes. There was no significant difference between the clearance of days 2 and 3. From this study it is apparent that manual percussion is a relatively ineffective procedure in patients with stable chronic airflow obstruction, but may be useful when the patient is not able to cough and cannot assume the appropriate position for postural drainage.

Aged↗
PubMed2006

Exercise-disordered breathing in chronic heart failure.

Patients with heart failure develop various ventilatory abnormalities, including reduced ventilatory reserves, increased ventilatory demands, and high work and cost of breathing. They tend to breathe with a rapid-shallow pattern, have low end-expiratory lung volumes, and may develop rhythmic oscillations in ventilation and tidal volume. These abnormalities likely contribute to exercise limitations and are associated with a worsening prognosis.

Exercise Tolerance↗
PubMed1990

Obligate mouth breathing during exercise. Nasal and laryngeal sarcoidosis.

A young black man presented with simultaneous nasal and laryngeal sarcoidosis, each uncommon entities. Despite severe upper airway obstruction and emergent tracheostomy, there was an uncharacteristic rapid response to oral steroids alone. The patient's predominant initial complaint of early mouth breathing during routine army physical training demonstrates a symptom complex and an alternate mechanism of dyspnea to consider in sarcoidosis.

Adult↗
PubMed1995

CO2 retention during hyperbaric exercise while breathing 40/60 nitrox.

We evaluated CO2 retention in 24 Navy construction divers breathing air at 1 atm abs (101.3 kPa) and 40% O2 (40/60) nitrox at 4 atm abs (Po2 of 162.1 kPa) inside a pressure chamber. The divers sat immersed to the sternal notch and exercised against pneumatically loaded pedals at a Vo2 of approximately 1.3 liter/min. The mean end-tidal CO2 tension (PET(CO2)2) at 1 atm abs (45.7 +/- 5.0 SD torr) was significantly higher than that of non-divers and diving trainees (40 +/- 5.0) but did not increase significantly at depth (47.1 +/- 6.3). The ranking of CO2 retention was not maintained at depth. Unpredictable upward and downward shifts of up to 10 torr occurred in some divers. The PET(CO2) of six of the divers at pressure was greater than 50 torr, which based on animal studies markedly increases the risk of central nervous system oxygen toxicity. We translated their values into individual depth limits with 40/60 nitrox: three with 50 < PET(CO2) < 55 torr were forbidden to dive beyond 25 m and three with values > 55 torr were restricted to 20 m. We propose that whenever possible, PET(CO2) during exercise at pressure be measured in potential nitrox users and that the above PO2 limits be enforced on moderate and extreme CO2 retainers, respectively.

Adult↗