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Giorgio Scano - One of the best experts on this subject based on the ideXlab platform.
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patterns of chest wall kinematics during volitional Pursed Lip Breathing in copd at rest
Respiratory Medicine, 2007Co-Authors: Roberto Bianchi, Francesco Gigliotti, Isabella Romagnoli, Barbara Lanini, Carla Castellani, Michela Grazzini, Barbara Binazzi, Loredana Stendardi, Giorgio ScanoAbstract:Summary Background Analysis of chest wall kinematics can contribute to identifying the reasons why some patients benefit from Pursed-Lip Breathing (PLB). Material and methods We evaluated the displacement of the chest wall and its compartments, the rib cage and abdomen, by optoelectronic plethysmography (OEP), during supervised PLB maneuver in 30 patients with mild to severe chronic obstructive pulmonary disease (COPD). Results OEP showed two different patterns. A first pattern characterized the 19 most severely obstructed and hyperinflated patients in whom PLB decreased end-expiratory volumes of the chest wall and abdomen, and increased end-inspiratory volumes of the chest wall and rib cage. Deflation of the abdomen and inflation of the rib cage contributed to increasing tidal volume of the chest wall. The second pattern characterized 11 patients in whom, compared to the former group, PLB resulted in the following: (i) increased end-expiratory volume of the rib cage and chest wall, (ii) greater increase in end-inspiratory volume of the rib cage and abdomen, and (iii) lower tidal volume of the chest wall. In the patients as a whole changes in end-expiratory chest wall volume were related to change in Borg score (r2=0.5, p Conclusions OEP helps identifying the reason why patients with COPD may benefit from PLB at rest.
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chest wall kinematics and breathlessness during Pursed Lip Breathing in patients with copd
Chest, 2004Co-Authors: Roberto Bianchi, Francesco Gigliotti, Isabella Romagnoli, Barbara Lanini, Carla Castellani, Michela Grazzini, Giorgio ScanoAbstract:Background Pursed-Lip Breathing (PLB) is a strategy often spontaneously employed by patients with COPD during distress situations. Whether and to what extent PLB affects operational lung volume is not known. Also, conflicting reports deal with PLB capability of decreasing breathlessness. Participants and measurements Twenty-two patients with mild-to-severe COPD were studied. Volumes of chest wall (CW) compartments (rib cage [RC] and abdomen) were assessed using an optoelectronic plethysmograph. Dyspnea was assessed by a modified Borg scale. Results Compared to spontaneous Breathing, patients with PLB exhibited a significant reduction (mean ± SD) in end-expiratory volume of the CW (V cw ) [V cw ee; − 0.33 ± 0.24 L, p cw (V cw ei; + 0.32 ± 0.43 L, p cw ee, mostly due to the decrease in end-expiratory volume of the abdomen (V a bee) [− 0.25 ± 0.21 L, p 1 (p e ) [ r 2 = 0.49, p tot ) [ r 2 = 0.35, p t ) of the chest wall (+ 0.65 ± 0.48 L, p t of the abdomen (0.31 ± 0.23 L, p t of the rib cage (+ 0.33 ± 0.29 L, p cw ee accounted for 27% of the variability in Borg score at 99% confidence level (p Conclusions Changes in V cw ee related to baseline airway obstruction but not to hyperinflation (FRC). By lengthening of T e and T tot , PLB decreases V cw ee and reduces breathlessness.
Alice Y. M. Jones - One of the best experts on this subject based on the ideXlab platform.
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Breathing exercises for chronic obstructive pulmonary disease
Cochrane Database of Systematic Reviews, 2012Co-Authors: Anne E. Holland, Catherine J Hill, Alice Y. M. Jones, Christine F McdonaldAbstract:Background: Breathing exercises for people with chronic obstructive pulmonary disease (COPD) aim to alter respiratory muscle recruitment, improve respiratory muscle performance and reduce dyspnoea. Although some studies have reported positive short-term physiological effects of Breathing exercises in people with COPD, their effects on dyspnoea, exercise capacity and well being are unclear.; Objectives: To determine whether Breathing exercises in people with COPD have beneficial effects on dyspnoea, exercise capacity and health-related quality of life compared to no Breathing exercises in people with COPD; and to determine whether there are any adverse effects of Breathing exercises in people with COPD.; Search Methods: The Cochrane Airways Group Specialised Register of trials and the PEDro database were searched from inception to October 2011.; Selection Criteria: We included randomised parallel trials that compared Breathing exercises to no Breathing exercises or another intervention in people with COPD.; Data Collection and Analysis: Two review authors independently extracted data and assessed the risk of bias. Primary outcomes were dyspnoea, exercise capacity and health-related quality of life; secondary outcomes were gas exchange, Breathing pattern and adverse events. To determine whether effects varied according to the treatment used, we assessed each Breathing technique separately.; Main Results: Sixteen studies involving 1233 participants with mean forced expiratory volume in one second (FEV(1)) 30% to 51% predicted were included. There was a significant improvement in six-minute walk distance after three months of yoga involving pranayama timed Breathing techniques (mean difference to control 45 metres, 95% confidence interval 29 to 61 metres; two studies; 74 participants), with similar improvements in single studies of Pursed Lip Breathing (mean 50 metres; 60 participants) and diaphragmatic Breathing (mean 35 metres; 30 participants). Effects on dyspnoea and health-related quality of life were inconsistent across trials. Addition of computerised ventilation feedback to exercise training did not provide additional improvement in dyspnoea-related quality of life (standardised mean difference -0.03; 95% CI -0.43 to 0.49; two studies; 73 participants) and ventilation feedback alone was less effective than exercise training alone for improving exercise endurance (mean difference -15.4 minutes; 95% CI -28.1 to -2.7 minutes; one study; 32 participants). No significant adverse effects were reported. Few studies reported details of allocation concealment, assessor blinding or intention-to-treat analysis.; Authors' Conclusions: Breathing exercises over four to 15 weeks improve functional exercise capacity in people with COPD compared to no intervention; however, there are no consistent effects on dyspnoea or health-related quality of life. Outcomes were similar across all the Breathing exercises examined. Treatment effects for patient-reported outcomes may have been overestimated owing to lack of blinding. Breathing exercises may be useful to improve exercise tolerance in selected individuals with COPD who are unable to undertake exercise training; however, these data do not suggest a widespread role for Breathing exercises in the comprehensive management of people with COPD.;
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Comparison of the oxygen cost of Breathing exercises and spontaneous Breathing in patients with stable chronic obstructive pulmonary disease
Physical Therapy, 2003Co-Authors: Elizabeth Dean, Alice Y. M. Jones, Cedric C. S. ChowAbstract:Background and Purpose. The oxygen demand of Breathing exercises and the clinical implications have not been studied in detail. In this study, the oxygen cost of 3 common Breathing exercises believed to reduce oxygen cost (ie, work of Breathing) was compared with that of spontaneous Breathing in patients with chronic obstructive pulmonary disease (COPD). Subjects. Thirty subjects with stable, moderately severe COPD participated. Methods. Oxygen consumption (VO2) and respiratory rate (RR) during spontaneous Breathing at rest (SB) were recorded for 10 minutes. Subjects then performed 3 Breathing exercises in random order, with a rest between exercises: diaphragmatic Breathing (DB), Pursed-Lip Breathing (PLB), and a combination of DB and PLB (CB). Oxygen consumption and RR were measured. Results. Mean VO2 (+ or -SD) was lower during the Breathing exercises (165.8+ or -22.3 mL O2/min for DB, 164.8+ or -20.9 mL O2/min for PLB, and 167.7+ or -20.7 mL O2/min for CB) compared with SB (174.5+ or -25.2 mL O2/min). Correspondingly, mean RR (+ or -SD) was higher during SB (17.3+ or -4.23 breaths/min), followed by DB (15.0+ or -4.32 breaths/min), PLB (12.8+ or -3.53 breaths/min), and CB (11.2+ or -2.7 breaths/min). Discussion and Conclusion. Given that patients do not spontaneously adopt the Breathing pattern with the least VO2 and the lowest RR, the results suggest that determinants of the Breathing pattern other than metabolic demand warrant being a primary focus in patients with COPD. [Jones AYM, Dean E, Chow CCS. Comparison of the oxygen cost of Breathing exercises and spontaneous Breathing in patients with stable chronic obstructive pulmonary disease. Phys Ther. 2003;83:424-431.] Key Words. Breathing exercises, Chronic obstructive pulmonary disease, Diaphragmatic Breathing, Oxygen cost, Pursed-Lip Breathing.
Roberto Bianchi - One of the best experts on this subject based on the ideXlab platform.
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patterns of chest wall kinematics during volitional Pursed Lip Breathing in copd at rest
Respiratory Medicine, 2007Co-Authors: Roberto Bianchi, Francesco Gigliotti, Isabella Romagnoli, Barbara Lanini, Carla Castellani, Michela Grazzini, Barbara Binazzi, Loredana Stendardi, Giorgio ScanoAbstract:Summary Background Analysis of chest wall kinematics can contribute to identifying the reasons why some patients benefit from Pursed-Lip Breathing (PLB). Material and methods We evaluated the displacement of the chest wall and its compartments, the rib cage and abdomen, by optoelectronic plethysmography (OEP), during supervised PLB maneuver in 30 patients with mild to severe chronic obstructive pulmonary disease (COPD). Results OEP showed two different patterns. A first pattern characterized the 19 most severely obstructed and hyperinflated patients in whom PLB decreased end-expiratory volumes of the chest wall and abdomen, and increased end-inspiratory volumes of the chest wall and rib cage. Deflation of the abdomen and inflation of the rib cage contributed to increasing tidal volume of the chest wall. The second pattern characterized 11 patients in whom, compared to the former group, PLB resulted in the following: (i) increased end-expiratory volume of the rib cage and chest wall, (ii) greater increase in end-inspiratory volume of the rib cage and abdomen, and (iii) lower tidal volume of the chest wall. In the patients as a whole changes in end-expiratory chest wall volume were related to change in Borg score (r2=0.5, p Conclusions OEP helps identifying the reason why patients with COPD may benefit from PLB at rest.
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chest wall kinematics and breathlessness during Pursed Lip Breathing in patients with copd
Chest, 2004Co-Authors: Roberto Bianchi, Francesco Gigliotti, Isabella Romagnoli, Barbara Lanini, Carla Castellani, Michela Grazzini, Giorgio ScanoAbstract:Background Pursed-Lip Breathing (PLB) is a strategy often spontaneously employed by patients with COPD during distress situations. Whether and to what extent PLB affects operational lung volume is not known. Also, conflicting reports deal with PLB capability of decreasing breathlessness. Participants and measurements Twenty-two patients with mild-to-severe COPD were studied. Volumes of chest wall (CW) compartments (rib cage [RC] and abdomen) were assessed using an optoelectronic plethysmograph. Dyspnea was assessed by a modified Borg scale. Results Compared to spontaneous Breathing, patients with PLB exhibited a significant reduction (mean ± SD) in end-expiratory volume of the CW (V cw ) [V cw ee; − 0.33 ± 0.24 L, p cw (V cw ei; + 0.32 ± 0.43 L, p cw ee, mostly due to the decrease in end-expiratory volume of the abdomen (V a bee) [− 0.25 ± 0.21 L, p 1 (p e ) [ r 2 = 0.49, p tot ) [ r 2 = 0.35, p t ) of the chest wall (+ 0.65 ± 0.48 L, p t of the abdomen (0.31 ± 0.23 L, p t of the rib cage (+ 0.33 ± 0.29 L, p cw ee accounted for 27% of the variability in Borg score at 99% confidence level (p Conclusions Changes in V cw ee related to baseline airway obstruction but not to hyperinflation (FRC). By lengthening of T e and T tot , PLB decreases V cw ee and reduces breathlessness.
Cedric C. S. Chow - One of the best experts on this subject based on the ideXlab platform.
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Comparison of the oxygen cost of Breathing exercises and spontaneous Breathing in patients with stable chronic obstructive pulmonary disease
Physical Therapy, 2003Co-Authors: Elizabeth Dean, Alice Y. M. Jones, Cedric C. S. ChowAbstract:Background and Purpose. The oxygen demand of Breathing exercises and the clinical implications have not been studied in detail. In this study, the oxygen cost of 3 common Breathing exercises believed to reduce oxygen cost (ie, work of Breathing) was compared with that of spontaneous Breathing in patients with chronic obstructive pulmonary disease (COPD). Subjects. Thirty subjects with stable, moderately severe COPD participated. Methods. Oxygen consumption (VO2) and respiratory rate (RR) during spontaneous Breathing at rest (SB) were recorded for 10 minutes. Subjects then performed 3 Breathing exercises in random order, with a rest between exercises: diaphragmatic Breathing (DB), Pursed-Lip Breathing (PLB), and a combination of DB and PLB (CB). Oxygen consumption and RR were measured. Results. Mean VO2 (+ or -SD) was lower during the Breathing exercises (165.8+ or -22.3 mL O2/min for DB, 164.8+ or -20.9 mL O2/min for PLB, and 167.7+ or -20.7 mL O2/min for CB) compared with SB (174.5+ or -25.2 mL O2/min). Correspondingly, mean RR (+ or -SD) was higher during SB (17.3+ or -4.23 breaths/min), followed by DB (15.0+ or -4.32 breaths/min), PLB (12.8+ or -3.53 breaths/min), and CB (11.2+ or -2.7 breaths/min). Discussion and Conclusion. Given that patients do not spontaneously adopt the Breathing pattern with the least VO2 and the lowest RR, the results suggest that determinants of the Breathing pattern other than metabolic demand warrant being a primary focus in patients with COPD. [Jones AYM, Dean E, Chow CCS. Comparison of the oxygen cost of Breathing exercises and spontaneous Breathing in patients with stable chronic obstructive pulmonary disease. Phys Ther. 2003;83:424-431.] Key Words. Breathing exercises, Chronic obstructive pulmonary disease, Diaphragmatic Breathing, Oxygen cost, Pursed-Lip Breathing.
Imron Rosyadi - One of the best experts on this subject based on the ideXlab platform.
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pengaruh pemberian Pursed Lip Breathing diaphragmatic Breathing dan upper limb stretching terhadap skala dispnea pada pasien ppok
NERS Jurnal Keperawatan, 2019Co-Authors: Imron Rosyadi, Defriman Djafri, Dally RahmanAbstract:Respiratory muscle weakness in patients with C hronic O bstructive P ulmonary D isease (COPD) was a problem that can affect the patient's ability to conduct daily activities. The aim of this study to see the difference between the intervention group given the Pursed-Lip Breathing exercises, diaphragmatic Breathing, and upper limb stretching with the control group which not given therapy. 38 COPD patients were grouped into intervention groups (n = 18) and control group (n = 18) randomly . The intervention group was given Pursed - Lip Breathing, diaphragmatic Breathing, and upper limb stretching for 4 weeks as much as two times for each week , while the control group was not given exercise. The dyspnea scale was measured using the MRC D yspnea Scale questionnaire and was categorized as Mild (scale 1), Medium (2-3 scale), and Severe (scale 4-5). The result showed there was a difference in dyspnea (p-value 0.008) for intervention group and there is no difference in the dyspnea for control group that was not given exercise (0.655). In conclusion , Pursed Lip Breathing, diaphragmatic Breathing, and upper limb stretching can give more significant benefits when done sustainably, especially for COPD patients.
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pengaruh pemberian modifikasi inspiratory muscle training Pursed Lip Breathing diaphragmatic Breathing dan upper limb stretching terhadap skala dipsnea dan kapasitas latihan pasien dengan penyakit paru obstruktif kronik
2019Co-Authors: Imron RosyadiAbstract:Penyakit Paru Obstruktif Kronik (PPOK) merupakan penyakit paru akibat adanya gangguan berupa obstruksi jalan nafas dan kelemahan pada otot pernapasan yang bersifat progresif. Obstruksi jalan nafas dan kelemahan otot pernapasan mengakibatkan pasien cenderung mengalami dispnea, terutama pada saat beraktivitas. Salah satu intervensi yang dapat dilakukan dalam mengoptimalkan kembali fungsi otot pernapasan adalah dengan pemberian modifikasi Inspiratory Muscle Training (IMT) berupa Pursed Lip Breathing, diaphragmatic Breathing, dan upper limb stretching. Tujuan dari penelitian ini untuk melihat pengaruh pemberian modifikasi IMT terhadap skala dispnea dan kapasitas latihan pada pasien PPOK. Sebanyak 36 pasien PPOK dibagi menjadi 2 kelompok secara acak, yaitu 18 orang kelompok intervensi dan 18 orang kelompok kontrol. Kelompok intervensi diberikan latihan modifikasi IMT selama 4 minggu sebanyak 2 kali dalam 1 minggu, sedangkan kelompok kontrol tidak diberikan latihan. Pengukuran derajat dispnea menggunakan kuesioner MRC Dyspnea Scale dan kapasitas latihan menggunakan 6 minutes walk test (6MWT) dilakukan setelah 4 minggu. Modifikasi IMT mampu menurunkan skala dispnea (p value 0,001) dan sekaligus meningkatkan kapasitas latihan (p value 0,003), Sedangkan pada kelompok kontrol tidak terjadi penurunan skala dispnea (p value 0,480) dan terjadi penurunan pada kapasitas latihan (p value 0,006). Modifikasi IMT dapat menurunkan dispnea dan meningkatkan kapasitas latihan pasien PPOK. Latihan ini dapat dijadikan sebagai home based training pada pasien setelah pulang dari rumah sakit.
