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Meredith Alvey , Abby Naville , Alex Piedmonte , Lauren Speelman

Among persons with COPD, is pursed lip breathing or diaphragmatic breathing a more effective technique to improve symptoms and efficiency of breathing?. Meredith Alvey , Abby Naville , Alex Piedmonte , Lauren Speelman. Factors Analyzed. Respiratory rate Work of breathing Dyspnea Oxygen.

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Meredith Alvey , Abby Naville , Alex Piedmonte , Lauren Speelman

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  1. Among persons with COPD, is pursed lip breathing or diaphragmatic breathing a more effective technique to improve symptoms and efficiency of breathing? Meredith Alvey, Abby Naville, Alex Piedmonte, Lauren Speelman

  2. Factors Analyzed • Respiratory rate • Work of breathing • Dyspnea • Oxygen

  3. Breathing Techniques Pursed Lip Breathing Diaphragmatic Breathing www.st-joseph.kramesonline.com www.my.clevelandclinic.org

  4. Respiratory Rate Pursed Lip Breathing Diaphragmatic Breathing Slowed breathing frequency from 17.3 to 15 (Jones, 2003) Increase in tidal volume (Vitacca, 1997) • Slowed breathing frequency from 17.3 to 12.8 (Jones, 2003) • Lowers oxygen costs (Jones, 2003) • Increased tidal volume (Gosselink, 2004)

  5. Work of Breathing Pursed Lip Breathing Diaphragmatic Breathing Causes respiratory muscle fatigue (Gosselink, 2004) Decrease in mechanical efficiency (Dechman, 2004; Gosselink, 1995) • Often adopted naturally (Dechman, 2004) • Utilizes the subject’s natural inspiratory breathing pattern (Jones, 2003)

  6. Oxygen Pursed Lip Breathing Diaphragmatic Breathing Partial pressure of oxygen increased (Vitacca, 1997) Decreased oxygen consumption compared to spontaneous breathing (Jones, 2003) 165.8 mL/min • Improves oxygen saturation in resting conditions (Gosselink, 2004) • No improvements in blood gases with exercise (Gosselink, 2004) • Decreased oxygen consumption compared to spontaneous breathing (Jones, 2003) • 164.8 mL/min

  7. Dyspnea Pursed Lip Breathing Diaphragmatic Breathing Three studies stated dyspnea increased with this technique Visual analog scale (Vitacca, 1997) 33 to 54 • Two articles reported improvements

  8. Scoreboard

  9. Conclusion • Pursed lip breathing is supported over diaphragmatic breathing • Carryover effect • Future studies needed

  10. COPD Support Groups • http://betterbreathers.freeservers.com/groups.htm

  11. Questions? www.en.hdyo.org

  12. References • Dechman G, Wilson C. Evidence Underlying Breathing Retraining in People With Stable Chronic Obstructive Pulmonary Disease. Physical Therapy [serial online]. December 2004;84(12):1189-1197. Available from: SPORTDiscus with Full Text, Ipswich, MA. Accessed October 24, 2013 • Gosselink R. Breathing techniques in patients with chronic obstructive pulmonary disease (COPD). Chronic Respiratory Disease [serial online]. 2004;1(3):163-172. Available from: MEDLINE, Ipswich, MA. Accessed October 24, 2013 • Gosselink R, Wagenaar R, Rijswijk H, Sargeant A, Decramer M. Diaphragmatic breathing reduces efficiency of breathing in patients with chronic obstructive pulmonary disease. American Journal Of Respiratory And Critical Care Medicine [serial online]. April 1995;151(4):1136-1142. Available from: MEDLINE, Ipswich, MA. Accessed October 24, 2013 • Jones A, Dean E, Chow C. Comparison of the Oxygen Cost of Breathing Exercises and Spontaneous Breathing in Patients With Stable Chronic Obstructive Pulmonary Disease. Physical Therapy [serial online]. May 2003;83(5):424-431. Available from: SPORTDiscus with Full Text, Ipswich, MA. Accessed October 24, 2013. • Vitacca M, Clini E, Bianchi L, Ambrosino N. Acute effects of deep diaphragmatic breathing in COPD patients with chronic respiratory insufficiency. The European Respiratory Journal [serial online]. February 1998;11(2):408-415. Available from: MEDLINE, Ipswich, MA. Accessed October 24, 2013.

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