title: Impact of laughter on air trapping in severe chronic obstructive lung disease.
abstract: Static and dynamic hyperinflation is an important factor of exertional dyspnea in patients with severe COPD. This proof-of-concept intervention trial sought to study whether laughter can reduce hyperinflation through repetitive expiratory efforts in patients with severe COPD. For small groups of patients with severe COPD (n = 19) and healthy controls (n = 10) Pello the clown performed a humor intervention triggering regular laughter. Plethysmography was done before and up to 24 hours after intervention. Laughing and smiling were quantified with video-analysis. Real-time breathing pattern was assessed with the LifeShirt, and the psychological impact of the intervention was monitored with self-administered questionnaires. The intervention led to a reduction of TLC in COPD (p = 0.04), but not in controls (p = 0.9). TLC reduction was due to a decline of the residual volume. Four (22 [CI 95% 7 to 46] %) patients were > or = 10% responders. The frequency of smiling and TLC at baseline were independent predictors of TLC response. The humor intervention improved cheerfulness, but not seriousness nor bad mood. In conclusion, smiling induced by a humor intervention was able to reduce hyperinflation in patients with severe COPD. A smiling-derived breathing technique might complement pursed-lips breathing in patients with symptomatic obstruction.
authors.affiliation: University Hospital Basel, Switzerland mbrutsche@uhbs.ch
authors.forename: Martin H
authors.initials: MH
authors.lastname: Brutsche
authors.forename: Paul
authors.initials: P
authors.lastname: Grossman
authors.forename: Rebekka E
authors.initials: RE
authors.lastname: Müller
authors.forename: Jan
authors.initials: J
authors.lastname: Wiegand
authors.lastname: Pello
authors.forename: Florent
authors.initials: F
authors.lastname: Baty
authors.forename: Willibald
authors.initials: W
authors.lastname: Ruch
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D045853:Exhalation / Q000502:physiology; D005260:Female; D006801:Humans; D027641:Laughter Therapy; D008297:Male; D008875:Middle Aged; D011653:Pulmonary Diffusing Capacity / Q000502:physiology; D029424:Pulmonary Disease, Chronic Obstructive / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D012904:Smiling; D013147:Spirometry; D014109:Total Lung Capacity; D016896:Treatment Outcome