Impact of laughter on air trapping in severe chronic obstructive lung disease.
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.
Brutsche
Martin H
MH
University Hospital Basel, Switzerland mbrutsche@uhbs.ch
Grossman
Paul
P
Müller
Rebekka E
RE
Wiegand
Jan
J
Pello
Baty
Florent
F
Ruch
Willibald
W
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