Comprehensive directed breathing retraining improves exertional dyspnea for men with spirometry within normal limits.
OBJECTIVE
To compare the effects of comprehensive directed breathing retraining with traditional diaphragmatic breathing on male smokers with exertional dyspnea but normal spirometry.


METHODS
This is a prospective randomized clinical trial in an exercise laboratory at a university hospital. Twenty-four nonmedicated exertional dyspnea subjects were randomly assigned to experimental (comprehensive directed breathing) and control (traditional diaphragmatic breathing) groups. Forty-four physiologic parameters associated with exertional dyspnea were studied before and after interventions for both groups at rest and at 40-W constant exercise for 10 mins. The interventions for both groups included diaphragmatic breathing exercises, walking, and arm exercises for 90 mins, 5 days/wk for 4 wks. In addition, the comprehensive directed breathing group was taught the anatomy and physiology of ventilation; they observed their ventilatory dyssynchrony in a mirror; they were shown their ventilatory rhythm on a spirogram; diaphragmatic movement was demonstrated in an educational movie; and verbal feedback was used to correct respiratory asynchrony.


RESULTS
We compared the relative changes of lung function parameters before and after intervention for each group. The comprehensive directed breathing group improvements were significantly greater (P < 0.05) than those of traditional diaphragmatic breathing for 34 of 44 lung function parameters.


CONCLUSIONS
Comprehensive directed breathing training improved exertional dyspnea, Dyspnea Index, and some clinical and functional parameters significantly more than traditional diaphragmatic breathing training.
INSERM (Institut National de la Santé et de la Recherche Médicale), Faculté de Médecine BP 184, Université de Nancy, F-54505 Vandoeuvre-lès-Nancy Cedex.
Manuel
M
Gimenez
Emilio
E
Servera
Encarnacion
E
Abril
Pedro
P
Saavedra
Maria
M
Darias
Arturo
A
Gomez
Bernard
B
Hannhart
D000328:Adult; D001945:Breathing Exercises; D004417:Dyspnea / Q000209:etiology / Q000534:rehabilitation*; D015444:Exercise / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012907:Smoking / Q000009:adverse effects; D013147:Spirometry