title: The effects of controlled breathing during pulmonary rehabilitation in patients with COPD.
abstract: BACKGROUND
  Conventional pulmonary rehabilitation programs improve exercise tolerance but have no effect on pulmonary function in patients with chronic obstructive pulmonary disease (COPD). The role of controlled breathing using respiratory biofeedback during rehabilitation of patients with COPD remains unclear.
  
  
  OBJECTIVE
  To compare the effects of a conventional 4-week pulmonary rehabilitation program with those of rehabilitation plus controlled breathing interventions.
  
  
  METHODS
  A randomized controlled trial was performed. Pulmonary function (FEV1), exercise capacity (6-min walking distance, 6 MWD), health-related quality of life (chronic respiratory questionnaire, CRQ) and cardiac autonomic function (rMSSD) were evaluated.
  
  
  RESULTS
  Forty COPD patients (mean±SD age 66.1±6.4, FEV1 45.9±17.4% predicted) were randomized to rehabilitation (n=20) or rehabilitation plus controlled breathing (n=20). There were no statistically significant differences between the two groups regarding the change in FEV1 (mean difference -0.8% predicted, 95% CI -4.4 to 2.9% predicted, p=0.33), 6 MWD (mean difference 12.2 m, 95% CI -37.4 to 12.2 m, p=0.16), CRQ (mean difference in total score 0.2, 95% CI -0.1 to 0.4, p=0.11) and rMSSD (mean difference 2.2 ms, 95% CI -20.8 to 25.1 ms, p=0.51).
  
  
  CONCLUSIONS
  In patients with COPD undergoing a pulmonary rehabilitation program, controlled breathing using respiratory biofeedback has no effect on exercise capacity, pulmonary function, quality of life or cardiac autonomic function.
authors.affiliation: Department of Pneumology, University Hospital Ruhrlandklinik, Essen, Germany. vrns@zhaw.ch
authors.forename: Arnoldus J R
authors.initials: AJ
authors.lastname: van Gestel
authors.forename: Malcolm
authors.initials: M
authors.lastname: Kohler
authors.forename: Jörg
authors.initials: J
authors.lastname: Steier
authors.forename: Sebastian
authors.initials: S
authors.lastname: Teschler
authors.forename: Erich W
authors.initials: EW
authors.lastname: Russi
authors.forename: Helmut
authors.initials: H
authors.lastname: Teschler
mesh_terms: D000368:Aged; D001945:Breathing Exercises; D005080:Exercise Test; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D005541:Forced Expiratory Volume / Q000502:physiology*; D006334:Heart Function Tests; D006801:Humans; D008297:Male; D008875:Middle Aged; D029424:Pulmonary Disease, Chronic Obstructive / Q000534:rehabilitation*; D011788:Quality of Life; D012129:Respiratory Function Tests