title: Efficacy of diaphragmatic breathing in patients with chronic obstructive pulmonary disease.
abstract: This study investigated the effects of diaphragmatic breathing (DB) on ventilation and breathing pattern, seeking to identify predictors of its efficacy in patients with chronic obstructive pulmonary disease (COPD). Twenty-nine patients with moderate and severe COPD were monitored using respiratory inductance plethysmography and metabolic gas analysis. After 4 minutes of natural breathing, subjects completed 2 minutes of DB followed by 4 minutes of natural breathing. Dyspnea was measured using a visual analogue scale. Diaphragmatic mobility was assessed using chest radiography. DB was associated with a significant increase in tidal volume and reduction in breathing frequency, leading to higher ventilation and oxygen saturation, with a reduction in dead space ventilation and ventilatory equivalent for carbon dioxide. A total of 10 subjects with moderate (5) and severe (5) COPD performed DB with asynchronous thoracoabdominal motion, worsening the dyspnea, and decreasing the gain of tidal volume. Diaphragmatic mobility, inspiratory muscular strength, lower scores for dyspnea and hypoxemia as well as coordinated thoracoabdominal motion are associated with effective DB. In patients with COPD, DB can improve breathing pattern and ventilatory efficiency without causing dyspnea in patients whose respiratory muscular system is preserved.
authors.affiliation: Physiotherapy Division, Heart Institute, University of São Paulo School of Medicine, São Paulo, Brazil. marcelo.fernandes@mackenzie.br
authors.forename: Marcelo
authors.initials: M
authors.lastname: Fernandes
authors.forename: Alberto
authors.initials: A
authors.lastname: Cukier
authors.forename: Maria Ignêz Zanetti
authors.initials: MI
authors.lastname: Feltrim
mesh_terms: D001784:Blood Gas Analysis; D001945:Breathing Exercises; D002245:Carbon Dioxide / Q000097:blood; D016022:Case-Control Studies; D003964:Diaphragm; D004417:Dyspnea / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010991:Plethysmography; D029424:Pulmonary Disease, Chronic Obstructive / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000628:therapy*; D012123:Pulmonary Ventilation; D011859:Radiography; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D002245:Carbon Dioxide