title: Pursed-lips breathing reduces dynamic hyperinflation induced by activities of daily living test in patients with chronic obstructive pulmonary disease: A randomized cross-over study.
abstract: BACKGROUND
  Dynamic hyperinflation leads to dyspnoea and consequent limitations in functional capacity in chronic obstructive pulmonary disease. It has been shown that the response to pursed-lips breathing in terms of dynamic hyperinflation and lower-limb exercise capacity is variable, and its effects on activities of daily living are unknown. This study aimed to evaluate the effect of pursed-lips breathing on dynamic hyperinflation and functional capacity in patients with chronic obstructive pulmonary disease in a lower-limb exercise test and in a multiple-task activities of daily living test.
  
  
  METHODS
  Randomized cross-over study.
  
  
  METHODS
  Twenty-five patients with chronic obstructive pulmonary disease (16 men, mean age 64 ± 7 years, forced expiratory volume in 1 s (FEV1) = 41.7 ± 14.7% predicted).
  
  
  METHODS
  Patients randomly performed two 6-min walk tests (6MWT) with and without pursed-lips breathing (6MWT(PLB) and 6MWT(Non-PLB)) and two Glittre-ADL tests with and without pursed-lips breathing (TGlittre(PLB) and TGlittre(Non-PLB)). Inspiratory capacity was assessed at baseline and immediately after the tests.
  
  
  RESULTS
  The 6MWT(Non-PLB) and TGlittre(Non-PLB) induced similar magnitude dynamic hyperinflation (0.22 ± 0.24 l and 0.31 ± 0.23 l, respectively; p > 0.05). Pursed-lips breathing did not improve dynamic hyperinflation induced by the 6MWT (0.24 ± 0.20 and 0.22 ± 0.24 l, respectively, with and without pursed-lips breathing; p > 0.05). Dynamic hyperinflation in the TGlittre(PLB) was significantly lower than in the TGlittre(Non-PLB) (0.19 ± 0.20 l and 0.31 ± 0.23 l, respectively; p = 0.02). Pursed-lips breathing did not improve 6MWT or TGlittre performance.
  
  
  CONCLUSIONS
  Pursed-lips breathing reduced dynamic hyperinflation in the TGlittre, but not in the 6MWT. However, pursed-lips breathing did not improve functional capacity.
authors.affiliation: Center of Assistance, Education and Research in Pulmonary Rehabilitation, Santa Catarina State University (UDESC), Florianópolis, Brazil.
authors.forename: Cintia Laura Pereira
authors.initials: CL
authors.lastname: de Araujo
authors.forename: Manuela
authors.initials: M
authors.lastname: Karloh
authors.forename: Cardine Martins
authors.initials: CM
authors.lastname: Dos Reis
authors.forename: Marina
authors.initials: M
authors.lastname: Palú
authors.forename: Anamaria Fleig
authors.initials: AF
authors.lastname: Mayer
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D018592:Cross-Over Studies; D004417:Dyspnea / Q000150:complications* / Q000534:rehabilitation; D017079:Exercise Tolerance / Q000502:physiology*; D006801:Humans; D007320:Inspiratory Capacity / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D011175:Positive-Pressure Respiration / Q000379:methods*; D029424:Pulmonary Disease, Chronic Obstructive / Q000534:rehabilitation; D012119:Respiration