The effects of breathing exercise types on respiratory muscle activity and body function in patients with mild chronic obstructive pulmonary disease

Effects of breathing control using visual feedback of thoracoabdominal movement on aerobic exercise

PURPOSE

To clarify whether voluntary respiratory movement control strategy is sustainable during exercise and to determine its effect on aerobic exercise.

MATERIAL AND METHODS

Ten healthy men were enrolled in this study. We developed a device that can convert information on thoracoabdominal changes from an inductance plethysmograph and display the Konno-Mead diagram on the monitor in real time for each breath. On the first day, an incremental load test (ILT) was performed under two conditions. On the second day, a constant load test (CLT) was performed under two conditions using the load 1 min before the anaerobic threshold (AT).

RESULTS

In the ILT, a significant prolongation of AT time was observed with voluntary respiratory movement control. In the CLT, carbon dioxide excretion showed no significant interaction, but the gas exchange ratio did.

CONCLUSION

Voluntary respiratory movement control using a combination of chest band and visual feedback of thoracoabdominal movements may be a respiratory strategy to enhance aerobic exercise.

Analysis of Reasonable Respiratory Efficiency in Tennis Competition and Training Environment Based on Cloud Computing

Competitive tennis is developing in the direction of quantification. How to use and give full play to all positive factors, in order to attack actively and give full play to the limits of body and psychology, breathing, as the basic metabolic function of human body, also plays a vital role in tennis. This paper studies that it plays an important role in the rationality and explosiveness of sports and the psychological and physiological regulation in competition. The characteristics of tennis events determine the importance of scientific and rational breathing. Reasonable breathing during exercise is conducive to maintaining the basic stability of the internal environment, improving the training effect, and giving full play to the functional ability of the human body, so as to create excellent sports results. First, reduce respiratory resistance. Second, there are two methods to improve alveolar ventilation efficiency and pulmonary ventilation: increasing respiratory rate and increasing respiratory depth. When the inhalation volume is constant, the alveolar gas freshness rate depends on the functional residual volume in the alveolar cavity at the end of expiratory or before inhalation. The less functional the residual air, the more fresh air inhaled, and the higher the oxygen partial pressure in alveolar gas. An effective way to reduce the functional residual volume in the alveolar cavity is to exhale as deeply as possible, so as to ensure that more oxygen enters the body. Reasonable breathing methods can not only accelerate the excitation of the body, increase movement strength, reduce fatigue, and promote recovery but also play a vital role in the rational allocation of physical fitness and the improvement of sports performance. The purpose of this study is to provide a theoretical basis for scientific tennis training by analyzing the characteristics of tennis events, the form of breathing in tennis and the efficiency of reasonable breathing in tennis.

Effects of visual feedback of thoracoabdominal motion on oxygen consumption during hyperventilation - Pilot study

INTRODUCTION

Respiratory muscle oxygen consumption increases with the work of breathing. We hypothesized that reducing excessive respiratory muscle activity during exercise may improve exercise tolerance.

METHOD

We developed a device to provide real-time visual feedback of thoracoabdominal movement and used it to examine the influence of visual feedback of thoracoabdominal movement during diaphragmatic breathing on oxygen consumption in eight healthy men. While sitting on a wheelchair with the backrest reclined at 60°, oxygen consumption per body weight (VO₂/BW), minute ventilation (VE), tidal volume (VT), and breathing frequency (fR) were measured, breath-by-breath, using an expired-gas analyzer. The breathing pattern was analyzed by inductance plethysmography, with transducer bands over the chest and abdomen recording thoracoabdominal movements.

RESULTS

There was no significant difference in RatioTH-ABD and the ventilatory parameters between diaphragmatic breathing and diaphragmatic breathing with visual feedback. The average VO₂/BW during diaphragmatic breathing with visual feedback was 0.6 ml/kg lower than that during diaphragmatic breathing without visual feedback (p<0.05).

CONCLUSION

When visual feedback was used during diaphragmatic breathing, the RatioTH-ABD remained essentially unchanged, but VO₂/BW decreased significantly. This suggests that visual feedback of thoracoabdominal movement during diaphragmatic breathing may reduce respiratory muscle oxygen consumption.

Breathing exercises in people with COPD: A realist review

AIMS

To determine the theoretical framework that explains the mechanisms of the success of breathing exercise interventions in people with chronic obstructive pulmonary disease.

DESIGN

A realist review.

DATA SOURCES

Seven bibliographic databases and the grey literature were searched from 2015-January 2020 to identify the studies of breathing exercises.

REVIEW METHODS

The evaluation criteria of realist review and the mixed method appraisal tool were both used to evaluate the included studies. We extracted and integrated the context-mechanism-outcome strings of each study to form the theoretical framework.

RESULTS

Six theoretical mechanisms that affected the success of the intervention were articulated: Wide acceptance of training methods, Integration of the intervention with life, Self-management of the participants, Confidence in controlling symptoms, Participation and support of practitioners, Motivation for intervention. Conversely, the other two mechanisms including the gap between implementation and training and the duration of the intervention, had negative impacts on the implementation of breathing exercises.

CONCLUSION

This review updates and expands the previous literature review on the impact of breathing exercises in people and provides researchers and clinical practitioners with theoretical mechanisms to ensure that the interventions achieve expected effects.

IMPACT

When formulating or selecting breathing exercise interventions, our theoretical framework will guide researchers and clinical practitioners to ensure that the intervention will have practical effects.

Evaluation of sleep quality and daytime somnolence in patients with chronic obstructive pulmonary disease in pulmonary rehabilitation

Background

Dyspnea, fatigue, and decline in sleep quality are symptoms of chronic obstructive pulmonary disease (COPD). Pulmonary rehabilitation programs have been shown to ameliorate dyspnea and fatigue. However, only a few studies have investigated the effects of pulmonary rehabilitation on the sleep quality of COPD patients. In this study, we analyzed the benefits of a pulmonary rehabilitation program to sleep quality and daytime somnolence in COPD patients.

Methods

This study was a study of 30 moderate-severe COPD patients. All patients were evaluated by a pulmonologist and underwent polysomnography before participating in the study. For this study, we selected only ex-smokers and patients with sleep apnea were referred to the sleep clinic. These participants were prospectively recruited and not selected based on program completion. Before the start of the program, sleep quality and daytime somnolence of the participants were evaluated using the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS), respectively. Rehabilitation program consisted of muscular training sessions conducted at the gym 3 times per week for 12 weeks. After rehabilitation program, the patients were reassessed and their sleep quality and daytime somnolence were reevaluated using the PSQI and the ESS, respectively.

Results

Before rehabilitation, PSQI evaluation revealed that 73% of the participants had poor sleep quality, and ESS evaluation showed that 86.7% of the participants experienced daytime somnolence. After pulmonary rehabilitation, the PSQI specifically improved in terms of subjective sleep quality and sleep duration (< 0.001), habitual sleep efficiency (0.001), and sleep latency and sleep alterations (0.002) and there was also improvement in the ESS (< 0.001).

Conclusion

Pulmonary rehabilitation program of gradually increasing intensity has the potential to provide sleep-related benefits to patients with COPD who have poor sleep quality and daytime somnolence.

Trial registration

Registro Brasileiro de Ensaios Clínicos (ReBEC) RBR62b4z2.

Effect of Liuzijue Qigong on patients with chronic obstructive pulmonary disease: Protocol for a systematic review and meta-analysis

BACKGROUND

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide with a substantial and increasing social and economic burden. Liuzijue Qigong is a kind of traditional Chinese Qigong exercises that Traditional Chinese Medicine practitioners prescribe to individuals with COPD to strengthen the internal organs' function. Liuzijue Qigong was recommended for use in COPD rehabilitation, and some clinical trials indicate that Liuzijue Qigong would produce better functional capacity and quality of life of individuals with COPD. The objective of this study is to conduct a systematic review of the existing studies to assess effectiveness and safety of Liuzijue Qigong for the prevention or treatment of COPD in patients.

METHODS

We will perform the comprehensive literature search in English and Chinese electronic database. The publication period will be from inception to the search date. In addition, the clinical trial registries, dissertations, informal publication, grey literature, reference lists of studies, systematic reviews, and conference abstracts will also be collected. Two reviewers will identify relevant studies, extract data information, and then assess the methodical quality by the Cochrane risk of bias assessment tool. Only randomized controlled trials comparing Liuzijue Qigong against other intervention or nonintervention will be included. Data will be synthesized by either fixed-effect or random-effect model regarding to a heterogeneity test. The routine lung function, arterial blood gas tensions, partial pressure of carbon dioxide, functional capacity, 30 seconds sit-to-stand test, respiratory function, maximal inspiration pressure, maximal expiratory pressure, airway resistance, and specific airway conductance will be assessed as primary outcomes. The secondary outcomes involved dyspnea, and fatigue levels, respiratory muscle strength, upper and lower limb muscle strength, handgrip strength test, and health-related quality of life and safety. Meta-analysis will be performed by using Cochrane's Review Manager software (version 5.3.5).

RESULTS

This systematic review and meta-analysis will provide a high-quality synthesis and evaluate the efficacy and safety based on current relevant literature evidence of Liuzijue Qigong intervention for COPD patient.

CONCLUSION

Our systematic review will provide evidence to determine whether Liuzijue Qigong is an effective and safe approach to prevention and treatment of COPD patients.

Correlation between pulmonary functions and respiratory muscle activity in patients with forward head posture

[Purpose] The purpose of this study is to determine the effect that secondary postural deformities and chronic postural abnormalities have on lung capacity, as well as correlate the activity of the respiratory muscles. The results provide basic objective data about the forward head posture and respiratory muscle activity that can be used in clinical situations. [Subjects and Methods] The subjects used in this study were 24 patients aged 25 to 35 years old who visited a hospital in Jeollanam-do Province, Korea, between September 2015 and January 2016. The patients were diagnosed with forward head posture because the vertical line between the acromion process and the external acoustic meatus was at least 5 cm. We measured the craniovertebral angle, pulmonary functions, and respiratory muscle activity of the subjects for correlation analysis. [Results] A positive correlation was found between the craniovertebral angle and the forced vital capacity (r=0.63), while a negative correlation was found between the craniovertebral angle and the sternocleidomastoid muscle (r=–0.77). The craniovertebral angle and the anterior scalene muscle showed a negative correlation (r=–0.65). There were positive correlations between the forced vital capacity and the sternocleidomastoid muscle (r=0.71), and between the forced vital capacity and the anterior scalene muscle (r=0.59). [Conclusion] Severe forward head posture increased the activities of the sternocleidomastoid muscles and the anterior scalene muscles, and decreased the forced vital capacity. Thus, it is necessary to develop more efficient interventions for managing forward head posture based on pulmonary function and the activity of the respiratory synergist muscles.

Preoperative Halo-Gravity Traction for Severe Thoracic Kyphoscoliosis Patients from Tibet: Radiographic Correction, Pulmonary Function Improvement, Nursing, and Complications

Background

This study investigated the outcomes of preoperative HGT as an adjunct treatment for severe thoracic kyphoscoliosis, its role in radiographic correction, and pulmonary function improvement, together with nursing strategy and incidence of complications.

Material/Methods

Eleven patients with a mean age of 18.8 years were retrospectively reviewed. Inclusion criteria were: patients with severe kyphoscoliosis (coronal Cobb angle and kyphosis angle ≥80°); duration of HGT ≥8 weeks; patients undergoing HGT for at least 12 h per day; traction weight no less than 40% of body weight; and patients not receiving physical therapies. All patients underwent respiratory training.

Results

The major coronal curve scoliosis averaged 114.00±24.43° and was reduced to 80.55±17.98° after HGT. The major kyphosis was 103.91±18.95° and was reduced to 80.55±17.98°. Significantly improved percent-predicted values for FVC was found after HGT (p=0.014), and significantly increased forced expiratory volume in 1 s (FEV1%) was also observed (p<0.001), with significantly improved percent-predicted values for PEF (p=0.003) after HGT.

Conclusions

Our data reveal that preoperative HGT can be performed safely, and can help achieve excellent curve correction in both the coronal and sagittal planes, together with improved respiratory function and no severe complications in patients with severe thoracic kyphoscoliosis.

The effects a respiration rehabilitation program on IADL, satisfaction with leisure, and quality of sleep of patients with chronic obstructive pulmonary disease

[Purpose] This study was designed to determine the effect of a respiration rehabilitation program on daily activities, satisfaction with leisure, and quality of sleep of patients with chronic obstructive pulmonary disease. [Subjects and Methods] The program was conducted three times a week for 12 weeks (a total of 36 times) with 20 patients aged between 50 and 70 years old. The Frenchay Activity Index was used to determine the instrumental activities of daily living before and after the intervention. The Korean scale of satisfaction with leisure was employed to determine the satisfaction with leisure, and the Korean version of the Pittsburgh Sleep Quality Index was used to measure the quality of sleep. [Results] The total score of all three instruments (instrumental activities of daily living (IADL), satisfaction with leisure, and quality of sleep) improved significantly after the intervention. [Conclusion] In conclusion, the scores of all three instruments (IADL, satisfaction with leisure, and quality of sleep) improved significantly after the intervention, indicating that the respiration rehabilitation program was effective at improving the overall quality of life for patients with chronic obstructive pulmonary disease.

The effect of feedback respiratory exercise on muscle activity, craniovertebral angle, and neck disability index of the neck flexors of patients with forward head posture

[Purpose] This study aimed to simultaneously investigate the activities of the sternocleidomastoid muscle and scalenus anterior muscle, which are agonists of neck and breathing accessory muscles, by implementing breathing exercises. [Subjects and Methods] Thirteen subjects were selected for the experimental group, which performed feedback respiratory exercises with McKenzie exercises, and 12 subjects were selected for the control group, which performed McKenzie exercises alone. The intervention program was performed for 30 minutes a session, once a day, four times a week, and for 2 weeks before conducting the experiment. Before intervention, muscle activity was measured using surface electromyogram, and the neck disability index was evaluated. [Results] There were meaningful differences in activities of the sternocleidomastoid muscle and the scalenus anterior muscle, craniovertebral angle, and neck disability index within both the experimental group and control group after intervention. There also were meaningful differences in sternocleidomastoid muscle and neck disability index changes between groups. [Conclusion] Neck flexors as accessory respiratory muscle can affect inefficient respiratory imbalance of forward head posture patients. Multimodal intervention method should be studied continually and not be exposed to upper chest breathing patterns by preventing such phenomenon.