Key result
Repeated pursed-lips breathing in COPD patients increased tidal volume and decreased breathing frequency, but significantly increased heart rate compared to spontaneous breathing.
Why the study?
Dynamic changes in cardiorespiratory and metabolic functions during and after repeated volitional pursed-lip breathing compared to spontaneous breathing at rest in COPD patients were unknown.
Does repeated pursed-lip breathing alter cardiorespiratory and metabolic functions compared to spontaneous breathing in patients with moderate-to-severe COPD?
RCT (n=16)
Open-label
Randomized crossover
No
Does repeated pursed-lip breathing alter cardiorespiratory and metabolic functions compared to spontaneous breathing in patients with moderate-to-severe COPD?
Absolute Event Rate: 85.69% vs 80.69%
p-value: p=<0.05
While pursed-lip breathing increases tidal volume in COPD patients, performing more than seven repeated cycles may induce mild cardiac stress by increasing heart rate.
May warrant HR monitoring with repeated PLB in COPD; leaves open cardiac safety in larger trials.
Introduction Pursed-lip breathing (PLB) is a breathing exercise treatment for patients with chronic obstructive pulmonary disease (COPD). The purpose of this study was to investigate the dynamic changes in the cardiorespiratory and metabolic functions during and after repeated volitional PLB and spontaneous breathing (SB) at rest in COPD patients. Methods Sixteen patients with moderate to severe airflow limitation participated in this crossover study in which the subjects in both the groups randomly received 10 repeated cycles of PLB and SB interventions. Cardiorespiratory and metabolic variables were collected at the baseline, throughout the 10 breathing cycles, and after a recovery period of 5 min. Results During PLB, the tidal volume (VT) increased progressively, whereas the breathing frequency (BF) decreased gradually throughout the 10 volitional PLB cycles (p > 0.05). However, minute ventilation (V̇E), oxygen consumption (V̇O2), and carbon dioxide production (V̇CO2) remained unchanged during PLB (p > 0.05). The VT and BF peaks appeared during the 8th and 7th cycles, respectively, and then plateaued until the 10th breathing cycle. The heart rate (HR) while performing PLB slightly increased (p < 0.05) from the 3rd to the 10th cycle compared to SB. Conclusions Despite the clinical benefits of PLB in increasing the inspired volume and slowing the rate of breathing, this maneuver in COPD patients should be prescribed with an awareness of the risk of cardiac stress, especially the effect on the HR, as well as the respiratory limitations with repeated PLB. Practically, this study recommends limiting repeated PLB in COPD patients to seven breathing cycles.
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Buranapuntalug et al. (2022) conducted an RCT in Chronic obstructive pulmonary disease (COPD) (n=16). Pursed-lips breathing vs. Spontaneous breathing was evaluated on Heart rate at 10th breathing cycle (bpm) (p=<0.05). Repeated pursed-lips breathing in COPD patients increased tidal volume and decreased breathing frequency, but significantly increased heart rate compared to spontaneous breathing.
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