Copd Breathing Exercises

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Copd Breathing Exercises

Plain language summaryPeople with chronic obstructive pulmonary disease (COPD) often have an altered breathing pattern and experience shortness of breath, particularly when they exercise. This review aimed to determine whether breathing exercises that are designed to retrain the breathing pattern could reduce breathlessness, increase exercise capacity and improve well being for people with COPD.Sixteen trials with 1233 participants were included, most of whom had severe COPD. The breathing techniques studied included pursed lip breathing (breathing out slowly with the lips in a whistling position), diaphragmatic breathing (deep breathing focusing on the abdomen), pranayam yoga breathing (timed breathing with a focus on exhalation), changing the breathing pattern using computerised feedback to slow the respiratory rate and increase exhalation time, or combinations of these techniques. The study quality was generally low. Breathing exercises appeared to be safe for people with COPD. Yoga breathing, pursed lip breathing and diaphragmatic breathing improved the distance walked in six minutes by an average of 35 to 50 metres in four studies. Effects of breathing exercises on shortness of breath and well being were variable. When added to whole body exercise training, breathing exercises did not appear to have any additional benefit.
copd breathing exercises 1

Copd Breathing Exercises

Out with the old, stale air and in with new fresh air. That’s the theme of the two most useful breathing exercises—pursed lip breathing and belly breathing—taught by pulmonary rehabilitation specialists to individuals with chronic lung diseases such as asthma and COPD. Like aerobic exercise improves your heart function and strengthens your muscles, breathing exercises can make your lungs more efficient. Why Breathing Exercises Help What Is Pulmonary Rehabilitation? Pulmonary rehabilitation is a program of education and exercise classes that teach you about your lungs and your disease, and how to exercise and be more active with less shortness of breath. When you have healthy lungs, breathing is natural and easy. You breathe in and out with your diaphragm doing about 80 percent of the work to fill your lungs with a mixture of oxygen and other gases, and then to send the waste gas out. Lung HelpLine respiratory therapist Mark Courtney compares the process to a screen door with a spring, opening and shutting on its own. “Our lungs are springy, like the door. Over time, though, with asthma and especially with COPD, our lungs lose that springiness. They don’t return to the same level as when you start breathing, and air gets trapped in our lungs,” Courtney explains. Over time, stale air builds up, leaving less room for the diaphragm to contract and bring in fresh oxygen. With the diaphragm not working to full capacity, the body starts to use other muscles in the neck, back and chest for breathing. This translates into lower oxygen levels, and less reserve for exercise and activity. If practiced regularly, breathing exercises can help rid the lungs of accumulated stale air, increase oxygen levels and get the diaphragm to return to its job of helping you breathe. Pursed Lip Breathing This exercise reduces the number of breaths you take and keeps your airways open longer. More air is able to flow in and out of your lungs so you can be more physically active. To practice it, simply breathe in through your nose and breathe out at least twice as long through your mouth, with pursed lips. Belly Breathing, aka Diaphragmic Breathing As with pursed lip breathing, start by breathing in through your nose. Pay attention to how your belly fills up with air. You can put your hands lightly on your stomach, or place a tissue box on it, so you can be aware of your belly rising and falling. Breathe out through your mouth at least two to three times as long as your inhale. Be sure to relax your neck and shoulders as you retrain your diaphragm to take on the work of helping to fill and empty your lungs. Practice Makes Perfect Courtney warns that although these exercises seem simple, they take some time to master. “You don’t want to first try these exercises when you’re short of breath,” he says. “You want to try them when you’re breathing OK, and then later on when you’re more comfortable, you can use them when you’re short of breath.” Ideally, you should practice both exercises about 5 to 10 minutes every day.
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Copd Breathing Exercises

Chronic obstructive pulmonary disease, or COPD, affects more than 12 million American adults. The term COPD includes two types of lung conditions: emphysema and bronchitis. Many people diagnosed with COPD have both emphysema and bronchitis. Together, the two reduce the amount of oxygen exchange in the lungs and thicken the lining of the airways. COPD is progressive and causes shortness of breath, wheezing, and chronic cough — a persistent, phlegm-producing cough. People with COPD can have varying abilities when it comes to breathing. Some may experience shortness of breath during moderate exercise. Others need oxygen just to walk across the room. There are things people with COPD can do to improve their breathing. And for the most part, things like exercise, pulmonary rehabilitation, and smoking cessation can be very helpful, even for those with little lung capacity. 1. Stop smoking. Long-term exposure to environmental pollutants can cause COPD but the main culprit, particularly in the U.S., is smoking. By the time someone gets COPD, their lungs are already damaged, but if they stop smoking, they can reduce future harm. Neil MacIntyre, MD, a pulmonologist and professor of medicine at Duke University Medical Center in Durham, N.C., tells his patients it is critical that they stop smoking when they become short-winded. “The first thing you have to do to get out of a hole is stop digging,” he says. 2. Take medication. It is important to take medication, and if there are problems, patients should talk with their doctors, MacIntyre says. Maintenance medications such as salmeterol and fluticasone don’t always start working immediately. It can take a week or two before a patient feels their breathing improve. This can be discouraging for some, but MacIntyre says not to give up. If there is no improvement after a couple of weeks, people should talk with their doctor to make sure they are using medications correctly. Many of the drugs used for COPD can be challenging to use properly because they come in specialized inhalers. 3. Mind your weight. People who are very sick with COPD use so much energy to breathe that they can have problems gaining weight, says Raed Dweik, MD, director of the pulmonary vascular program at Cleveland Clinic. They often need to eat enough to gain weight. But if people are overweight, shedding excess pounds can improve their breathing. “It is two ends of the spectrum,” Dweik says. “For people who are overweight, it is like carrying something around that contributes to their shortness of breath.”
copd breathing exercises 3

Copd Breathing Exercises

Sixteen trials with 1233 participants were included, most of whom had severe COPD. The breathing techniques studied included pursed lip breathing (breathing out slowly with the lips in a whistling position), diaphragmatic breathing (deep breathing focusing on the abdomen), pranayam yoga breathing (timed breathing with a focus on exhalation), changing the breathing pattern using computerised feedback to slow the respiratory rate and increase exhalation time, or combinations of these techniques. The study quality was generally low. Breathing exercises appeared to be safe for people with COPD. Yoga breathing, pursed lip breathing and diaphragmatic breathing improved the distance walked in six minutes by an average of 35 to 50 metres in four studies. Effects of breathing exercises on shortness of breath and well being were variable. When added to whole body exercise training, breathing exercises did not appear to have any additional benefit.

Copd Breathing Exercises

Continued 8. Do breathing exercises. There are two main exercises that are practiced in rehab to help people with COPD improve their breathing. The first is pursed-lip breathing. Some people with COPD have particular difficulty breathing out. When this occurs, air gets built up in the lungs and the lungs can’t expand as well, Dweik says. Pursed-lip breathing helps regulate this problem. To perform this, sit comfortably and inhale deeply through the nose. Purse lips (as though whistling) and breathe out three times longer than the in breath, but don’t force the air out. This technique can be used when shortness of breath occurs to regulate breathing patterns. A second exercise is diaphragm breathing. This technique helps strengthen the diaphragm muscle so people use less energy when breathing. To perform the exercise, lie on the back with knees bent, one hand on the upper chest and another resting on the abdomen. When inhaling and exhaling, keep the chest as still as possible and use the stomach to breathe. This should be practiced for five to 10 minutes three times daily. 9. Get active. Though someone who can’t breathe well may not feel like exercising, it is one of the most important things people with COPD can do to improve their breathing and overall health. Exercise doesn’t directly change a person’s lung function, but it improves muscle tone and cardiac function, MacIntyre says. This allows oxygen in the blood to be delivered more efficiently to the muscles and increases stamina. “Patients with COPD have different degrees of ability,” Dweik says. “Even if they are progressed, they can still remain active — the more the better — but their activity has to be moderated by their capability.” Dweik tells patients to be mindful of their limits and not push through when they can’t breathe. For people with “symptom-limited exercise” he recommends walking a couple of blocks until they get winded, stopping to rest, and walking more when they can. Eventually, a person may be able to walk farther with less shortness of breath.

Copd Breathing Exercises

Copd Breathing Exercises
Copd Breathing Exercises

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