The Impact of Pursed-lips Breathing Maneuver on Cardiac, Respiratory, and Oxygenation Parameters in COPD Patients
Keywords:Chronic Obstructive Pulmonary Disease, Pursed Lip Breathing, Vital Sign, Pulse Oximetry, Blood Oxygen Saturation
BACKGROUND: Respiratory system, together with the cardiovascular and central nervous system, is responsible for all processes related to oxygenation and hemodynamics and the defect in the functioning of each of these systems, along with ageing, can have mutual effects on their performance and physiological symptoms. The use of Pursed-lips Breathing (PLB) training is an essential part of the treatment of patients with the obstructive pulmonary disease, PLB stimulates the autonomic nervous system and causes relaxation and improvement of physiological parameters.
AIM: This study was conducted to evaluate the effect of PLB on cardiac, pulmonary and oxygenation level in patients with Chronic Obstructive Pulmonary Disease (COPD).
METHODS: A three-group clinical trial study with experimental and control which was purposefully conducted with the participation of patients with COPD and healthy individuals referring to Madani hospital Khoy, in 2017. The sample size was selected to be 60 subjects. The patients were randomly allocated to two groups of intervention and control with 20 patients, and 20 healthy subjects were assigned to the healthy intervention group. The demographic, anthropometric information form and checklist recording changes in levels of oxygenation, respiration, temperature, heart rate and blood pressure with cardiopulmonary follow up in three stages before, during and after PLB were used for data collection. Data were analysed using descriptive statistics, repeated measure test, ANOVA, and Chi-square.
RESULTS: On evaluation within the COPD patient intervention group in Saturation of Peripheral Oxygen (SPO2) index with the mean difference of 2.05 percent, Respiratory Rate(RR)-0.65 minute and Pulse Rate(PR)-1.6 bpm was significant (p â‰¤ 0.05), and systolic blood pressure index in healthy subjects was increased (3.35 mmHg).
CONCLUSION: The results of this study indicated that using effective PLB as an easy, inexpensive, non- invasive and non-pharmacological method is considered as an important factor in improving the status of oxygenation and physiological indicators in patients with COPD and should be considered as an important part of rehabilitation programs for these patients.
Brunner LS. Brunner & Suddarth's textbook of medical-surgical nursing. Lippincott Williams & Wilkins, 2010.
Goldman L. Ausiello D. Cecil textbook of medicine. Trans Arjomand M, Setudenia AH, Qasemi ShTehran: Nasle Farda, 2003:11.
Decramer M, De Benedetto F, Del Ponte A, Marinari S. Systemic effects of COPD. Respiratory medicine. 2005; 99:S3-S10. https://doi.org/10.1016/j.rmed.2005.09.010 PMid:16219454
Wade LM. A Pilot Study of Pursed-Lip Breathing, Singing, and Kazoo Playing on Lung Function and Perceived Exertion of Participants Who Smoke: University of Kansas, 2017.
Montes de Oca M, Perez-Padilla R. Global Initiative for Chronic Obstructive Lung Disease (GOLD)-2017: la visiÃ³n desde alat. Archivos de BronconeumologÃa. 2017; 53(3):87-8. https://doi.org/10.1016/j.arbres.2017.01.002 PMid:28222935
Paz HL, Wood CA. Pneumonia and chronic obstructive pulmonary disease: What special considerations do this combination require? Postgraduate medicine. 1991; 90(5):77-86. https://doi.org/10.1080/00325481.1991.11701072
RyynÃ¤nen O-P, Soini EJ, Lindqvist A, KilpelÃ¤inen M, Laitinen T. Bayesian predictors of very poor health-related quality of life and mortality in patients with COPD. BMC medical informatics and decision making. 2013; 13(1):1. https://doi.org/10.1186/1472-6947-13-34
Potter PA, Ochs G, Perry AG, LaMar J, Turchin L. Study Guide and Skills Performance Checklists for Potter/Perry Fundamentals of Nursing: Elsevier Health Sciences, 2008.
Sakhaei S, Motaarefi H, Zinalpoor S, Sadagheyani HE. Utilizing the information and communication technology as a learning tool for students. Annals of Tropical Medicine and Public Health. 2017; 10(5):1189. https://doi.org/10.4103/ATMPH.ATMPH_325_17
Ortega R, Hansen CJ, Elterman K, Woo A. Pulse oximetry. New England Journal of Medicine. 2011; 364(16):e33. https://doi.org/10.1056/NEJMvcm0904262 PMid:21506738
Nici L, Donner C, Wouters E, Zuwallack R, Ambrosino N, Bourbeau J, et al. American thoracic society/European respiratory society statement on pulmonary rehabilitation. American journal of respiratory and critical care medicine. 2006; 173(12):1390-413. https://doi.org/10.1164/rccm.200508-1211ST PMid:16760357
Emtner M, Herala M, Stalenheim G. High-intensity physical training in adults with asthma: a 10-week rehabilitation program. CHEST Journal. 1996; 109(2):323-30. https://doi.org/10.1378/chest.109.2.323
Solanes I, GÃ¼ell R, Casan P, Sotomayor C, Gonzalez A, Feixas T, et al. Duration of pulmonary rehabilitation to achieve a plateau in quality of life and walk test in COPD. Respiratory medicine. 2009; 103(5):722-8. https://doi.org/10.1016/j.rmed.2008.11.013 PMid:19117744
Brophy C, Kastelik J, Gardiner E, Greenstone M. Quality of life measurements and bronchodilator responsiveness in prescribing nebulizer therapy in COPD. Chronic respiratory disease. 2008; 5(1):13-8. https://doi.org/10.1177/1479972307087652 PMid:18303097
Kurabayashi H, Kubota K, Machida I, Tamura K, Take H, Shirakura T. Effective physical therapy for chronic obstructive pulmonary disease: Pilot Study of Exercise in Hot Spring Water1. American journal of physical medicine & rehabilitation. 1997; 76(3):204-7. https://doi.org/10.1097/00002060-199705000-00008
Rossi RC, Vanderlei FM, Bernardo AF, Souza NMd, Goncalves ACCR, Ramos EMC, et al. Effect of pursed-lip breathing in patients with COPD: linear and nonlinear analysis of cardiac autonomic modulation. COPD: Journal of Chronic Obstructive Pulmonary Disease. 2014; 11(1):39-45. https://doi.org/10.3109/15412555.2013.825593 PMid:24111515
Sharma G, Goodwin J. Effect of aging on respiratory system physiology and immunology. Clinical interventions in aging. 2006; 1(3):253. https://doi.org/10.2147/ciia.2006.1.3.253 PMid:18046878 PMCid:PMC2695176
Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J. Harrison's principles of internal medicine, 19e. USA2015, 2015.
Izadi-avanji FS, Afshar M, Adib-Hajbaghery M. Effects of Education Pursed Lip Breathing in Patients with COPD. Journal of Yazd University of Medical Sciences. 2011; 14(2):61-7.
Ramos E, Vanderlei L, Ramos D, Teixeira L, Pitta F, Veloso M. Influence of pursed-lip breathing on heart rate variability and cardiorespiratory parameters in subjects with chronic obstructive pulmonary disease (COPD). Brazilian Journal of Physical Therapy. 2009; 13(4):288-93. https://doi.org/10.1590/S1413-35552009005000035
Solomon V. Assess the effectiveness of pursed lip breathing exercise on selected vital parameters and respiratory status among patients with chronic obstructive pulmonary disease. International Journal of Pharma and BioSciences. 2017; 8(2):795-8.
Roberts S, Schreuder F, Watson T, Stern M. Do COPD patients taught pursed lips breathing (PLB) for dyspnoea management continue to use the technique long-term? A mixed methodological study. Physiotherapy. 2017; 103(4):465-70. https://doi.org/10.1016/j.physio.2016.05.006 PMid:27623386
GarzÃ³n PÃ©rez LV. Reactivation of the parasympathetic System with pursed lips after physical exercise. 2017.
Santos M, Moraes F, MarÃ£es V, Sakabe D, Takahashi A, Oliveira L, et al. Estudo da arritmia sinusal respiratÃ³ria e da variabilidade da freqÃ¼Ãªncia cardÃaca de homens jovens e de meia-idade. Rev Soc Cardiol Estado de SÃ£o Paulo. 2003; 13(3 supl):15-24.
Kim HFS, Kunik ME, Molinari VA, Hillman SL, Lalani S, Orengo CA, et al. Functional impairment in COPD patients: the impact of anxiety and depression. Psychosomatics. 2000; 41(6):465-71. https://doi.org/10.1176/appi.psy.41.6.465 PMid:11110109
Silva CS, Nogueira FR, Porto EF, Gazzotti MR, Nascimento OA, Camelier A, et al. Dynamic hyperinflation during activities of daily living in COPD patients. Chronic Respiratory Disease. 2015; 12(3):189-96. https://doi.org/10.1177/1479972315576143 PMid:25896955
Maind G, Nagarwala R, Retharekar S, Gondane S, Bedekar N, Shyam A, et al. Comparison between effect of pursed lip breathing and mouth taping on dyspnoea: A cross sectional study. International Journal of Current Research and Review. 2015; 7(16):17.
Barbosa Filho J, Barbosa PRB, Cordovil I. ModulaÃ§Ã£o autonÃ´mica do coraÃ§Ã£o na hipertensÃ£o arterial sistÃªmica. Arq Bras Cardiol. 2002; 78(2):181-95. PMid:11887194
Mayer AF, Karloh M, dos Santos K, de Araujo CLP, Gulart AA. Effects of acute use of pursed-lips breathing during exercise in patients with COPD: a systematic review and meta-analysis. Physiotherapy. 2017. PMid:28969859
How to Cite
Copyright (c) 2018 Shahriar Sakhaei, Hassan Ebrahimpour Sadagheyani, Soryya Zinalpoor, Abdolah Khorami Markani, Hossein Motaarefi
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All rights reserved.