Respiratory muscle mechanics during diaphragmatic breathing

M. Pastó, J. Gea, M. C. Aguar, E. Barreiro, M. Orozco-Levi, M. Félez, J. Broquetas

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Abstract

Noteworthy among breathing training techniques is so-called diaphragmatic breathing. In spite of the technique's name, however, little is known of the functional characteristics of this ventilatory method. OBJECTIVE: To assess the mechanics of respiratory muscles, particularly diaphragm muscles, during diaphragmatic breathing in patients with severe chronic obstructive pulmonary disease (COPD). METHODS: Ventilatory pattern and respiratory pressures (abdominal [Pga], intrathoracic [Pes] and transdiaphragmatic [Pdi]) were studied in 10 patients with severe COPD in stable phase (age 69 ± 6 years, FEV1 33 ± 12% ref) at baseline and during deep breathing with spontaneous muscle recruitment (SMR) and during breathing training. Measurements were taken with the patient seated and in supine decubitus position. RESULTS: In seated position ventilatory pattern was similar with SMR and during breathing training. Mean Pdi during airflow, however, was greater during breathing training than with SMR (34.8 ± 8.0 and 29.3 ± 9.3 cmH2O, respectively, p < 0.05) for similar levels of Pes. Mechanical effectiveness of the diaphragm expressed as Vt/Pdi) was less during breathing training, however (36.1 ± 10.4 and 49.5 ± 15.8 cc/cmH2O, p < 0.05), with no changes in overall efficacy of respiratory muscles (Vt/Pes). In supine decubitus position, ventilatory patterns of SMR and breathing training were similar, although Vt and T1 were slightly higher in the latter (1,065 ± 305 vs. 1,211 ± 314 cc, p < 0.01; and 2.76 ± 1.32 vs. 3.07 ± 1.23 sec, p < 0.05). Pdi was also higher during breathing training (29.7 ± 10.2 and 38.0 ± 10.5 cmH2O, p < 0.05), although accompanied in this case by a higher Pes (21.2 ± 7.5 to 26.4 ± 8.4 cmH2O, p < 0.005). In supine decubitus position, the effectiveness of both diaphragm muscles and respiratory muscles overall was similar for both ventilatory modes. CONCLUSIONS: Breathing training truly involves greater use of the diaphragm, both in seated and supine decubitus positions. Breathing training does not provide greater ventilatory efficacy than SMR, however, in COPD patients.
Original languageEnglish
Pages (from-to)13-18
JournalArchivos de Bronconeumologia
Volume36
Issue number1
Publication statusPublished - 1 Jan 2000

Keywords

  • Breathing training
  • COPD
  • Diaphragm

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    Pastó, M., Gea, J., Aguar, M. C., Barreiro, E., Orozco-Levi, M., Félez, M., & Broquetas, J. (2000). Respiratory muscle mechanics during diaphragmatic breathing. Archivos de Bronconeumologia, 36(1), 13-18.