RESUMO
BACKGROUND: Breathing exercises, such as diaphragmatic breathing and pursed-lips breathing, play a role in some individuals with COPD and might be considered for those patients who are unable to exercise. However, in the literature are reports of some adverse effects of diaphragmatic breathing in patients with COPD. Thus, the purpose of this study was to assess the effects of diaphragmatic breathing and diaphragmatic breathing combined with pursed-lips on chest wall kinematics, breathlessness, and chest wall asynchrony in subjects with COPD, and also to assess whether the combination of both exercises reduces the adverse effects of diaphragmatic breathing while maintaining its benefits. METHODS: Seventeen subjects with COPD, mean ± SD, 65 ± 7 y of age, with a history of smoking and clinical stability without hospitalization or symptoms of exacerbation in the past 4 wk, were evaluated. On day 1, participants' characteristics were collected, and they learned diaphragmatic breathing and its combination with pursed-lips breathing. On day 2, the participants were evaluated by optoelectronic plethysmography with the participants in the seated position while performing breathing exercises. RESULTS: Diaphragmatic breathing and diaphragmatic breathing plus pursed-lips breathing promoted a significant increase in chest wall tidal volume and its compartments as well as a reduction in breathing frequency compared with quiet breathing. No significant changes were observed in dyspnea or end-expiratory volume of the chest wall. A significant increase in asynchrony (inspiratory-expiratory phase ratio) was observed during diaphragmatic breathing and diaphragmatic breathing plus pursed-lips breathing compared with quiet breathing, with no differences observed between the exercises. CONCLUSIONS: Despite the increase in asynchrony, both breathing exercises were able to improve chest wall volumes without affecting dyspnea. The combination of exercises maintained the benefits but did not reduce the adverse effects of diaphragmatic breathing.
Assuntos
Exercícios Respiratórios/métodos , Dispneia/terapia , Doença Pulmonar Obstrutiva Crônica/terapia , Idoso , Fenômenos Biomecânicos , Diafragma/fisiopatologia , Dispneia/etiologia , Dispneia/fisiopatologia , Feminino , Humanos , Lábio , Masculino , Pessoa de Meia-Idade , Pletismografia , Doença Pulmonar Obstrutiva Crônica/complicações , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Respiração , Mecânica Respiratória/fisiologia , Parede Torácica/fisiopatologia , Volume de Ventilação Pulmonar , Resultado do TratamentoRESUMO
CONTEXTUALIZAÇÃO: A pletismografia optoeletrônica (POE) é um método inovador de mensuração indireta da ventilação pulmonar, capaz de avaliar ciclo a ciclo, de forma tridimensional e em tempo real, os volumes pulmonares absolutos e suas variações nos três compartimentos que compõem a parede torácica (caixa torácica pulmonar, caixa torácica abdominal e abdome). A POE permite mensurar variáveis do padrão respiratório, da assincronia respiratória, além da contribuição de cada compartimento da parede torácica e de cada hemitórax para o volume corrente. OBJETIVOS: Fazer uma revisão de literatura sobre os seguintes aspectos relacionados à POE: histórico, princípio de funcionamento, vantagens de utilização, propriedades psicométricas, variáveis mensuradas e método de análise do sistema, ressaltando informações sobre seu manuseio. Em uma segunda parte, abordar a aplicabilidade da pletismografia optoeletrônica em diferentes condições de saúde/situações, tais como: doença pulmonar obstrutiva crônica (DPOC; efeitos agudos do exercício, reabilitação pulmonar, exercício respiratório e transplante pulmonar), asma, pacientes em terapia intensiva, doenças neuromusculares e hemiplegia. MÉTODO: Foi realizada uma busca na base de dados MedLine, SciELO e Lilacs com o termo "optoelectronic plethysmography". Foram incluídos 43 estudos. CONCLUSÃO: Tendo por base a literatura revisada, a POE mostrou-se um instrumento de avaliação respiratória capaz de fornecer informações sobre parâmetros ventilatórios de indivíduos saudáveis e com disfunções em diferentes posições, situações e ambientes. Foram apresentados os principais resultados dos estudos em que a POE foi usada em indivíduos que apresentavam DPOC representando o maior corpo de conhecimento até o momento, assim como em alguma outra condição de saúde.
BACKGROUND: Optoelectronic plethysmography (OEP) is an innovative method of indirect measurement of pulmonary ventilation, capable of breath-by-breath, three-dimensional, real time assessment of absolute lung volumes and their variations in the three compartments of the chest wall (pulmonary rib cage, abdominal rib cage, and abdomen). OEP allows the measurement of variables of breathing pattern, breathing asynchrony, and contribution of each chest wall compartment and hemithorax to the tidal volume. OBJECTIVES: To review the literature on the following aspects related to OEP: history, operating principle, advantages, psychometric properties, variables, and method of system analysis, highlighting information about its handling. In a second part, the objective is to analyze the applicability of OEP in different health conditions/situations such as: chronic obstructive pulmonary disease (COPD; acute effects of exercise, pulmonary rehabilitation, breathing exercise, and lung transplantation), asthma, patients in intensive care, neuromuscular diseases, and stroke. METHOD: A search was performed in MedLine, SciELO and Lilacs with the term "optoelectronic plethysmography". Forty-three papers were included. CONCLUSION: Based on the literature reviewed, OEP has been shown to be an assessment tool that can provide information about ventilatory parameters in healthy subjects and subjects with various dysfunctions in different positions, situations, and settings. The main results of studies on OEP in COPD are shown, representing the largest body of knowledge to date. The results of studies on OEP in other health conditions are also shown.
Assuntos
Humanos , Pneumopatias/fisiopatologia , Pletismografia , Mecânica Respiratória , RespiraçãoRESUMO
BACKGROUND: Optoelectronic plethysmography (OEP) is an innovative method of indirect measurement of pulmonary ventilation, capable of breath-by-breath, three-dimensional, real time assessment of absolute lung volumes and their variations in the three compartments of the chest wall (pulmonary rib cage, abdominal rib cage, and abdomen). OEP allows the measurement of variables of breathing pattern, breathing asynchrony, and contribution of each chest wall compartment and hemithorax to the tidal volume. OBJECTIVES: To review the literature on the following aspects related to OEP: history, operating principle, advantages, psychometric properties, variables, and method of system analysis, highlighting information about its handling. In a second part, the objective is to analyze the applicability of OEP in different health conditions/situations such as: chronic obstructive pulmonary disease (COPD; acute effects of exercise, pulmonary rehabilitation, breathing exercise, and lung transplantation), asthma, patients in intensive care, neuromuscular diseases, and stroke. METHOD: A search was performed in MedLine, SciELO and Lilacs with the term "optoelectronic plethysmography". Forty-three papers were included. CONCLUSION: Based on the literature reviewed, OEP has been shown to be an assessment tool that can provide information about ventilatory parameters in healthy subjects and subjects with various dysfunctions in different positions, situations, and settings. The main results of studies on OEP in COPD are shown, representing the largest body of knowledge to date. The results of studies on OEP in other health conditions are also shown.