Source: Annual Congress 2002 - Physiotherapy: assessment and outcome in healthy subjects and patients with chronic lung disease
Disease area: Airway diseases

Abstract

Pursed lip breathing (PLB) may provide a potential mechanism for reducing dyspnoea during daily activities (1) although it is unknown whether this enhances exercise tolerance. The purpose of this pilot study is to investigate the effect of PLB on exercise tolerance and breathlessness in COPD patients.
22 patients with severe COPD, mean (SD) FEV11.43 (0.59)l, age 71 (55 -81) yrs, performed a baseline practice walk using the Shuttle Walk Test (SWT), 2 patients demonstrated PLB and were excluded from the trial. The remaining patients then performed two more walks: A = SWT without PLB, B =SWT using PLB. Respiratory rate (RR), arterial oxygen saturation SaO2,heart rate (HR) and Borg breathlessness score were measured before and after each walk. Results were double blinded. Data was analysed using the paired t test.
There was a statistically significant difference in post exercise RR between the two walks, mean (SD) walk A 28.1 (6.37) walk B 25.1 (3.97), mean difference 95% CI; 3.05 (0.69 to 5.30). However, there were no statistically significant differences in any other outcomes: SWT mean difference, 17 (58)metres p = 0.20; breathlessness; -0.3 (1.18) p = 0.20; SaO2, 1.05 (2.6) p = 0.9, HR, 0.8 (14) p = 0.8.
This pilot study suggests that PLB performed during exercise may lower post exercise RR in patients who do not normally adopt this technique. Although there appears to be little effect of PLB on exercise tolerance, larger studies are warranted to eliminate a type II error.
1. Barach, A. L. Physiologic advantages of grunting, groaning, and pursed-lip breathing: adaptive symptoms related to the development of continuous positive pressure breathing. Bulletin of the New York Academy of Medicine 49[8], 666-73. 1973 Aug.

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Citations should be made in the following way:
R. Garrod, C. Daly, C. Hoareau (London, United Kingdom). The effect of pursed lip breathing on exercise capacity and breathlessness in patients with chronic obstructive pulmonary disease. Eur Respir J 2002; 20: Suppl. 38, 1167

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