EFFECT OF DIAPHRAGMATIC BREATHING WITH AND WITHOUT PURSE-LIPS BREATHING IN SUBJECT WITH EMPHYSEMA DISEASE

Background: Breathing exercise such as purse-lop breathing and diaphragmatic breathing play a role in some individual with Emphysema and might be considered for those patients who are unable to exercise. However, in this study is report of some adverse effect of diaphragmatic breathing in patient with Emphysema disease. Thus the purpose of the study was to assess the effect of diaphragmatic breathing and diaphragmatic breathing combined with purse-lip breathing on chest wall kinematics, breathlessness, and chest wall asynchrony in subject with obstructive disease, and also assess the whether the combination of both exercise reduce the adverse effect of diaphragmatic breathing while maintaining its benefits. Methods: Fifteen Subjects with pulmonary obstructive disease, mean 60 to 65 year age group, with a history of smoking and clinical stability without hospitalization or symptoms of exacerbation in the past 4 week, were evaluated. On day 1, participant's characteristics were collected, and they learnt diaphragmatic breathing. On day 2, the participants were evaluated by spirometery with the participants in the seated position while performing breathing exercise. Results: Diaphragmatic breathing and diaphragmatic breathing plus pursed-lip breathing promoted a significant increase in chest wall tidal volume of the chest wall. A significant increase in inspiratory- expiratory phase ratio was observed during diaphragmatic breathing and diaphragmatic breathing plus purse-lip breathing compared with quiet breathing, with no difference observed between the exercises. Conclusion: Despite the increase the inspiratory-expiratory phase volume, both breathing exercise were able to improve chest wall volume without affecting Dyspnea. The combination of exercises maintains the benefit but did not reduce the adverse effect of diaphragmatic breathing.