Pulmonary Rehabilitation For Asthma, Cystic Fibrosis, COPD, Emphysema

Pursed lip breathing is most often practiced to treat asthma, pulmonary/cystic fibrosis and chronic obstructive pulmonary disease (COPD). The purpose of PLB is to create positive pressure inside airways to splint them open. Moving air then takes less work. Additionally it prolongs exhalation and allows more air out of the body therefore increasing lung volumes (FEV, FVC).

This leads to:

More efficient breathing
Improved oxygenation
Reduced breathing rate
Reduced shortness of breath

Table of Contents

Contraindications

Diabetes

If you suffer from diabetes and use insulin or other blood glucose-lowering medication, the pursed lip breathing exercise can increase your sensitivity to medication. This can make your blood glucose level lower than usual. You may suffer then from hypoglycemic shock, which is much more dangerous than high blood sugar. You should have a small snack immediately after the breathing session.

Depression

Breathing with longer exhalations triggers the parasympathetic nervous system, the rest-and-digest response. If you suffer from depression, this can further aggravate it as you tend to predominantly activate your parasympathetic; Putting the body in a state of relaxation but increasing a lack of motivation.

Severe Personality Disorders

Personality disorders, psychopathic disorders, severe forms of depression, mania, obsessive-compulsive disorder and delirium. In these disorders the patient is more likely to interpret a breathing exercise in the context of his/her personality disorder in which the therapist no longer has sufficient control over the therapy’s effect.

Age

Kids under 7 years should use the product in assistance with their parents or caregivers.

Psychoactive Substances

Opioids, benzodiazepines and caffeine may decrease the effectiveness of therapy.

Side Effects

Dehydration
Dizziness

Practicing pursed lip breathing expels air that was previously trapped in the lungs. This air is saturated with water and CO2 resulting in dehydration. Thus the patient is required to drink some water after the exercise.

In elderly patients a short-term dizziness is possible therefore after exercise the patient should rest for a while.

Guidelines

Exercise should be provided at least once daily in the form of ten (10) prolonged exhalations (blows). Exercise should be carried out in a relaxed sitting position. The aim is to achieve longest blow possible.

Warnings

Supply patients with extra drinking water
Before and after use, clean headset with dry tissue
Store the headset in a clean and dry environment

Did you know? With each exhalation humans eliminate water from their bodies. Chemical equation is: Glucose + Oxygen –> Carbon Dioxide + Water + Energy (ATP). That’s why you feel thirsty after playing breathing games.

References

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de F. Fregonezi, G. A., Resqueti, V. R. & Güell Rous, R. Pursed Lips Breathing. Archivos de Bronconeumología ((English Edition)) 40, 279–282 (2004).

Spahija, J., de Marchie, M. & Grassino, A. EFfects of imposed pursed-lips breathing on respiratory mechanics and dyspnea at rest and during exercise in copd*. Chest 128, 640–650 (2005).

Ingham, R. H. & Schilder, D. P. Effect of Pursed Lips Expiration on the Pulmonary Pressure-Flow Relationship in Obstructive Lung Disease. Am Rev Respir Dis 96, 381–388 (1967).

Garrodl, R., Dallimore, K., Cook, J., Davies, V. & Quade, K. An evaluation of the acute impact of pursed lips breathing on walking distance in nonspontaneous pursed lips breathing chronic obstructive pulmonary disease patients. Chron Respir Dis 2, 67–72 (2005).

Ramos, E. M. C. et al. 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 13, 288–293 (2009).

Breathing exercises for chronic obstructive pulmonary disease.

Mueller, R. E., Petty, T. L. & Filley, G. F. Ventilation and arterial blood gas changes induced by pursed lips breathing. Journal of Applied Physiology 28, 784–789 (1970).

Thoman, R. L., Stoker, G. L. & Ross, J. C. The Efficacy of Pursed-Lips Breathing in Patients with Chronic Obstructive Pulmonary Disease. Am Rev Respir Dis 93, 100–106 (1966).