Effect of Pursed Lips Breathing on Chest Wall, Mobility Diaphragmatic and Exercise Tolerance in Patients With Chronic Obstructive Pulmonary Disease

Study Overview
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Brief Summary
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This study aimed to evaluate the acute effect of PLB technique on diaphragmatic mobility, the kinematics of the thoracoabdominal complex analysis of lung volumes and exercise tolerance in patients with Chronic Obstructive Pulmonary Disease (COPD). This is a study randomized cross-over clinical trial and blind, in subjects with Chronic Obstructive Pulmonary Disease (COPD) according to criteria of the Global Initiative for Chronic Obstructive Lung Disease (GOLD) (FEV1 / FVC <0.7 and FEV1 <80% predicted) selected at the Clinical Hospital of the Federal University of Pernambuco (UFPE) and Otavio de Freitas General Hospital (HGOF). The investigators recruited 13 patients COPD (according to previous sample calculation) aged between 40 and 80 years, of both sexes. The first day was held evaluation of lung function, respiratory muscle strength, body composition, dyspnea index and functional capacity. On the second day was held evaluation of thoracoabdominal complex kinematics by plethysmography Optoelectronics (OEP) with Quiet Breathing (QB) or pursed-lips breathing (PLB). Lung volumes with 2 minutes with QB and 6 minutes PLB or only 6 minutes by QB as randomization were observed. Before and after performing the requested breathing pattern diaphragmatic mobility was observed by Ultrasonography (US) and requested the patient an Inspiratory Capacity maneuver (IC). The evaluator who performed the ultrasound was blinded as to the beginning of the breathing pattern of order performed by the patient.

Conditions
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Chronic Obstructive Pulmonary Disease

Intervention / Treatment
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* Other: Pursed Lips Breathing
* Other: Quiet Breathing


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: COPD diagnosis with stage II-IV (GOLD), Stable clinical condition (no exacerbation or hospital admission in the last four weeks preceding the study) Absence of other disease that may potentially contribute to dyspnea (heart disease, congestive heart failure, neuromuscular diseases, severe postural changes) Exclusion Criteria: BMI> 30 kg / m2 Musculoskeletal limitations Use of oxygen therapy Extreme discomfort during the procedure application

Ages Eligible for Study
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Minimum Age: 40 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Supportive Care
Allocation: Randomized
Intervention Model: Crossover Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Quiet Breathing or Pursed Lips Breathing<br>Free or natural breathing for six minutes. | Other: Pursed Lips Breathing<br>* Pursed Lips Breathing for six minutes.<br>Other: Quiet Breathing<br> <br> |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Chest wall (Analysis of lung volumes) | (L) by plethysmography optoelectronics. | One day during eight minutes | 
| Mobility diaphragmatic (mobility diaphragmatic (mm) by Ultrassonography) | Analysis of mobility diaphragmatic (mm) by Ultrassonography. | One day, before and after eight minutes of pursed lips breathing | 
| Exercise tolerance (Glittre AVD-Test) | Analysis by Glittre AVD-Test (capacity functional test) observing the test execution time (s). | One day, for six minutes approximately. The test will be repeated after 20 minutes of rest. | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Dyspnea (Borg and MRC Scale) | Assessed by Borg and MRC Scale (Medical Research Council). | One day, before and after implementation of Glittre-ADL Test | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Chronic Obstructive Pulmonary Disease, Respiratory mechanics, Plethysmography, Diaphragm, Respiratory muscles, Breathing exercises