Volume 90, Issue 5, Pages (November 1986)

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Presentation transcript:

Volume 90, Issue 5, Pages 662-669 (November 1986) Resistive Breathing Training in Patients with Chronic Obstructive Pulmonary Disease Michael J. Belman, M.D., F.C.C.P., Scott G. Thomas, Ph.D., Michael I. Lewis, M.D., F.C.C.P. CHEST Volume 90, Issue 5, Pages 662-669 (November 1986) DOI: 10.1378/chest.90.5.662 Copyright © 1986 The American College of Chest Physicians Terms and Conditions

Figure 1 Experimental setup for measurement of breathing strategy during resistive breathing (see text for explanation). CHEST 1986 90, 662-669DOI: (10.1378/chest.90.5.662) Copyright © 1986 The American College of Chest Physicians Terms and Conditions

Figure 2 Flow characteristics of resistive training device. Each regression line represents pressure required to produce flow at each of six orifices. By decreasing flow, it is possible to maintain pressure relatively low, even though smaller orifice is used. Regression lines from left to right represent orifices 6 (diameter, 0.17 cm) through 1 (diameter, 0.54 cm), respectively. CHEST 1986 90, 662-669DOI: (10.1378/chest.90.5.662) Copyright © 1986 The American College of Chest Physicians Terms and Conditions

Figure 3 Maximal sustained ventilatory capacity (MSVC) before and after training. Values before and after are similar, and mean is not significantly different (32.5 ± 17.4 L/min to 30.4 ± 20.1 L/min). CHEST 1986 90, 662-669DOI: (10.1378/chest.90.5.662) Copyright © 1986 The American College of Chest Physicians Terms and Conditions

Figure 4 Maximal inspiratory pressure (MIP) (40.2 ± 23.0 cm H2O to 35.6 ± 19.6 cm H2O) and maximal expiratory pressure (MEP) (103.8 ± 56.6 cm H2O to 93.4 ± 50.6 cm H2O) before and after training (n = 9). These values were not significantly different. CHEST 1986 90, 662-669DOI: (10.1378/chest.90.5.662) Copyright © 1986 The American College of Chest Physicians Terms and Conditions

Figure 5 Endurance time for seven patients while breathing through orifice one smaller than critical orifice in uncoached and coached manner. There was significant increase in endurance time (5.78 ± 4.59 minutes to 11.56 ± 5.86 minutes) (p<0.05). Five patients who improved their endurance time to 15 minutes are shown as open circles. Two patients who did not improve are shown as closed triangles. CHEST 1986 90, 662-669DOI: (10.1378/chest.90.5.662) Copyright © 1986 The American College of Chest Physicians Terms and Conditions

Figure 6 Fifteen-second records of pressure (top) and flow (bottom) patterns, respectively, in one patient while breathing through orifice one smaller than cricital orifice. Uncoached and coached tracings are superimposed, with dotted line representing coached breathing. From tracings, it can be seen that with coaching, there is reduced Pm, peak inspiratory flow rate, and breathing frequency, with increase in Ti and VT. CHEST 1986 90, 662-669DOI: (10.1378/chest.90.5.662) Copyright © 1986 The American College of Chest Physicians Terms and Conditions

Figure 7 Rating of perceived effort (RPE) calculated from equation (Pm1.3 × Ti0.52 × fb0.26)20 for five patients who increased with endurance time to 15 minutes; RPE before and after training was 152 ± 36 and 123 ± 13 (p = 0.054), respectively. Two patients who failed to increase their endurance time had the same or higher values for RPE (solid triangles). CHEST 1986 90, 662-669DOI: (10.1378/chest.90.5.662) Copyright © 1986 The American College of Chest Physicians Terms and Conditions