Diaphragmatic Breathing Training Program Improves Abdominal Motion During Natural Breathing in Patients With Chronic Obstructive Pulmonary Disease: A.

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Presentation transcript:

Diaphragmatic Breathing Training Program Improves Abdominal Motion During Natural Breathing in Patients With Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial Wellington P. Yamaguti, PhD, Renata C. Claudino, PT, Alberto P. Neto, PT, Maria C. Chammas, PhD, Andrea C. Gomes, MD, João M. Salge, PhD, Henrique T. Moriya, PhD, Alberto Cukier, PhD, Celso R. Carvalho, PhD Archives of Physical Medicine and Rehabilitation Volume 93, Issue 4, Pages 571-577 (April 2012) DOI: 10.1016/j.apmr.2011.11.026 Copyright © 2012 American Congress of Rehabilitation Medicine Terms and Conditions

Fig 1 Study flow diagram. Archives of Physical Medicine and Rehabilitation 2012 93, 571-577DOI: (10.1016/j.apmr.2011.11.026) Copyright © 2012 American Congress of Rehabilitation Medicine Terms and Conditions

Fig 2 The RC/ABD ratio during NB and voluntary DB at baseline and after a 4-week follow-up period in the CG and TG. Reduction in the RC/ABD ratio reflects improvements in abdominal motion. Abbreviation: NS, not significant (compared with CG). *P<.05 compared with CG for both conditions (NB and DB). Archives of Physical Medicine and Rehabilitation 2012 93, 571-577DOI: (10.1016/j.apmr.2011.11.026) Copyright © 2012 American Congress of Rehabilitation Medicine Terms and Conditions

Fig 3 Diaphragmatic mobility in patients with COPD after the 4-week follow-up period in the CG and TG. The dotted line represents the threshold for diaphragmatic dysfunction.10 Circles represent the mean, and whiskers represent 95% confidence intervals. *P<.001 compared with baseline. Archives of Physical Medicine and Rehabilitation 2012 93, 571-577DOI: (10.1016/j.apmr.2011.11.026) Copyright © 2012 American Congress of Rehabilitation Medicine Terms and Conditions

Fig 4 Changes in SGRQ scores in patients with COPD after the 4-week follow-up in the CG and TG (negative difference is interpreted as an improvement). A difference >4.0 (deterioration) and <−4.0 (improvement) is considered clinically important. The dotted line indicates the minimal clinically important difference for SGRQ scores.41 Circles represent the mean, and whiskers represent 95% confidence intervals. Abbreviations: A, activity; I, impact; NS, not significant (compared with CG); S, symptom; Total, SGRQ total score. *P<.05 compared with CG. Archives of Physical Medicine and Rehabilitation 2012 93, 571-577DOI: (10.1016/j.apmr.2011.11.026) Copyright © 2012 American Congress of Rehabilitation Medicine Terms and Conditions

Fig 5 Linear relationship between baseline RC/ABD ratio (A), baseline diaphragmatic mobility (B), and the improvement in abdominal motion (Δ RC/ABD ratio) during NB in patients that completed DBTP. Negative changes in the RC/ABD ratio reflect improvement in abdominal motion. In A, the points included in the bottom right area correspond to patients who improved their abdominal motion. Note that 92.9% of the patients who showed an improvement in abdominal motion after DBTP had a baseline predominance of costal breathing. Abbreviation: DM, diaphragmatic mobility. Archives of Physical Medicine and Rehabilitation 2012 93, 571-577DOI: (10.1016/j.apmr.2011.11.026) Copyright © 2012 American Congress of Rehabilitation Medicine Terms and Conditions