Breathing Exercises

Original Editor - Lucinda hampton

Top Contributors - Lucinda hampton, Prashna Singh, Stella Constantinides, Robin Amel, Kim Jackson, Samuel Winter and Rishika Babburu

Introduction

Breathing through the nose

Breathing is an function controlled by the autonomic nervous system and is also under volotional control. Breathing exercises are a form of exercise which can improve the overall efficiency at which the lungs function. They can be helpful in individual with both healthy lungs as well as those with impaired lung function. In the absence of disease our breathing becomes altered with stress and when left unchecked over time can result in disordered breathing patterns. (breathing pattern disorder) Disordered breathing can upset the oxygen and carbon dioxide exchange and contribute to anxiety, panic attacks, fatigue, and other physical and emotional disturbances.

Benefits of breathing exercises include a variety of health-related reasons. eg: to enhance the respiratory system by improving ventilation; strengthening respiratory muscles; make breathing more efficient; and for relieving stress and anxiety.

Diaphragmatic Breathing

Diaphragmatic breathing

Diaphragmatic breathing is a type of breathing exercise that helps strengthen the diaphragm, the main muscle that helps with breathing, as it represents 80% of breathing. Diaphragmatic exercises help to make people feel relaxed and rested.

This breathing exercise is also sometimes called belly breathing or abdominal breathing.

Technique:

• Position patient in a gravity-assisted position eg. semi fowler's positions

• Focusing on the Diaphragm - Place one hand on the chest and the other on your stomach. Take a slow deep breath, paying attention to which hand moves. In diaphragmatic breathing, the stomach hand should move most
• Slow the breathing - Inhale to fully inflate the lungs, then slowly exhale. Breathing out through the nose can help control exhalation rate. Pause briefly after exhaling then inhale again.

Pursed Lip Breathing

Pursed-lip breathing is a breathing technique that consists of exhaling through tightly pressed (pursed) lips and inhaling through the nose with the mouth closed. It is an effective way of slowing down breathing and increasing exhalation time allowing more air to be released with each breath cycle.

This technique has been found to benefit people who have obstructive lung diseases eg chronic obstructive pulmonary disease (COPD) and asthma leading to dyspnea during exertion.

Deep Breathing

Deep breathing helps to reexpand lungs and can be useful for improving ventilation esp following surgery where certain areas of the lungs may be underventilated due to pain. It can also be called lateral costal or umbrella breathing and can be done unilaterally or bilaterally. Deep breaths are also necessary for sputum mobilisation and form part ot the Active Cycle of Breathing Techniques mentioned below.

Technique:

• While standing or sitting, place your hands on the lower aspect of the rib cage.
• Instruct patient to breathe out and apply pressure in downward and inward direction.
• Shortly before instructing the patient to breathe in, apply quick stretch in the down and inward direction
• With the tactile stimulation and cuing, facilitate patient to take a deep breath in
• Slowly release your breath by exhaling through the nose

Active Cycle of Breathing Techniques

The Active Cycle of Breathing Techniques (ACBT) is an active breathing technique performed by the patient and can be used to mobilize and clear excess pulmonary secretions and to generally improve lung function. Once ACBT has been taught, the patient can be encouraged to use it independently without the supervision of a physiotherapist. This exercise does not require the use of any special equipment.

Box Breathing

Box breathing can be helpful with relaxation. Box breathing is a breathing exercise to assist patients with stress management and can be implemented before, during, and/or after stressful experiences. Box breathing involves visualizing a journey around the four sides of a square, pausing while traveling horizontally, and breathing in while traveling up the square and out while traveling down it. This exercise can be implemented in many environments, not requiring a calm environment to be effective.

• Step One: Breath in through the nose for a count of 4.
• Step Two: Hold your breath for a count of 4.
• Step Three: Breath out for a count of 4.
• Step Four: Hold your breath for a count of 4.
• Repeat

Research Findings

Relaxed breathing

Breathing affects all body systems; these systems in turn influence breathing. Optimal breathing patterns help to maintain homeostasis, but when breathing is disrupted, significant issues can arise.

Examples of how breathing can help in health outcomes are shown below:

• Breathing exercises can improve pulmonary function, respiratory muscle strength, exercise capacity, dyspnea, and health-related quality of life in patients with COPD
• Evidence suggests that diaphragmatic breathing may decrease stress as measured by physiologic biomarkers, as well psychological self-report tools
• Evidence exists to support the use of breathing exercises in the treatment of chronic, nonspecific low back pain.
• The way of breathing decisively influences autonomic and pain processing. Deep slow breathing in concert with relaxation are essential feature in the modulation of sympathetic arousal and pain perception. Thus can be useful in chronic pain management.
• Breathing exercises for adults with asthma may have some positive effects on quality of life, hyperventilation symptoms, and lung function

See The Science of Breathing Well