Diaphragmatic Breathing Exercises: Difference between revisions

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== Introduction==
== Introduction==
Diaphragmatic breathing is intended to help you use the diaphragm correctly while breathing to:
Breathing exercise is as part of a comprehensive pulmonary rehabilitation program for patient with respiratory diseases, such as chronic obstructive pulmonary disease (COPD).<ref name=":0">Effects of Breathing Exercises in Patients With Chronic Obstructive Pulmonary Disease: Systematic Review and Meta-Analysis
* Strengthen the diaphragm


* Decrease the work of [[Breathing Pattern Disorders|breathing]] by slowing your breathing rate
Nutsupa Ubolnuar, PT, BSc,1 Anong Tantisuwat, PT, PhD,1 Premtip Thaveeratitham, PT, PhD,1 Somrat Lertmaharit, MSc,2 Chathipat Kruapanich, PT, MSc,1 and Witaya Mathiyakom, PT, PhD3
* Decrease oxygen demand
</ref> Same as other types of breathing exercise, diaphragmatic breathing is prescribed by physiotherapist aiming to strengthen the diaphragm, improve exercise endurance, reduce dyspnoea and improve quality of life (QoL).<ref>Holland AE, Hill CJ, Jones AY, McDonald CF. Breathing exercises for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2012;10:CD008250. [PubMed] [Google Scholar]</ref>
* Use less effort and energy to breathe
 
----
Diaphragmatic breathing is also called belly breathing since a patient abdomen should rise and lower as they are completing inspiration and expiration respectively.


== Diaphragmatic breathing technique ==
== Diaphragmatic breathing technique ==
For patient who has not expose to any kind of breathing exercise, it might be difficult for them to learn and understand diaphragmatic breathing technique. So, it relies on clear and effective explanation and demonstration from a teaching therapist. Below is an example of instructing beginner patient who has a respiratory condition.
'''1)'''Lie on your back on a flat surface or in bed, with your knees bent and your head supported. You can use a pillow under your knees to support your legs. Place one hand on your upper chest and the other just below your rib cage. This will allow you to feel your diaphragm move as you breathe[[File:9445-hic-diaphragmatic-breathing-1.jpg|center|thumb|
'''1)'''Lie on your back on a flat surface or in bed, with your knees bent and your head supported. You can use a pillow under your knees to support your legs. Place one hand on your upper chest and the other just below your rib cage. This will allow you to feel your diaphragm move as you breathe[[File:9445-hic-diaphragmatic-breathing-1.jpg|center|thumb|
diaphragmatic-breathing
diaphragmatic-breathing
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]]
]]


'''3)'''Tighten your stomach muscles, letting them fall inward as you exhale through pursed lips (see "Pursed Lip Breathing Technique"). The hand on your upper chest must remain as still as possible.
'''3)'''Tighten your stomach muscles, letting them fall inward as you exhale through pursed lips. The hand on your upper chest must remain as still as possible.
[[File:9445-hic-diaphragmatic-breathing-3.jpg|center|thumb|
[[File:9445-hic-diaphragmatic-breathing-3.jpg|center|thumb|
-hic-diaphragmatic-breathing-3
-hic-diaphragmatic-breathing-3
]]
]]
== Effects of diaphragmatic breathing exercise ==
Diaphragmatic breathing exercise is normally completed along with other breathing exercises as a comprehensive program. It is common that it is prescribed in conjunction with purse lip breathing, slow breathing and relaxation technique.<ref name=":1">Comparison of the oxygen cost of breathing exercises and spontaneous breathing in patients with stable chronic obstructive pulmonary disease.
Jones AY, Dean E, Chow CC
Phys Ther. 2003 May; 83(5):424-31.
</ref><ref>A study of short-term effect of rehabilitative therapy in chronic obstructive pulmonary disease.
Ambrosino N, Paggiaro PL, Macchi M, Filieri M, Toma G, Lombardi FA, Del Cesta F, Parlanti A, Loi AM, Baschieri L
Respiration. 1981; 41(1):40-4.
</ref>
The combined exercises are effective in reducing tidal volume and inhibiting sympathetic pathways of COPD patient.<ref name=":1" /><ref>Effects of guided deep breathing on breathlessness and the breathing pattern in chronic obstructive pulmonary disease: a double-blind randomized control study.
Borge CR, Mengshoel AM, Omenaas E, Moum T, Ekman I, Lein MP, Mack U, Wahl AK
Patient Educ Couns. 2015 Feb; 98(2):182-90.
</ref> The effects are then demonstrated as reduction of the sensation of shortness of breath and decreasing respiratory rate.<ref name=":0" /> Along with improvement in dyspnoea, QoL of COPD patient might be improved after four weeks of diaphragmatic breathing training.<ref>Yamaguti WP, Claudino RC, Neto AP, Chammas MC, Gomes AC, Salge JM, et al. Diaphragmatic breathing training program improves abdominal motion during natural breathing in patients with chronic obstructive pulmonary disease: a randomized controlled trial. Arch Phys Med Rehabil. 2012;93:571–7. [PubMed]</ref>


== References==
== References==

Revision as of 12:10, 23 February 2020

This article is currently under review and may not be up to date. Please come back soon to see the finished work! (23/02/2020)

Introduction[edit | edit source]

Breathing exercise is as part of a comprehensive pulmonary rehabilitation program for patient with respiratory diseases, such as chronic obstructive pulmonary disease (COPD).[1] Same as other types of breathing exercise, diaphragmatic breathing is prescribed by physiotherapist aiming to strengthen the diaphragm, improve exercise endurance, reduce dyspnoea and improve quality of life (QoL).[2]

Diaphragmatic breathing is also called belly breathing since a patient abdomen should rise and lower as they are completing inspiration and expiration respectively.

Diaphragmatic breathing technique[edit | edit source]

For patient who has not expose to any kind of breathing exercise, it might be difficult for them to learn and understand diaphragmatic breathing technique. So, it relies on clear and effective explanation and demonstration from a teaching therapist. Below is an example of instructing beginner patient who has a respiratory condition.

1)Lie on your back on a flat surface or in bed, with your knees bent and your head supported. You can use a pillow under your knees to support your legs. Place one hand on your upper chest and the other just below your rib cage. This will allow you to feel your diaphragm move as you breathe

diaphragmatic-breathing

2)Breathe in slowly through your nose so that your stomach moves out against your hand. The hand on your chest should remain as still as possible

diaphragmatic-breathing-2

3)Tighten your stomach muscles, letting them fall inward as you exhale through pursed lips. The hand on your upper chest must remain as still as possible.

-hic-diaphragmatic-breathing-3

Effects of diaphragmatic breathing exercise[edit | edit source]

Diaphragmatic breathing exercise is normally completed along with other breathing exercises as a comprehensive program. It is common that it is prescribed in conjunction with purse lip breathing, slow breathing and relaxation technique.[3][4]

The combined exercises are effective in reducing tidal volume and inhibiting sympathetic pathways of COPD patient.[3][5] The effects are then demonstrated as reduction of the sensation of shortness of breath and decreasing respiratory rate.[1] Along with improvement in dyspnoea, QoL of COPD patient might be improved after four weeks of diaphragmatic breathing training.[6]

References[edit | edit source]

  1. 1.0 1.1 Effects of Breathing Exercises in Patients With Chronic Obstructive Pulmonary Disease: Systematic Review and Meta-Analysis Nutsupa Ubolnuar, PT, BSc,1 Anong Tantisuwat, PT, PhD,1 Premtip Thaveeratitham, PT, PhD,1 Somrat Lertmaharit, MSc,2 Chathipat Kruapanich, PT, MSc,1 and Witaya Mathiyakom, PT, PhD3
  2. Holland AE, Hill CJ, Jones AY, McDonald CF. Breathing exercises for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2012;10:CD008250. [PubMed] [Google Scholar]
  3. 3.0 3.1 Comparison of the oxygen cost of breathing exercises and spontaneous breathing in patients with stable chronic obstructive pulmonary disease. Jones AY, Dean E, Chow CC Phys Ther. 2003 May; 83(5):424-31.
  4. A study of short-term effect of rehabilitative therapy in chronic obstructive pulmonary disease. Ambrosino N, Paggiaro PL, Macchi M, Filieri M, Toma G, Lombardi FA, Del Cesta F, Parlanti A, Loi AM, Baschieri L Respiration. 1981; 41(1):40-4.
  5. Effects of guided deep breathing on breathlessness and the breathing pattern in chronic obstructive pulmonary disease: a double-blind randomized control study. Borge CR, Mengshoel AM, Omenaas E, Moum T, Ekman I, Lein MP, Mack U, Wahl AK Patient Educ Couns. 2015 Feb; 98(2):182-90.
  6. Yamaguti WP, Claudino RC, Neto AP, Chammas MC, Gomes AC, Salge JM, et al. Diaphragmatic breathing training program improves abdominal motion during natural breathing in patients with chronic obstructive pulmonary disease: a randomized controlled trial. Arch Phys Med Rehabil. 2012;93:571–7. [PubMed]

COPD Foundation. What is COPD? Accessed 4/11/2019.

Centers for Disease Control and Prevention. Chronic Obstructive Pulmonary Disease (COPD). Accessed 4/11/2019.