BACKGROUND: Shrinkage lip respiration can improve breathlessness and exercise tolerance in patients with chronic obstructive pulmonary disease (COPD). OBJECTIVE: Shrinkage lip respiration is considered as control. This study serves to investigate the respiratory training in relation to respiratory pathophysiology effects on respiratory muscle function and exercise tolerance in COPD patients. DESIGN, TIME AND SETTING: The randomized control grouping experiment was performed at the Second People's Hospital from October 2006 to December 2007. PARTICIPANTS: The acute and severe 60 patients with COPD on the basis of Global Initiative for Chronic Obstructive Lung Disease (2006) were selected in this study, including 51 males and 9 females. METHODS: A total of 60 patients were divided into three groups by randomized control trial. Patients in the experimental group were subjected to respiratory training on the basis of respiratory pathophysiology, three times a day, once 15 minutes, for 8 weeks. Patients in the positive control group were given respiratory training with shrinkage lip respiration, three times a day, once 15 minutes, for 8 weeks. Patients in the negative control group did not receive respiratory training. Each group consisted of 20 individuals. MAIN OUTCOME MEASURES: Medical research council scale, activities of daily living, quality of life, 6-minute walking distance, maximal expiratory pressure and maximal inspiratory pressure. RESULTS: A total of 3, 5 and 5 patients dropped out this study respectively in the experimental, positive control and negative control groups. Medical research council scale grade after respiratory training was lower than that before respiratory training in the experimental group and the positive control group (p < 0.01). Activities of daily living, 6-minute walking distance, maximal expiratory pressure and maximal inspiratory pressure increased compared with that before respiratory training (p < 0.01, p < 0.05). After respiratory training, activities of daily living, 6-minute walking distance, maximal expiratory pressure and maximal inspiratory pressure increased in the experimental group compared with the positive control group (p < 0.05). Compared with that before respiratory training, significant differences in each index were detected after respiratory training in the experimental and the positive control groups (p < 0.01, p < 0.05). CONCLUSION: Respiratory training in relation to respiratory pathophysiology can ameliorate significantly dyspnea, improve activities of daily living, quality of life, exercise tolerance, respiratory muscle function of the severe and very severe patients with COPD.

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