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Pursed-lips breathing reduces dynamic hyperinflation induced by activities of daily living test in patients with chronic obstructive pulmonary disease: a randomized cross-over study
de Araujo CLP, Karloh M, dos Reis CM, Palu M, Mayer AF
Journal of Rehabilitation Medicine 2015 Nov;47(10):957-962
clinical trial
5/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: No; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed*

BACKGROUND: Dynamic hyperinflation leads to dyspnoea and consequent limitations in functional capacity in chronic obstructive pulmonary disease. It has been shown that the response to pursed-lips breathing in terms of dynamic hyperinflation and lower-limb exercise capacity is variable, and its effects on activities of daily living are unknown. This study aimed to evaluate the effect of pursed-lips breathing on dynamic hyperinflation and functional capacity in patients with chronic obstructive pulmonary disease in a lower-limb exercise test and in a multiple-task activities of daily living test. DESIGN: Randomized cross-over study. PATIENTS: Twenty-five patients with chronic obstructive pulmonary disease (16 men, mean age 64 +/- 7 years, forced expiratory volume in 1 s (FEV1) 41.7 +/- 14.7% predicted). METHODS: Patients randomly performed two 6-min walk tests (6MWT) with and without pursed-lips breathing (6MWTPLB and 6MWTnon-PLB) and two Glittre-ADL tests with and without pursed-lips breathing (TGlittrePLB and TGlittrenon-PLB). Inspiratory capacity was assessed at baseline and immediately after the tests. RESULTS: The 6MWTnon-PLB and TGlittrenon-PLB induced similar magnitude dynamic hyperinflation (0.22 +/- 0.24 l and 0.31 +/- 0.23 l, respectively; p > 0.05). Pursed-lips breathing did not improve dynamic hyperinflation induced by the 6MWT (0.24 +/- 0.20 and 0.22 +/- 0.24 l, respectively, with and without pursed-lips breathing; p > 0.05). Dynamic hyperinflation in the TGlittrePLB was significantly lower than in the TGlittrenon-PLB (0.19 +/- 0.20 l and 0.31 +/- 0.23 l, respectively; p = 0.02). Pursed-lips breathing did not improve 6MWT or TGlittre performance. CONCLUSION: Pursed-lips breathing reduced dynamic hyperinflation in the TGlittre, but not in the 6MWT. However, pursed-lips breathing did not improve functional capacity.

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