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Pursed-Lips Breathing Decreases Dyspnea and Improves Health-Related Quality of Life in 4-Group Randomized, Controlled Study FREE TO VIEW

Margaret Nield, PhD*; Guy Soo Hoo, MD, MPH; Janice Roper, PhD, RN; Silverio Santiago, MD
Author and Funding Information

VA, Greater Los Angeles, West LA VA, Los Angeles, CA


Chest. 2004;126(4_MeetingAbstracts):805S. doi:10.1378/chest.126.4_MeetingAbstracts.805S-a
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PURPOSE:  Chronic dyspnea is a distressing symptom that reduces health-related quality of life (HQOL). Breathing strategies such as pursed-lips breathing (PLB) are frequently encouraged by rehabilitation staff for dyspnea relief. However, contradictory evidence exists for breathing strategy efficacy. The study objective was to compare 3 methods for teaching a breathing strategy of prolonged, gentle exhalation on dyspnea relief and improved HQOL in patients with severe COPD.

METHODS:  53 subjects (mean±sd age = 66±9 years, forced expiratory volume 1sec (FEV1)/ forced vital capacity = 47±11, FEV1% pred = 38 ± 14, Body Mass Index (BMI) = 26±6, inspiratory muscle strength (PImax) = 71±22 cm H20) were randomized to either: 1) control; 2) inspiratory muscle training (IMT) at 30% PImax; 3) expiratory muscle training (EMT) at 10% PEmax; or 4) structured PLB with oxygen saturation level as feedback. Dyspnea measures of visual analogue scale, modified Borg, University of California, San Diego Shortness of Breath and HQOL measure of SF-36 were done at baseline, end of 4 weekly visits to the research laboratory, and 3 months. ANCOVA with planned post hoc analyses was used to explore differences among and between groups.

RESULTS:  Group effect was present for the modified Borg after 6-minute walk distance (6MWD) (p = 0.016) and SF-36 domains of mental health (p = 0.037) with covariate PImax and physical function (0.023) with covariate BMI. Dyspnea was significantly different (p = 0.015) for the PLB group after 6MWD, but not IMT or EMT, as compared to the control group.

CONCLUSION:  A significant decrease in dyspnea occurred with the PLB group after 6MWD at 3 months. The only group with sustained improvement in dyspnea, mental health and physical function occurred for the PLB group.

CLINICAL IMPLICATIONS:  Decreased dyspnea after activity and improved HQOL may result with regular use of PLB for those with COPD.

DISCLOSURE:  M. Nield, None.

Wednesday, October 27, 2004

12:30 PM - 2:00 PM




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