Article

OBJECTIVE: To investigate the effects of a diaphragmatic breathing training
program (DBTP) on thoracoabdominal motion and functional capacity in patients
with chronic obstructive pulmonary disease. DESIGN:
A prospective, randomized
controlled trial. SETTING: Academic medical center. PARTICIPANTS: Subjects (N=30;
forced expiratory volume in 1s, 42%+/-13% predicted) were randomly allocated to
either a training group (TG) or a control group (CG). INTERVENTIONS: Subjects in
the TG completed a 4-week supervised DBTP (3 individualized weekly sessions),
while those in the CG received their usual care.
MAIN OUTCOME MEASURES:
Effectiveness was assessed by amplitude of the rib cage to abdominal motion ratio
(RC/ABD ratio) (primary outcome) and diaphragmatic mobility (secondary outcome).
The RC/ABD ratio was measured using respiratory inductive plethysmography during
voluntary diaphragmatic breathing and natural breathing. Diaphragmatic mobility
was measured by ultrasonography. A 6-minute walk test and health-related quality
of life were also evaluated. RESULTS: Immediately after the 4-week DBTP, the TG
showed a greater abdominal motion during natural breathing quantified by a
reduction in the RC/ABD ratio when compared with the CG
(F=8.66; P<.001).
Abdominal motion during voluntary diaphragmatic breathing after the intervention
was also greater in the TG than in the CG (F=4.11; P<.05). The TG showed greater
diaphragmatic mobility after the 4-week DBTP than did the CG (F=15.08; P<.001).
An improvement in the 6-minute walk test and in health-related quality of life
was also observed in the TG. CONCLUSIONS: DBTP for patients with chronic obstructive pulmonary disease induced increased diaphragm participation during
natural breathing, resulting in an improvement in functional capacity.
CI - Copyright (c) 2012 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS