Influence of pursed-lip breathing on heart rate variability and cardiorespiratory parameters in subjects with chronic obstructive pulmonary disease (COPD)

Ramos, Ercy M. C.; Vanderlei, Luiz Carlos Marques; Ramos, Dionei; Teixeira, Luiz Antônio; Pitta, Fábio; Veloso, Márcia Paranho

doi:10.1590/s1413-35552009005000035

Cited by 29 publications

(45 citation statements)

References 34 publications

(40 reference statements)

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“…Tug et al 45 found no significant difference between mild and moderate-to-severe COPD groups for the isolated parasympathetic, sympathetic, or mixed form (P Ͼ .05). Similarly, Ramos et al 29 Two studies of high methodological quality assessed the influence of disease duration on autonomic function in subjects with COPD, and both studies concluded that it had none (P Ͼ .05). 17,45 Furthermore, one study of high methodological quality indicated that COPD exacerbation was associated with a significant increase in LF, HF, LF/HF, and TP (P Ͻ .05) compared with subjects with stable COPD and/or healthy controls.…”

Section: Factors Influencing Autonomic Function In Subjectsmentioning

confidence: 99%

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Evidence for Autonomic Function and Its Influencing Factors in Subjects With COPD: A Systematic Review

et al. 2015

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SummaryCardiovascular autonomic neuropathy is one of the factors implicated in the high morbidity and mortality rate in patients with COPD. Thus, several studies and nonsystematic reviews have increasingly reported autonomic function impairment in these subjects. For a better understanding, this systematic review was performed to evaluate not only the evidence for autonomic function impairment, but also factors influencing it. The results of the studies reviewed showed a strong level of evidence to support the impairment of heart rate variability in the time domain. A similar evidence level was also found to support impairment in baroreceptor sensitivity and muscle sympathetic nerve activity. Furthermore, this review identified physical activity level, muscle function, and circadian rhythm as the major influencing factors (strong evidence) of autonomic function in subjects with COPD. However, no definite conclusion could be reached for factors such as dyspnea, anxiety, body composition, pulmonary function, age, breathing frequency, ventilatory effort, quality of life, and disease severity due to limited, conflicting, or lack of existing evidence. The results of this review highlight relevant clinical messages for clinicians and other health-care providers regarding the role autonomic function can play as an important physiological marker for prognostication and stratification. Hence, autonomic function outcomes should be identified and considered during management of patients with COPD. Moreover, this review can serve as basis for future research aimed at assessing the interventions for autonomic function abnormalities in these patients.

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Section: Factors Influencing Autonomic Function In Subjectsmentioning

confidence: 99%

“…Four studies of low 26,29 and high 37,45 methodological quality evaluated the influence of disease severity on autonomic function in subjects with COPD. Two of the studies concluded that disease severity had a significant effect on autonomic function.…”

Section: Factors Influencing Autonomic Function In Subjectsmentioning

confidence: 99%

Evidence for Autonomic Function and Its Influencing Factors in Subjects With COPD: A Systematic Review

et al. 2015

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“…Creemos además que es importante trabajar la musculatura periférica ya que los pacientes con EPOC se vuelven más sedentarios por la disnea en ejercicio y esto provocaría pérdida de masa muscular 22 . Por otra parte, es crucial la kinesiterapia respiratoria principalmente la aceleración del flujo espiratorio (aFe lento y rápido) más tos dirigida, para favorecer la eliminación de secreciones 8,23 y la rLF ya que esta última técnica desplazaría el punto de igual presión a vías aéreas menos colapsables, favoreciendo la salida del aire, disminuyendo así el atrapamiento aéreo y la hiperinsuflación pulmonar, lo cual reduce la disnea 24 , además esta técnica aumenta el volumen corriente y disminuye la frecuencia respiratoria 25 , se educa bastante en los pacientes para que la ocupen en momentos de exacerbación.…”

Section: Comentariosunclassified

Efectos de un Programa de Rehabilitación Pulmonar con énfasis en el entrenamiento de la musculatura respiratoria y actividades recreativas en un grupo de pacientes con EPOC

2017

Rev. chil. enferm. respir.

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“…Os Quadros 1 e 2 descrevem os dez ensaios clínicos selecionados [11][12][13][14][15][16][17][18][19][20] . As duas revisões bibliográficas encontradas na busca realizada estão apresentadas a seguir de forma descritiva, por não possuírem a formatação estabelecida para a análise dos dados.…”

Section: Características Dos Estudos Selecionadosunclassified

“…Ramos et al 18 estudaram a manobra realizada durante o repouso e observaram que sua realização eleva o valor do índice de raiz quadrada da média do quadrado das diferenças entre intervalos RR normais adjacentes (RMSSD), indicativo da atividade parassimpática, quando comparado à respiração espontânea. Os autores inferem que a RFL diminui o balanço simpatovagal, o que pode ser decorrente da diminuição da f. Em função das alterações observadas em parâmetros cardiorrespiratórios e autonômicos, os autores ressaltam a importância da monitorização destes pacientes durante a realização da manobra.…”

Section: Respiração Frenolabial E Mecânica Respiratóriaunclassified

A respiração frenolabial na doença pulmonar obstrutiva crônica: revisão da literatura

et al. 2012

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interesse: nada a declarar.RESUMO | Esta revisão teve por objetivo destacar os principais achados publicados nos últimos dez anos sobre os efeitos da respiração frenolabial (RFL) em pacientes com doença pulmonar obstrutiva crônica (DPOC). A busca dos artigos foi realizada nas bases de dados Lilacs, IBECS, MEDLINE e SciELO, por meio dos seguintes descritores da área da saúde (DeCS): doença pulmonar obstrutiva crôni-ca, reabilitação, respiração, hiperinsuflação e dispneia, e suas respectivas versões na língua inglesa (MeSH), além do termo pursed-lip breathing. Após a eliminação dos títu-los repetidos, foram selecionados somente os estudos que abordavam a RFL como tema principal, resultando em 12 artigos científicos, 10 ensaios clínicos e 2 revisões bibliográ-ficas. Segundo os achados, a RFL proporciona: alterações sobre a gasometria arterial, caracterizada pelo aumento da saturação e pressão parcial de oxigênio; padrão ventilatório, com diminuição da frequência respiratória e aumento de tempo expiratório e do volume corrente; mecânica ventilatória, por meio do recrutamento de musculatura abdominal expiratória e dos músculos da caixa torácica e acessórios da inspiração; diminuição no consumo de oxigênio; alterações na modulação autonômica cardíaca induzida pelo aumento da atividade parassimpática e, por fim, melhora na qualidade de vida destes pacientes. A RFL é considerada uma manobra de grande importância, por repercutir de forma positiva em diversos sistemas e sobre a qualidade de vida de pacientes portadores da DPOC.Descritores | doença pulmonar obstrutiva crônica; dispneia; respiração.ABSTRACT | This review aimed at standing out the main findings published in the last ten years on the effects of pursed-lip breathing (PLB) in patients with chronic obstructive pulmonary disease (COPD). The search for articles was performed in Lilacs, IBECS, MEDLINE, and SciELO database by using the descriptors of health (DeCS): doença pulmonar obstrutiva crônica, reabilitação, respiração, hiperinsuflação e dispneia, and their respective versions in the English language (MeSH), the term pursed-lip breathing was also in such list. After removing the repeated titles, only studies addressing PLB as the main theme were selected, resulting in 12 papers, 10 clinical trials, and 2 systematic reviews. According to the findings, the PLB provides: changes on arterial gases, which are characterized by increased oxygen saturation and partial pressure of oxygen; ventilatory pattern with decreased respiratory rate and increased expiratory time and tidal volume; respiratory mechanics, by recruiting the expiratory abdominal muscles and muscles of the rib cage and accessories inspired; decrease in oxygen consumption; alterations in cardiac autonomic modulation induced by increase in parasympathetic activity and, ultimately, improved quality of life of these patients. The PLB is considered a maneuver of great importance to have a positive effect on various systems and on the quality of life of patients with COPD.

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Influence of pursed-lip breathing on heart rate variability and cardiorespiratory parameters in subjects with chronic obstructive pulmonary disease (COPD)

Cited by 29 publications

References 34 publications

Evidence for Autonomic Function and Its Influencing Factors in Subjects With COPD: A Systematic Review

Evidence for Autonomic Function and Its Influencing Factors in Subjects With COPD: A Systematic Review

Efectos de un Programa de Rehabilitación Pulmonar con énfasis en el entrenamiento de la musculatura respiratoria y actividades recreativas en un grupo de pacientes con EPOC

A respiração frenolabial na doença pulmonar obstrutiva crônica: revisão da literatura

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