Preliminary study: comparative effects of lung volume therapy between slow and fast deep-breathing techniques on pulmonary function, respiratory muscle strength, oxidative stress, cytokines, 6-minute walking distance, and quality of life in persons with COPD

Abstract

BackgroundLung volume therapy with the Voldyne® device can improve lung volume and has a nonsignificant benefit on respiratory muscle strength via the slow deep-breathing technique (SDBT); whereas respiratory muscle training with a respiratory muscle trainer via the fast deep-breathing technique (FDBT) has produced a significant improvement in people with COPD. Thus, the aim of this study was to compare the efficiency of lung volume therapy with the Voldyne® device with the SDBT and FDBT on pulmonary function, respiratory muscle strength, oxidative stress, cytokines, walking capacity, and quality of life (QoL) in people with COPD.MethodsA total of 30 COPD patient volunteers with mild (stage I) to moderate (stage II) severity were randomized into two groups: SDBT (n=15) and FDBT (n=15). Pulmonary function (FVC, FEV1, and FEV1/FVC), maximal inspiratory mouth pressure (PImax), oxidative stress status (total antioxidant capacity [TAC], glutathione [GSH], malondialdehyde [MDA], and nitric oxide [NO]), inflammatory cytokines (tumor necrosis factor-alpha [TNF-α] and IL-6), 6-minute walking distance (6MWD), and total clinical COPD questionnaire (CCQ) score were evaluated before and after 4 weeks of training.ResultsAll the parameters had no statistical difference between the groups before training. The PImax, TAC, IL-6, total QoL score, and 6MWD changed significantly in the SDBT group after the 4-week experiment as compared to those in the pre-experimental period, whereas FVC, FEV1, FEV1%, FEV1/FVC%, PImax, TAC, MDA, NO, TNF-α, IL-6, 6MWD, and total CCQ score changed significantly in the FDBT group as compared to those in the pre-experimental period. The FEV1%, PImax, TNF-α, IL-6, and total CCQ score differed significantly in the FDBT group in the post-experimental period as compared to those in the SDBT group.ConclusionThis preliminary study concluded that the application of incentive spirometry with the Voldyne® device via fast deep breathing possibly improved respiratory muscle strength and QoL and reduced inflammatory cytokines, MDA, and NO better than that via slow deep breathing among people with COPD.

Breathing exercises in people with COPD: A realist review

“…Part of the resulting feedback received by the people during the process of training came from the exercise effect feedback provided by the training device itself (Heydari et al., 2015; Leelarungrayub et al., 2018; Sørensen & Svenningsen, 2018), and the resulting feedback detected by the practitioners through the measurement tools (Kang et al., 2016; Morrow et al., 2016). These feedback results enhanced the people' sense of self‐efficacy to a certain extent so that people could confidently complete this disease‐friendly respiratory rehabilitation to achieve the desired results.…”

“…Some different forms of respiratory muscle training equipment used in RMT were popular because of their short training duration, but they were expensive (Langer et al., 2015); others were accepted by people because the equipment was relatively cheap, controllable and reliable (Heydari et al., 2015; Leelarungrayub et al, 2017, 2018; Majewska‐Pulsakowska et al., 2016; Mehani, 2017; Nikoletou et al., 2016; Sørensen & Christensen, 2019). These RMT methods could improve respiratory muscle function better than routine nursing or other forms of exercise.…”

“…Throughout the entire study, it was found that the self‐efficacy of people is a key part when exploring how BEs work. This sense of self‐efficacy was the basis for exercise to achieve real results, which may come from the people’ confidence in the feedback of the results (Heydari et al., 2015; Kang et al., 2016; Leelarungrayub et al., 2018; Morrow et al., 2016; Sørensen & Svenningsen, 2018), their confidence in disease control (Liu et al., 2019; Mendes et al., 2019; Roberts et al., 2017; Sakhaei et al, 2018; Sørensen & Christensen, 2019) or the support and encouragement given by practitioners (therapists or researchers; Borge et al., 2015; Kang et al., 2016; Summers et al., 2017).…”

“…Their satisfaction and compliance will be increased(M1) and it is easier to accept and adopt breathing training(M2) to improve the quality of life(O) Gu et al (2018), Heydari et al (2015), Kang et al (2016), Langer et al (2015), Leelarungrayub et al (2017Leelarungrayub et al ( , 2018, Li et al (2018), Liu et al (2019), Majewska-Pulsakowska et al (2016), Mehani (2017), Nikoletou et al (2016), Sørensen and Svenningsen (2018), Sørensen and Christensen (2019), Wu et al (2018) and Xiao and Zhuang (2015) 2. Integration of the intervention with life…”

Comparison of Two Treadmill Gait Training Techniques on the Gait and Respiratory Function in Stroke Patients

“…In this study, we measured the forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and maximum voluntary ventilation (MVV). All measurements were performed three times in total, and the maximum value was used for analysis [23]. FVC and FEV1 are general indicators that assess respiratory function [24], and MVV is an indicator that assesses endurance of inspiratory muscles [25].…”