The effect of different pattern of relaxed breathing exercises on the resting energy expenditure in patients with chronic obstructive pulmonary disease

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The effect of different pattern of relaxed breathing exercises on the resting energy expenditure in patients with chronic obstructive pulmonary disease

 

Author: Chow, Chi-sum Cedric
Title: The effect of different pattern of relaxed breathing exercises on the resting energy expenditure in patients with chronic obstructive pulmonary disease
Year: 1999
Subject: Lungs -- Diseases, Obstructive -- Patients -- Rehabilitation
Breathing exercises -- Therapeutic use
Hong Kong Polytechnic University -- Dissertations
Department: Multi-disciplinary Studies
Dept. of Rehabilitation Sciences
Pages: xv, 71 leaves : col. ill. ; 30 cm
Language: English
InnoPac Record: http://library.polyu.edu.hk/record=b1479915
URI: http://theses.lib.polyu.edu.hk/handle/200/2226
Abstract: Studies have shown that patients with chronic obstructive pulmonary disease (COPD) have an elevated resting energy expenditure (REE) (Donahoe, Rogers, Wilson & Pennock 1989, Schols, Fredrix, Soeters, Westesterp & Wouters 1991). Since REE occupies about 70% of the total energy expenditure (TEE) of the body, an elevation of REE may imply a large energy output. A raised energy output is believed to be one of the factors contributed to 'weight loss' in patients with COPD. It is hypothesized that the high energy output in patients with COPD is caused by the abnormality of the breathing mechanics of the respiratory system leading to a high work of breathing (WOB). During the rehabilitation of patients with COPD, physiotherapists often use relaxed breathing exercises to alleviate dyspnoea so that the patient's WOB can be reduced. Relaxed breathing exercises commonly adopted include pursed lip breathing exercises (PLB), diaphragmatic breathing (DBE) and sometimes a combination of both (MRB). However, the relationship between relaxed breathing exercises and REE has not been investigated. This study aims to investigate the effect of relaxed breathing exercises on REE in patients with COPD. Method: REE of subjects with or without COPD was measured by the MedGraphics Critical Care Management System (MCCMS R ). Heart rate (HR) was then monitored during the measurement. Subjects without COPD (control group) were required to breathe normally (NB) during a 10 minute measurement of REE. Subjects with COPD were required to breathe for 10 minutes with each of the three relaxed breathing exercise patterns (pursed lip breathing, diaphragmatic breathing, a combination of both) and NB. The REE measured was compared with REE predicted using a formula computation (Harris Benedict equation). The REE measured during the different breathing patterns were also compared. Result: Thirty COPD and 26 control subjects were recruited in the study. Result showed that there was no change in heart rate before or during the test for both groups subjects. The measured REE was higher than the predicted REE in COPD group by 11.6% (p=0.000) but not in the control group (p=0.464). The measured REE and respiratory rate of all form of relaxed breathing exercises were significantly lower than neutral breathing. Further analysis showed the measured REE of neutral breathing was highest, followed by mixed relaxed breathing (MRB), then the diaphragmatic breathing (DBE) and pursed-lip breathing (PLB). The measured REE during relaxed breathing exercises was lower than neutral breathing which could be due to a lower work of breathing (WOB) when relaxed breathing exercises were used. Conclusion: The measured REE was higher than that predicted in subjects with COPD but not in the control group, suggesting that the measured REE did not accurately reflect the energy level in patients suffering from COPD. A breathing pattern with the lowest REE perhaps is more beneficial for patients with COPD as a lower level of energy expenditure could probably minimize weight loss in these patients.

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