Effects of Imposed Pursed Lips Breathing on Breathing Pattern, Dyspnea and Pulmonary Function Test at Rest and During Exercise in COPD Patients

Chronic obstructive pulmonary disease (COPD) is a main and growing worldwide prevailing disease that has lacking consideration from medical practitioners. COPD is self-imposed by cigarette smoking and underlying pathology is commonly irreparable. This is main reason of morbidity and mortality in under developing countries, so quick response is necessary to be aware of disease signs and symptoms to provide valuable impediment and management programs.

In U.S public survey the way prevalence of COPD has figure out by questioning adult population in case they had one of seventeen pulmonary diseases in previous months. Asthma, bronchitis and emphysema listed in these 17 diseases to approximate the cases for prevalence of disease. In era of 2000, approx. 10 million people diagnosed with COPD by doctor. Along this calculation large ratio of COPD-ers left over under diagnosed. In different countries the occurrence rate varies from 3.5% in Hong Kong and Singapore to 6.7% in Vietnam. Taken as a whole the prevalence rate is higher in Asian Pacific countries about 6.3% as compared to World Health Organisation (WHO) report data that hypothesized the figure of 3.8%.

Dyspnea is a main cause for seek medical advice or referral to pharmacotherapy and pulmonary rehabilitation regimes to lessen the inflammation and spasm of airways in addition to self management approach for example breathing retraining techniques. COPD patients have inadequate exhalation time because of increased resistance in the airways with increase chance of collapse. While doing exercise airflow limitation exacerbates that leads to air trapping with shortened exhalation phase. This is noticeable by increase in expiratory lung volumes which causes reduction in exercise capacity that might be restricted by fatigue of their lower limb muscles other than the ventilatory causes. The disease severity can be decided through the intenseness of breathlessness therefore the primary aim of COPD management is dyspnea reduction.

Commonly used strategy for ventilatory pattern training is purse lips breathing technique (PLB). PLB is supposed to alter the ventilatory pattern as a result of that breathlessness is decreased. The action of PLB technique is to improve exhalation and prevent airway obstruction. The patient performs expiration actively by means of partly opened mouth by applying pressure of 5cm of water (H2O).

PLB reduces rapid and prolong breathing and causes increased level of Carbon dioxide (CO2) in alveoli. These improved levels may dilate the airway smooth muscles and V/Q ratio and O2 in circulation. PLB is worked by generating back pressure in airways in a way to open up the narrowed airways. It is also create positive pressure during expiratory phase to prolong the exhalation time in order to decrease expiratory lung volumes and increase in tidal volume.