How breathing can help with COPD

Chronic obstructive pulmonary disease, or COPD, is a term for a group of lung diseases, including chronic bronchitis and emphysema, that makes it hard to breathe. In patients with COPD (chronic obstructive pulmonary disease), each breath is something they have to focus on. Each breath is crucial not only for people with COPD but for every human being. Breathing is a gift and the essence of life.

Patients with COPD often experience increased mucus production and shortness of breath, which they describe as air hunger. When they feel breathless, they avoid physical activities and exercises, which makes their muscle weak leading to more worsening of symptoms. 

Since COPD is an obstructive pulmonary disease, the airways are narrowed and produce increased resistance to the airflow. The patients have trouble maintaining oxygen saturation resulting in hypoxemia (decrease oxygen concentration in the blood). Each cell of the body suffers from this distress. In acute exacerbation of COPD – a medical emergency characterized by a sudden spasm of muscles lining the respiratory tree – the shortness of breath even worsens and oxygen delivery to the tissues drops to a life-threatening level. (1)

COPD is a lifelong disease and requires strict compliance with medicine to prevent relapses. There are other measures that can help in lowering breathlessness associated with COPD, the most useful of which are breathing exercises.

What are the best breathing exercises for COPD?

Breathing exercises for COPD help get more oxygen into the bloodstream, strengthens muscles, and improves the quality of life. Here are the following breathing exercises. (2)

PURSED LIP BREATHING

Pursed lip breathing is a technique that allows people to control their oxygenation, ventilation, and shortness of breath. This technique promotes relaxation and aids in the release of air trapped in the lungs. Pursed lip breathing helps control shortness of breath, making each breath more effective. It helps get more oxygen into your lungs and carbon dioxide out of the lungs and calms you down. It also helps to keep airways open longer, removing the air that is trapped in the lungs by slowing down the breathing rate and relieving shortness of breath. To practice it:

  • Breathe in through your nose for 2 seconds.
  • Breathe out through the mouth for 4-6 seconds, with pursed lips.
  • Repeat several times. 

DIAPHRAGMATIC BREATHING

Diaphragmatic breathing, also known as deep breathing, is a technique used to strengthen the diaphragm, a major muscle of respiration. When the air gets trapped in the airways in COPD patients, the diaphragm has difficulty functioning, and that is why the Patients with COPD use muscles of the neck and shoulder to breathe rather than diaphragm. Diaphragmatic breathing is very beneficial for COPD patients, It helps them retrain the diaphragm to work better, so they can breathe more efficiently. It is quite easy to learn, and all you need is a comfortable place to sit or lay down. Here are the steps to do deep breathing: (3)

  • Get into a comfortable position with your back straight. 
  • Breathe in through the nose. Inhale slowly and deeply by counting to four as you hold the breath. 
  • Exhale all of the air through the nose. 
  • Place one hand on your stomach and the other on your chest. As you breathe in and out, feel the rise and fall of breathing more in the abdomen, than in the chest. You have to make the hand that rests over the stomach move more than the one on the chest. 
  • Take three more slow and deep breaths, allowing the body to become relaxed. 

CONTROLLED COUGHING

Increased mucus production, one of the prominent symptoms of COPD, can lead to shortness of breath, airway collapse, and an increased risk of infection if not cleared. 

An effective cough is the one that is controlled and comes from deep within the lungs, clearing away all the mucus in it. Controlled coughing loosens and moves mucus out of the airway. It also saves oxygen. (4)

  • Sit on a chair with both feet on the floor. Lean slightly forward. 
  • Fold both arms across your abdomen and breathe in slowly through your nose. 
  • Lean forward, and exhale. Pressing your arms into your belly. 
  • Slightly open your mouth and cough 2-3 times. Each cough should be sharp and short. 
  • Inhale through your nose gently and slowly. 
  • Rest and repeat if required. 

HUFF COUGH

Huffing or huff cough is gentle and controlled coughing for bringing up mucus all you have to do is: (5)

  • Sit in a comfortable position 
  • Take a breathe slightly deeper than normal
  • Make three rapid exhalations using your stomach muscles, making a “ha, ha, ha” sound

COPD Breathing exercise guidelines

  • Always consult a doctor or your healthcare provider before doing any breathing exercise. 
  • Start slow. Balance your exercise with rest. 
  • Keep a record of your breathing exercise.
  • Avoid cold or hot showers right after your exercise session. 

Breathing exercises give people a way to manage their symptoms, but these techniques can not take the place of medications and other oxygen therapies provided by the doctor. Think reassuring thoughts while doing breathing exercises and be consistent. 

References:

  1. Agusti A, Calverley PM, Celli B, Coxson HO, Edwards LD, Lomas DA, MacNee W, Miller BE, Rennard S, Silverman EK, Tal-Singer R. Characterisation of COPD heterogeneity in the ECLIPSE cohort. Respiratory research. 2010 Dec 1;11(1):122.
  1. Holland, A. E., Hill, C. J., Jones, A. Y., & McDonald, C. F. (2012). Breathing exercises for chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews, (10).
  1. Vitacca, M., Clini, E., Bianchi, L., & Ambrosino, N. (1998). Acute effects of deep diaphragmatic breathing in COPD patients with chronic respiratory insufficiency. European Respiratory Journal, 11(2), 408-415.
  1. Smith J, Woodcock A. Cough and its importance in COPD. International journal of chronic obstructive pulmonary disease. 2006 Sep;1(3):305.
  1. Burman, D., Ghuman, S., Jaiswal, V., & Ghodey, S. (2017). FACILITATING HUFF FOR AIRWAY CLEARANCE AND TO RELIEVE DYSPNEA IN SUBJECTS WITH COPD. Int J Physiother Res, 5(3), 2031-34.

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