Breathing Exercise

Outline:
•Definition
•Indications
•Goals of Breathing Exercise
•Types of Breathing Exercise
What is Breathing Exercise?
Breathing Exercise

Is a appropriate to refer to the “work

of breathing ” concept in discussing
methods of improving breathing
patterns.
Indications for Breathing
Exercise
 Indications for Breathing Exercise
1.Pain: from surgery or trauma
2.Nervousness, apprehension.
3.Surgical procedures such as thoracic surgery or
abdominal surgery
4.Bronchospasm
5.Airway Obstruction
6.Atelectasis
7.Restriction due to musculoskeletal abnormalities,
obesity, pregnancy, increased gas in the stomach,
pulmonary pathology such as fibrosis or secondary
pulmonary effects such as in scleroderma
8.CNS deficit
9.Narcotic Medication or Drug Overdose
10.Pulmonary Disease, either primary or
secondary
11.Neurogenic patients with muscle weakness
12.Pulmonary Emboli
13.Pulmonary Edema or congestive heart failure
14.Ventilatory disturbances
15.Patient on ventilator
16.Pleural reactions
17.Debilitated or bedridden patients
Goals of Breathing Exercise
Goals of Breathing Exercise

1.To improve ventilation

2.To prevent atelectasis
3.To decrease the work of breathing
4.To increase cough efficiency
5.To increase strength, coordination
and efficiency of respiratory
muscles
6.To teach the patient’s
determination to help himself and
gain confidence
7. In his ability to control his
breathing.
8.To help the patient relax
9.To mobilize and maintain mobility
of the chest wall.
Types of Breathing Exercise
 Types of Breathing Exercise

1. Diaphragmatic Breathing
2. Ventilatory Muscle Training
3. Segmental Breathing
4. Glossopharyngeal Breathing
5. Pursed-lip Breathing
 Diaphragmatic Breathing
• The diaphragm is the most efficient muscle of
breathing. It is a large, dome-shaped muscle located
at the base of the lungs. Your abdominal muscles help
move the diaphragm and give you more power to
empty your lungs. But chronic obstructive pulmonary
disease (COPD) may prevent the diaphragm from
working effectively.
• Attempts to enhance movement of the diaphragm
upon inspiration & expiration & diminish accessory
muscle use.
 Procedure

1. Lie on your back on a flat surface or in

bed, with your knees bent and your head
supported. You can use a pillow under
your knees to support your legs. Place
one hand on your upper chest and the
other just below your rib cage. This will
allow you to feel your diaphragm move
as you breathe.
2. Breathe in slowly through your nose so
that your stomach moves out against
your hand. The hand on your chest should
remain as still as possible.
3. Tighten your stomach muscles, letting
them fall inward as you exhale through
pursed lips
 To perform this exercise while sitting in a chair
• Sit comfortably, with your knees bent and your shoulders,
head and neck relaxed.
• Breathe in slowly through your nose so that your stomach
moves out against your hand. The hand on your chest should
remain as still as possible.
• Place one hand on your upper chest and the other just below
your rib cage. This will allow you to feel your diaphragm move
as you breathe.
• Tighten your stomach muscles, letting them fall inward as you
exhale through pursed lips (see "Pursed Lip Breathing
Technique"). The hand on your upper chest must remain as still
as possible
 Ventilatory Muscle Training

• Is the process of improving the strength or

endurance of the muscles of breathing.
Ventilatory Muscle Training has been used in
treatment of patient’s with a variety of acute or
chronic pulmonary disorders associated with
weakness, atrophy or inefficiency of the muscles
of inspiration, specifically the diaphragm and
external intercostal.
3 forms of Ventilatory Muscle Training
• Weight training to strengthen the diaphragm
• Inspiratory resistance training- breathing devices are
used to improve the strength and endurance of the
muscles of inspiration and decrease the occurrence of
inspiratory muscle fatigue
• Incentive Spirometry- is a form of low-level resistance
training that emphasizes sustained maximal
inspiration.
A synonymous term is sustained maximal inspiratory
maneuver which is performed with or without the use if
spirometer
 Segmental Breathing

• To emphasize expansion on problem areas

of the lungs or chest wall.
 3 Types of Segmental Breathing

• Lateral costal expansion

• Posterior basal expansion
• Apical expansion
 Procedure

• Patient position hook lying or sitting

• Place your hands along lateral aspect of lower ribs to
fix the patient’s attention to the areas at which
movement is to occur
• Ask Patient to breathe out, and feel the rib cage move
downward and inward
• As Patient breathes out, place firm pressure into the
ribs with palm of hand.
• Just prior to inspiration, apply a quick downward and
inward stretch to the chest.
• Tell Patient to expand the lower rib area against your
hands as he breathes in
• Apply gentle manual pressure to lower rib area as the
Patient breathes in and chest expands and ribs flares
• As Patient breathes out, assist by gently squeezing
the rib cage in a downward and inward direction.
• Teach Patient to be independent with segmental
breathing technique
 Glossopharyngeal Breathing

• It is also called a Frog Breathing

• Glossopharyngeal breathing is a form of
positive pressure breathing technique that
can be used to assist failing respiratory
muscles
 Procedure

• The mouth is open, allowing the air to enter the oral

and pharyngeal cavities
• While the mouth is sealed by the lips or the tongue,
muscles of the tongue and pharynx are used to propel
small volumes of air into the lower airways through
the open glottis, which is raised during the maneuver.
• Closure of the glottis ensures that the air is trapped
into the lungs while preparing for the next gulp of air.
 Pursed-lip Maneuver

respiration characterized by deep inspirations

followed by prolonged expirations through
pursed lips. It is done to increase expiratory
airway pressure, improve oxygenation of the
blood, and help prevent early airway closure.
 Procedure
• Relax your neck and shoulder muscles.
• Breathe in (inhale) slowly through your nose for two counts,
keeping your mouth closed. Don't take a deep breath; a
normal breath will do. It may help to count to yourself: inhale,
one, two.
• Pucker or "purse" your lips as if you were going to whistle or
gently flicker the flame of a candle.
• Breathe out (exhale) slowly and gently through your pursed
lips while counting to four. It may help to count to yourself:
exhale, one, two, three, four