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PubMed1981

[Kind, value and risks of known relaxation techniques in bronchial asthma (author's transl)].

Therapy and prophylaxis of Bronchial Asthma and cardiopulmonary consecutive diseases are commented upon with special reference to 1. indication and expected effectivity of scientifically based relaxation techniques, 2. some methods of treatment by gymnastics and breathing exercises as well by sports therapy, 3. nature, general risks and absolute contraindications by "modern" parascientific procedures.

Asthma↗
PubMedDate not supplied

Thoracic kyphosis in cystic fibrosis.

The incidence of thoracic kyphosis in 91 older children and adolescents suffering from cystic fibrosis was 15.1%. Only 5.5% of 91 hospitalized "normal" adolescents had the deformity. Among the group of patients with cystic fibrosis we found a positive correlation between incidence of kyphosis and severe pulmonary disease. Because the kyphosis does not seem to represent a problem in itself, and owing to the various and multiple problems of these young people, braces are indicated only in exceptional cases with rapidly progressing deformity. A program of proper stretching, thoracic extension, and breathing exercises should be recommended for such patients.

Cystic Fibrosis↗
PubMedDate not supplied

Psychogenic cough treated with biofeedback and psychotherapy. A review and case report.

Psychogenic cough is a barking or honking cough, which is persistent and disruptive to normal activity. The cough may be a debilitating condition that interferes with work and social relationships. Although the frequency of this condition is low, it is not rare. The majority of cases reported involve pediatric or adolescent patients. Surprisingly, there are scant data describing this condition in the adult population and no reports of biofeedback being used to treat this syndrome. We present a case report of an adult patient with psychogenic cough and review the available pediatric and adult literature. A 41-yr-old obese female presented with a complex 7-yr history of intractable, nonproductive, chronic cough. She had been avoiding social activities because of embarrassment by her repeated episodes of coughing. Extensive diagnostic work-up failed to find an organic etiology. Numerous medical and surgical treatments had failed. The patient was treated with a combination of biofeedback-assisted relaxation training, psychotherapy, and physical therapy. Review of the literature revealed only one report on adults, in which three of four patients were successfully treated with a combination of speech therapy, relaxation techniques, breathing exercises, and psychotherapy. Our success suggests a possible future use of this treatment protocol for cases of psychogenic cough.

Adult↗
PubMed1994

Respiratory dysfunction associated with traumatic injury to the central nervous system.

Pulmonary dysfunction is a common complication of head trauma and spinal cord injury. Abnormal breathing patterns reflect the influence of altered neural integration. Early arterial hypoxemia can result from ventilation-perfusion mismatching, microatelectasis, aspiration, fat embolism, or the development of the adult respiratory distress syndrome. Significant changes in lung volumes, ventilation, and gas exchange can occur in spinal cord injury as a result of the loss of diaphramatic or intercostal muscle function. Recruitment of accessory respiratory muscles plays an important role in stabilizing the rib cage and improving expiratory function. Strength training improves expiratory muscle function in quadriplegics and should be continued indefinitely. Most importantly, survival of patients with CNS injuries improves with meticulous and vigorous pulmonary hygiene. The pulmonary hygiene program should include regular changes in the patient's position, assisted coughing and deep breathing exercises, incentive spirometer, bronchodilators, fiberoptic bronchoscopy when indicated, and frequent monitoring of pulmonary mechanics. Long-term survival of the patient with head trauma or spinal cord injury is correlated to successful weaning from mechanical ventilation. Various forms of mechanical ventilator support can be adopted for the patient's ventilatory needs, and many patients will achieve some degree of freedom from mechanical ventilation. Newer ventilatory assist devices that do not require tracheostomy should be considered.

Brain Injuries↗
PubMed1994

[Stress in school-age children].

In April 1988, following preliminary research, Notre Dame Elementary School in Edmunston, N.B. initiated a pilot project entitled Management of Children's Stress. Using a three-dimensional process, parents, teachers and students collaborated to empower all students enrolled at the school to effectively manage their day-to-day stress. To prepare, the children, parents and teachers participated in nine- and 15-hour education sessions, respectively. Various techniques, including deep breathing exercises, stretching, relaxation techniques and listening to music, were considered. Visualization, maximizing the mind's potential to envision relaxing images, became the preferred technique. In addition to complementing other relaxation techniques used by the children, visualization facilitated their learning; developed and improved their concentration, motivation and self-confidence; gave them a positive self-image; and reduced health problems. The project has surpassed all expectations. In March 1993, it became part of a Quality of Life Education Project at the school.

Child↗
PubMed1977

A test for evaluation of peritoneo-venous shunt function: concise communication.

A simple imaging procedure has been devised for patients with peritoneovenous shunts when ascites reaccumulates and a decision must be made on whether or not to revise the shunt. A dose of 99mTc-sulfur colloid is injected into the peritoneal cavity and imaging of the abdomen and chest is performed 30 and 60 min later. After checking for tracer distribution throughout the peritoneal cavity, one looks for radioactivity in the liver and spleen and in the anterior chest tube. With a properly functioning shunt and effective breathing exercises, these are easily identifiable. If the shunt is obstructed, tracer activity will remain in the peritoneal cavity and thus cannot be identified in the liver or spleen.

Ascites↗
PubMed1993

Outpatient management of common problems in patients with chronic obstructive pulmonary disease.

Dyspnea, ineffective secretion clearance, and the potential for exacerbation are three common problems of patients with chronic obstructive pulmonary disease. Assessment and management of these problems are important in the overall care of this population. Teaching patients breathing exercises and secretion clearance techniques and referring them to comprehensive pulmonary rehabilitation programs improves functional capacity and quality of life.

Ambulatory Care↗
PubMed1993

[The effect of respiratory rehabilitation on the functional ventilation changes in the asthmatic child].

UNLABELLED: The aim of this study was to evaluate the improvement of lung function abnormalities during asymptomatic periods in children with perennial atopic asthma after physical respiratory rehabilitation and swimming (RR). MATERIAL AND METHODS: 240 lung function tests were performed regularly by whole-body plethysmography during asymptomatic periods on 68 atopic asthmatic children aged 5-13 (means 8.7 y), in a follow up four years study (1983-87). TLC, VC, FEV1, Raw, MEF50, RV and TGV were recorded. We selected TGV for measured hyperinflation, Resistance (Raw) for bronchial obstruction and MEF50 for small airways obstruction. We divided these children population in two groups: group A control (20 subjects, means 9.3 y. age) immunotherapy (IT) alone; group B (48 subjects, means 8.03 y. age) IT and respiratory rehabilitation and swimming. Furthermore, we compared the evolution of the lung function according to the severity of asthma on B group alone. RESULTS: the number of hyperinflated or bronchial obstructed children who did RRS is significantly smaller than on the control group. Nevertheless, breathing exercises and swimming has no effect on peripheral airway obstruction. When we compared the effect of asthma on B group alone, we noted that the recovery of lung abnormalities were observed on the great majority of mild and moderate hyperinflated and bronchial obstructed asthma. In severe asthma, the results were not so good, particularly on bronchial and peripheral airway obstruction. In these last cases the functional prognosis will be uncertain. CONCLUSION: respiratory rehabilitation and swimming have an unquestionable effect on improvement of hyperinflated asthmatic children, some effect on improvement on permanent bronchial obstruction, and without any benefit on permanent peripheral airway obstruction. Lung function tests might be monitored the RR in all asthmatic children with lung function impairment.

Adolescent↗
PubMed1993

Mood change and perceptions of vitality: a comparison of the effects of relaxation, visualization and yoga.

The effects of three different procedures, relaxation, visualization and yogic breathing and stretch (pranayama) on perceptions of physical and mental energy and on positive and negative mood states have been assessed in a group of normal volunteers (N = 71, age range 21-76). Pranayama produced a significantly greater increase in perceptions of mental and physical energy and feelings of alertness and enthusiasm than the other two procedures (P < 0.5). Relaxation made subjects significantly more sleepy and sluggish immediately after the session than pranayama (P < 0.05). Visualization made them more sluggish but less content than pranayama (P < 0.05) and more upset than relaxation after the second session (P < 0.05). Thus, a 30 min programme of yogic stretch and breathing exercises which is simple to learn and which can be practised even by the elderly had a markedly 'invigorating' effect on perceptions of both mental and physical energy and increased high positive mood. A more extensive investigation is planned to establish whether such a programme can readily be incorporated into everyday life, and with what long-term results.

Adult↗
PubMed1977

[Prevention of complications after lung resection (author's transl)].

Experiences with prophylaxis of postoperative complications in 1179 lung resections (1960 to 1974) are discussed. Preoperatively exercises in breathing, inhalations with mucolytic and proteolytic drugs, in some cases therapeutic bronchosopy are used. An atraumatic thoracotomy with minimal cutting of muscles is preferred. In the postoperative course early mobilization of the patients and substitution of large amounts of fluid are used. The number of postoperative complications was reduced from 15,2% (1960 to 1966) to 2,6% (1971 to 1974). Artificial respiration or postoperative therapeutic bronchoscopy were not necessary during the last 6 years.

Breathing Exercises↗
PubMed1995

[Rehabilitation of patients with respiratory problems--bronchogenic carcinoma].

Rehabilitation of the patients suffering from the pulmonologic problems with the bronchogenic cancer under our circumstances has not, practically, been established. There are neither physiotherapy nor kinesiology methods in rehabilitation. It would be necessary to appoint a team, consisting of: pulmonologist, physiatrist, physiotherapist and nurses with the consultation of the service corresponding the needs of the bronchogenic carcinoma problems. Basic breathing exercises principles, prior and post operative ones, kinesiotherapy and posture drainage techniques were presented in the paper.

Carcinoma, Bronchogenic↗
PubMed1998

Pain control in voluntary surgical contraception.

The reduction of anxiety and control of pain in 1,546 clients undergoing voluntary surgical contraception (VSC) is presented. Psychological support through adequate counselling and abdominal breathing exercises are vital. General anaesthesia was used in 254 (16.4%) of the clients; sedation plus local anaesthetic agents in 296 (19.2%) while local anaesthetic alone was used in 996 (64.4%) of clients. There was progressive shift from the use of general anaesthesia (GA) to local anaesthesia (LA), particularly for the minilaparotomy procedure following the introduction of Association for Voluntary Surgical Contraception (AVSC) programme in our department since this type of anaesthesia was cheap, safe, affordable and readily available. Recommendations for successful VSC techniques include gentle tissue handling, proper use of the correct instruments to reduce painful stimuli, while low dose intravenous sedation should be used only when necessary. Minilaparotomy under local anaesthesia (ML/LA) has been successfully established in Jos University Teaching Hospital, Jos, Nigeria.

Adult↗
PubMed1998

Outpatient management.

The successful management of outpatients with COPD requires a multifaceted approach that includes prophylactic, palliative, and life-extending therapies. All patients should undergo smoking cessation, avoid potentially harmful environments, and receive influenza and pneumococcal vaccines at recommended intervals. Although medical therapy may yield only marginal benefits in patients with minimal airway responsiveness, even small improvements may translate into significant functional benefits and will be greatly appreciated. Therefore, every effort should be expended to optimize the patient's medical regimen and to ascertain that methods of delivery (such as use of spacers) are as recommended. Physical therapy measures may be useful in patients with copious sputum production, and pursed-lip and diaphragmatic breathing exercises may reduce dyspnea and lend a sense of control to patients with severe flow limitation. Oxygen therapy is the only modality demonstrated to improve survival in patients with severe COPD and may give symptomatic relief to some patients. Its use, however, is restricted to patients meeting guidelines for hypoxemia, and although dyspneic patients not meeting these guidelines may desire oxygen, insurers will decline coverage for them. Newer modalities, such as noninvasive ventilation, may improve gas exchange and quality of life in some patients with hypercapnia and nocturnal oxygen desaturations, but subgroups of COPD patients who benefit have not been well-defined, and pending further investigation, guidelines for use should be considered tentative. Patients should be encouraged to enter a comprehensive rehabilitation program, but if one is unavailable or the patient declines, a rehabilitation approach should be applied. Practitioners should attempt to educate patients at each visit, offering advice not only on medications, but also on regular exercise, good nutrition, and ways of coping psychologically with chronic illness. By taking such a comprehensive and caring approach, and being available to assist with problems and crises, the practitioner can help to enhance the quality and length of the COPD patient's life.

Acute Disease↗
PubMed1997

Ventilatory response to exercise in subjects breathing CO2 or HeO2.

To investigate the effects of mechanical ventilatory limitation on the ventilatory response to exercise, eight older subjects with normal lung function were studied. Each subject performed graded cycle ergometry to exhaustion once while breathing room air; once while breathing 3% CO2-21% O2-balance N2; and once while breathing HeO2 (79% He and 21% O2). Minute ventilation (VE) and respiratory mechanics were measured continuously during each 1-min increment in work rate (10 or 20 W). Data were analyzed at rest, at ventilatory threshold (VTh), and at maximal exercise. When the subjects were breathing 3% CO2, there was an increase (P < 0.001) in VE at rest and at VTh but not during maximal exercise. When the subjects were breathing HeO2, VE was increased (P < 0.05) only during maximal exercise (24 +/- 11%). The ventilatory response to exercise below VTh was greater only when the subjects were breathing 3% CO2 (P < 0.05). Above VTh, the ventilatory response when the subjects were breathing HeO2 was greater than when breathing 3% CO2 (P < 0.01). Flow limitation, as percent of tidal volume, during maximal exercise was greater (P < 0.01) when the subjects were breathing CO2 (22 +/- 12%) than when breathing room air (12 +/- 9%) or when breathing HeO2 (10 +/- 7%) (n = 7). End-expiratory lung volume during maximal exercise was lower when the subjects were breathing HeO2 than when breathing room air or when breathing CO2 (P < 0.01). These data indicate that older subjects have little reserve for accommodating an increase in ventilatory demand and suggest that mechanical ventilatory constraints influence both the magnitude of VE during maximal exercise and the regulation of VE and respiratory mechanics during heavy-to-maximal exercise.

Aged↗
PubMed1989

Heart rate response to breath-holding during supramaximal exercise.

The cardiovascular responses to breath-holding (BH) during short-lasting supramaximal exercise (415 W) on a cycle ergometer were investigated in 15 healthy male subjects. The arterial oxygen saturation, heart rate (HR), endtidal PO2 and PCO2 were continuously monitored. Firstly, 15 subjects performed exercise during BH, preceded by air breathing (air-BH test), and secondly, exercise without BH. Then 9 of the subjects performed the same procedure as in the air-BH test, except that all subjects breathed 100% O2 for 1 min before apnoea (O2-BH test). In 2 of these subjects, the systemic arterial blood pressure was continuously measured via a catheter in the radial artery and plasma catecholamine concentration [CA] was also measured both during the air-BH and the O2-BH tests. In the later period of the air-BH test, the high HR level became progressively depressed. This response, however, was absent in the O2-BH test. There was a late increase in the arterial blood pressure in both tests, and both tests produced hypercapnia. Only the air-BH test resulted in hypoxia, substantial hypertension and HR-depression. The increase in plasma CA was similar in both tests. The marked HR-depression demonstrated here is ascribed mainly to activation of the peripheral arterial chemoreceptors by asphyxia, and partially to baroreceptor activity due to elevated blood pressure.

Adolescent↗