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At least 991 records · Page 55Linked to original sources
PubMed1986

Pursed lips breathing training using ear oximetry.

Pursed lips breathing (PLB) training is often used in the management of patients with chronic obstructive lung disease (COLD). Previous clinical studies have demonstrated that PLB improves arterial oxygen saturation (SaO2) and CO2 removal as well as relieving dyspnea. Twelve hypoxemic subjects with stable COLD were randomly assigned to either the pursed lips (P) or control group consisting of general relaxation (R). The SaO2 was monitored via ear oximetry, and respiratory rate and tidal volume were monitored using a strain gage transducer and the minute volume was calculated. The PLB was taught by an experienced instructor using the ear oximeter as a monitoring display with a goal toward increasing SaO2. The subject was taught general relaxation (Rlx) with the aid of pleasant music. We compared PLB and Rlx treatments using an A-B-A crossover study design. In both groups, PLB significantly improved SaO2 over baseline (p less than 0.001) whereas Rlx did not. We conclude that patients can learn to increase their SaO2 by PLB using ear oximetry adjunctively.

Aged↗
PubMed1986

Pulmonary rehabilitation for the elderly.

The elements of a pulmonary rehabilitation program require a variety of different skills. However, the number of people involved in a rehabilitation program will vary with the clinical setting and the number of patients served. In a large program, a physician, respiratory nurse, physical and occupational therapist, psychologist, social worker, respiratory therapist, and dietitian might all be involved on a full- or part-time basis. In other settings, two or three individuals, mostly working part-time, may be the entire team. Pulmonary rehabilitation may be performed on an outpatient basis, in a group practice setting, or in an inpatient hospital unit. Whatever its size, a system must be developed that allows for thorough initial evaluation of patients, formation of rational goals with the patient, adequate time for patient education and training, ongoing re-enforcement to consolidate and maintain gains, and an appropriate means of intervention when the patient experiences an exacerbation of his disease. It should also be recognized that in many areas of the country, there are too few patients and scarce medical resources to mount an intensive pulmonary rehabilitation program. In such instances, referral can be made to larger medical centers. More importantly, the individual practitioner can successfully incorporate many of the elements of pulmonary rehabilitation into his practice by taking the time and effort necessary to ascertain how illness affects the daily lives of the patient with COPD and then addressing patient concerns in an ongoing, comprehensive manner.

Activities of Daily Living↗
PubMed1986

Comparison of isocapnic hyperventilation and walking exercise training at home in pulmonary rehabilitation.

Eighteen COPD patients enrolled in a comprehensive, multidisciplinary pulmonary rehabilitation program were randomly assigned to perform either: 1) walking, or 2) ventilatory muscle exercise training (VMT) using a prototype, portable device for isocapnic hyperventilation training. Both groups performed exercise training at home. Twelve patients completed the study and follow-up evaluation (five VMT, seven walkers). Pulmonary function did not change in either group. For the VMT patients, there were modest increases in ventilatory muscle endurance and exercise performance. VO2max and VEmax increased significantly. For the walkers, only walking endurance time increased significantly. These results indicate that isocapnic hyperventilation exercise training can be performed successfully by COPD patients in an unsupervised home setting and can lead to improvement in both ventilatory muscle endurance and exercise performance. Walking exercise training did not improve ventilatory muscle endurance.

Aged↗
PubMed2004

Evidence of exercise-induced arterial hypoxemia in prepubescent trained children.

Exercise-induced arterial hypoxemia (EIAH) is a recognized phenomenon in highly trained adults. Like adult athletes, prepubescent trained children may develop high-level metabolic demand but with a limited lung capacity in comparison with adults. The purpose of this investigation was to search for evidence of EIAH in prepubescent trained children. Twenty-four prepubescent (age: 10.3 +/- 0.2 y) trained children (10.0 +/- 0.7 h of weekly physical activity) performed pulmonary function tests and a graded maximal exercise test on a cycle ergometer. EIAH was defined as a drop of at least 4% from resting level arterial oxygen saturation (Sao(2)) measured by pulse oximetry. EIAH was observed in seven children. Forced vital capacity (FVC), ventilatory response to exercise (Delta(E)/Deltaco(2)), and breathing reserve at maximal exercise were significantly lower, whereas tidal volume relative to FVC was higher in hypoxemic children than in nonhypoxemic children; weekly physical activity and maximal oxygen uptake were similar. Moreover, positive relationships were found between Sao(2) at maximal exercise and breathing reserve (r = 0.56; p < 0.05) or volume relative to FVC (r = 0.70; p < 0.01). EIAH may occur in prepubescent trained children with a relatively low maximal oxygen uptake (42 mL. min(-1). kg(-1)); however, the mechanisms remain unclear and need to be investigated more accurately.

Adult↗
PubMed2004

[Development of 'Ordnungstherapie' by Bircher-Benner in naturopathy of the 20th century].

BACKGROUND: The German term 'Ordnungstherapie' is one of the five therapeutics which defines naturopathy in German-speaking countries. OBJECTIVE: Who formed the term Ordnungstherapie in naturopathy and what does it mean? MATERIAL AND METHODS: Heuristics and criticism of literature of the 20th century as well as database research. RESULTS: Nowadays in German-language medical books Ordnungstherpie belongs to the five therapeutics which define European naturopathy. Yet, the interpretation ranges from health education to body-orientated forms of psychotherapy. The term Ordnungstherapie is often related with the German priest and hydropath Sebastian Kneipp, however, term and definition have been founded by the Swiss physician Maximillian Bircher-Benner. In 1937 he defined Ordnungstherapie as a complex concept of natural healing. It is based upon the rather nosological idea that health is order/harmony in the human body (physically, psychologically), the environment and the daily course. Illness occurs if disorder appears in one of these fields. The therapeutic setting of Ordnungstherapy is defined by 9 rules of conduct to maintain order, which include nutrition, the skin as an organ (exposure to light, air, water), breathing, movement, rhythm of life, and psyche. For all these aspects Bircher-Benner himself uses the terms somatotherapy (dietotherapy, sun and light therapy, hydrotherapy, exercise therapy, breathing technique, order of the rhythm of live) and psychotherapy. He chose these complementary methods subjectively after learning them from 1897 onwards in an eclectic manner and after gaining therapeutic empiricism. Nevertheless his ideas of the Ordnungstherapie correlate with the socio-political context of the 1940ies. CONCLUSIONS: The term Ordnungstherapie was introduced by Bircher-Benner as an umbrella term in 1937 to describe a complex concept of naturopathic therapies. It comprises, with certain limitations for phytotherapy, the therapies which nowadays define European naturopathy. Yet, in European naturopathy today Ordnungstherapie is mostly considered as one out of 5 constituents of naturopathy (dietotherapy, hydrotherapy, exercise therapy, phytotherapy, Ordnungstherapie). The classification of Ordnungstherapie as one of the 5 pillars of the Kneipp therapy was only done by Kneipp physicians in the middle of the 20th century and needs to be thought over.

Germany↗
PubMed1988

Control of blood-gas and acid-base status during isometric exercise in humans.

1. At a given level of pulmonary gas exchange, ventilation (VE) is appreciably higher during isometric exercise than during isotonic exercise. It is presently not clear whether the resultant hypocapnia represents a compensatory hyperventilation for an arterial metabolic acidaemia or whether it might reflect a primary respiratory alkalaemia. 2. To resolve this issue, five subjects performed isometric leg exercise designed to induce exhaustion in ca. 5 min and, on a separate occasion, ca. 8 min. VE, CO2 output (VCO2), O2 uptake (VO2) and end-tidal gas tensions (PET,CO2, PET,O2) were measured breath-by-breath during exercise and recovery; arterialized venous blood (drawn from the dorsum of the heated hand) was sampled frequently and analysed for PCO2, PO2, pH, bicarbonate and lactate. These response profiles were compared with those resulting from exhausting bouts of isotonic leg exercise (cycle ergometry) of similar duration. 3. The isotonic exercise induced a metabolic (lactic) acidaemia with partial respiratory compensation. In contrast, isometric exercise consistently resulted in a respiratory alkalaemia, with little or no increase of blood [lactate]. At the end of the isometric exercise, VE fell abruptly and then rose again after a short interval (20 s, on average). This secondary stimulation presumably reflected the acid-base consequences of the increased blood [lactate] (3-5 mM, on average) which occurred in the recovery phase. 4. We therefore conclude that a primary respiratory alkalaemia occurs during isometric exercise, and that this results from ventilatory stimulation at a time when the 'exercise' metabolites are trapped within the contracting muscles as a consequence of impeded blood flow. The initial rapid reduction of ventilation which occurred at the cessation of the isometric exercise is consistent with a washing-out of 'hyperpnoea-inducing' metabolites from the muscles. Allowing for transit to the central circulation, the reduced ventilation is subsequently supplemented by a powerful humoral drive to breathe which results in a further hyperpnoea and secondary hypocapnia. Because of its latency, we hypothesize that this secondary hypocapnia is of peripheral chemoreceptor origin. 5. The ventilatory response profile for isometric exercise, and the subsequent recovery phase, supports the contention that both the exercising muscles and the peripheral chemoreceptors can be important sites for inducing hyperpnoea in humans.

Acid-Base Equilibrium↗
PubMed1980

The effect of training on strength and endurance of the diaphragm in quadriplegia.

The diaphragmatic electromyogram was used to detect fatigue of the diaphragm in six chronic quadriplegics while they breathed for 10 minutes against a variety of inspiratory resistances. The maximum static inspiratory mouth pressure was measured at functional residual capacity (Pmmax) and from the electromyogram the critical inspiratory mouth pressure that developed in each inspiration (Pmcrit) below which electromyographic changes of diaphragmatic fatigue do not develop was estimated. The measurements were repeated after 8, 12 and 16 weeks of inspiratory muscle training consisting of inspiring for a period of 30 minutes daily, six days a week, against a resistance just sufficient to produce the electromyographic changes of fatigue. A significant and progressive increase in Pmmax and Pmcrit was found during the training. It was concluded that (1) quadriplegics are predisposed to the development of inspiratory muscle fatigue due to reduced muscle strength and reduction in endurance, and (2) in these patients inspiratory muscle training increases both strength and endurance, and protects against fatigue.

Adolescent↗
PubMed1975

Respiratory care following open heart surgery.

Respiratory care of patients undergoing open heart surgery should begin in the preoperative period. Patients must stop smoking, and if obese they are encouraged to lose weight. Pulmonary infection is treated and secretions must be eliminated. Postoperative hypoxemia, which is an expected event following anesthesia and surgery, is aggravated by circulatory instability and pulmonary complications. Following open heart surgery pulmonary complications such as atelectasis, congestion, edema, postperfusion lung, pneumothorax, pleural effusion, and hemothorax are common. Respiratory care should be planned to avoid these complications and to treat them promptly should they occur. Routinely every patient is mechanically ventilated for at least 12 to 18 hours following surgery. The type of ventilator used and its parameters are adjusted according to the clinical condition of the patient to maintain adequate oxygenation and to prevent any respiratory acidosis. When indicated, PEEP is applied to improve arterial oxygenation. Respiratory care is extended for at least 5 days after termination of artificial ventilation. Oxygen therapy is given with either a nasal catheter or a mask, according to the patient's need. IPPB and physiotherapy are continued until the patient shows no signs of pulmonary infection and is capable of effectively eliminating secretions. This routine management and extended postoperative respiratory care definitely contribute to the successful outcome of open heart surgery.

Breathing Exercises↗