Breathing Exercises

Question 1

What position can a patient use to find relief from Dyspnea?

Answer 1

Patient leans forward on supported hands

• Increases intraabdominal pressure, pushing the diaphragm up into a lengthened position
• increases strength of contraction

Question 2

What is Pursed-Lip Breathing and what is it used for?

Answer 2

Patient instructed to inhale through the nose for several seconds, then exhale through pursed lips slowly. (Lips in a whistling/kissing position) - Maintaining patent airways

• used to decrease dyspnea
• slow patients respiratory rate
• decreasing airway collapse during expiration (present in advanced stages of COPD)

Question 3

What is Paced Breathing?

Answer 3

The volitional coordination of breathing during activity.

• breathing can be coordinated with the rhythm of activity
• used to help patient control their respiratory rate

Question 4

What is the Inspiratory Hold Technique?

Answer 4

Prolonged holding of breath at maximum inspiration

• With vibration techniques, aid in airway clearance
• May improve flow of air to poorly ventilated regions of lungs

Question 5

What is Stacked Breathing?

Answer 5

Series of deep breaths, that build on top of the previous breath without expiration.

Done until a maximal volume is tolerated.

Each inspiration followed by a brief inspiratory hold.

Question 6

What is Diaphragmatic Breathing?

Answer 6

Used to manage: Dyspnea, reducing atelectasis, and increasing oxygenation.

Decreases use of accessory muscles and increases recruitment of the diaphragm.

• Facilitating outward motion of the abdominal region while reducing upper rib cage motion during inspiration
• may be easiest to this in the supine position. Then to sitting, then standing, finally during activity.

Question 7

What techniques/positions can facilitate recruitments of the diaphragm?

Answer 7

Positioning patient with a Posterior Pelvic Tilt

Sniffing in a gravity eliminated position (side lying or semi-Fowler Position)

Question 8

What is Lateral Costal Breathing?

Answer 8

Unilateral costal expansion or bilateral costal exercise to address one side or both sides.

• When patient have limited chest wall expansion to a specific side secondary to incisions.

Question 9

What is Butterfly Breathing?

Answer 9

Upright version of the counter-rotation technique. Used when patient has good motor control.

• Unsupported sitting, therapist assist patient with bring their arms up into a butterfly position
• Inspiration; increase shoulder flexion
• Expiration; Lower arms

Used to increase tidal volume and decrease respiratory rate.

Question 10

Indications for using Pursed-Lip Breathing?

Answer 10

Dyspnea at rest, or with exertion

Wheezing

Question 11

Indication for using Diaphragmatic Breathing?

Answer 11

Hypoxemia

Tachypnea & Anxiety

Atelectasis

Excess Pulmonary Secretions

Question 12

Indications for using Lateral Costal Breathing?

Answer 12

Asymmetrical Chest Wall Expansion
Localized Lung Consolidation or secretion
Asymmetrical Posture

Question 13

Indications for using Inspiratory Hold Technique?

Answer 13

Hypoventilation
Atelectasis
Ineffective Cough

Question 14

Indications for using Stacked Breathing?

Answer 14

Hypoventilation
Atelectasis
Ineffective Cough
Pain
Uncoordinated Breathing Pattern

Question 15

Indications for using Paced Breathing?

Answer 15

Low Endurance and Fatigue

Dyspnea on Exertion

Anxiety and Tachypnea

Question 16

Indications for using Upper Chest Inhibiting Techniques?

Answer 16

Excessive use of accessory muscles during breathing

Question 17

Indications for using Butterfly Technique?

Answer 17

Impaired chest wall mobility
Hypoventilation
Impaired trunk muscle performance/tightness
Ineffective Cough