Breathing exercises Flashcards
diaphragmatic breathing
■ Increase ventilation, improve gas exchange, decrease workload, facilitate relaxation, improve mobility of the chest wall
■ Facilitate outward motion of the abdominal wall while reducing upper rib cage motion during inspiration
■ Used for obstructive and restrictive pulmonary diseases, excessive secretions, tachypnea, postoperative care, posttrauma treatment
● Not the best technique for chronic pulmonary dysfunction
diaphragmatic breathing procedure
- Patient supine, sitting, or in semi-Fowler position
➤ Maintain posterior pelvic tilt (PPT), which can help facilitate use of the diaphragm - Place hand over subcostal angle of the thorax → apply gentle pressure throughout
exhalation (increase to firm pressure) - Ask patient to inhale
lateral costal breathing
■ Asymmetrical chest wall expansion; relieves localized lung consolidation or secretions
■ Most commonly in side-lying position with uninvolved side against the bed and arm of
the involved side abducted over the head
segmental breathing
■ Improve ventilation to hypoventilated lung segment, alter regional distribution of gas,
maintain or restore functional residual capacity
■ Used with pleuritic, incisional, or posttrauma pain that causes decreased movement in a
portion of the thorax (splinting) and for those at risk of developing atelectasis`
segmental breathing procedure
- Position patient to facilitate inhalation to certain segment (PD position, upright)
- Apply gentle pressure to thorax over area of hypoventilation during exhalation
(increase to firm pressure before inhalation) - Ask patient to breath in against resistance of PT’s hand → release resistance, allowing
for full inhalation
sustained max inspiration
■ Increase inhaled volume, restore functional residual capacity
■ Used in acute situations (posttrauma pain, postsurgery, acute lobar collapse, ineffective
cough)
■ Can be used during vibration techniques
sustained max inspiration procedure
- Inhale slowly through nose or pursed lips to maximal inspiration; hold for 3 seconds
- Passively exhale
■ Incentive spirometers (encourage deep inspiration) can help patient achieve maximal
inspiration during SMI
● Prevent alveolar collapse
● Commonly used after surgery
pursed lip breathing
■ Increase TV, reduce RR, reduce dyspnea, facilitate relaxation
● Better gas exchange!
■ Used for patients with obstructive disease who experience dyspnea at rest or with minimal activity
■ Positive back pressure due to pursed lips helps in preventing early airway collapse
■ Used to slow RR and decrease resistive pressure
pursed lip breathing procedure
■ Procedure
1. Slowly inhale through the nose
2. Passively exhale through pursed lips for 4 to 6 seconds (as if blowing out candle)
stacked breathing
■ Series of deep breaths that build on top of previous breaths without expiration until maxi-
mal volume can be tolerated
● Each inspiration is held with a minor hold
■ Used for hypoventilation, atelectasis, ineffective cough
■ Also used for uncoordinated breathing patterns during ADLs
upper chest inspiration technique
■ Used only after all other techniques have been attempted
■ Apply pressure to upper chest to limit excursion
■ Add more pressure each time
abdominal strengthening
Used when abdominal muscles are too weak to provide effective cough
■ Abdominal support: used when the abdominal muscles cannot provide necessary support for passive exhalation (high thoracic spine or cervical spine SCI)
● Make sure that binder does not restrict inspiration
■ Glossopharyngeal breathing (air gulping): can be taught to assist coughing
● Good for high-level cervical spine SCI (eg, C4)
Positioning for dyspnea relief
■ Leaning forward with arms supported → accessory muscles can act on rib cage and thorax, allowing for expansion and inspiration
