BREATHING EXERCISES Flashcards
What is the technique for diaphragmatic breathing
- Slow inspiration (4-5s) to allow for air to go to lower lung zones
- Relaxed expiration (for sustained time)
- Monitor chest movement
- Prescription is usually 10 breaths/set for every waking hour
What are some variations to diaphragmatic breathing
- Positional changes
- Verbal explanation or visualization cues
- Demonstrations
- tactile cueing
- Calming voice if patient is in respiratory distress/experiencing dyspnea
Indications for diaphragmatic breathing
- Post-operative patients
- Respiratory failure
- Chronic respiratory disease
What is the evidence based practice for diaphragmatic breathing
- Increases lung compliance & expansion
- Reduces V/Q mismatch
- Decreases dead space
- Replenishes surfactant
- prevent destuartion
- diminish breathlessness
- Increase inspiratory muscle strength
What is the technique for diaphragmatic breathing with maximum end inspiratory hold
- Slow sustained diaphragmatic breath with a hold of 3-5 seconds OR slow continuous inspiration (post reaching total lung capacity), for 3-5 seconds. relaxed expiration
What is the evidence based practice for diaphragmatic breathing with maximum end inspiratory hold
- Produces a more uniform distribution of ventilation b/w apices and bases compared to rapid inspiration
- Uses collateral channels of ventilation
- Allows for a longer time period for gas exchange to occur
What are the contraindications for diaphragmatic breathing with maximum end inspiratory hold
- COPD and/or asthma
What are collateral channels
the ventilation of alveolar structures through passages or channels that bypass the normal airways
What are 4 types of collateral channels
- inter-bronchiolar
- inter-alveolar
- bronchiolo-alveolar
- interlobar
What is the technique for lateralcostal breathing and prescription
- Slow inspiration (4-5 sec) to allow for air to go to lower lung zones
- Emphasis is on lateral expansion of rib cage
- Relaxed expiration
- Monitor upper chest movement (should be relaxed)
- Prescription is usually 10 breaths/set for evert waking hour
What is the technique for pursed lip breathing
- Pucker lips with slow expiration
- Expiration is usually double the time of inspiration
- usually done sitting or standing
- Inspiration 2x expiration
What is the evidence based practice for pursed lip breathing
- Primarily beneficial for those with COPD
- Pursed lip = increase pressure and increased exhalation time, keeps air tracts open and air in system for longer
What is the technique for segmental breathing
- localized breathing to a lobe of a lung
- uses tactile input and pressure to increase expansion of specific areas
What is the evidence based practice for segmental breathing
- Healthy individuals are able to direct oxygen to upper or lower regions upon instruction
What is the technique for incentive spirometry
- Sustain inspiration effort ~3 seconds, then perform relaxed expiration
- max inspiration to TLC
- Gives visual input and provides incentive goal
What are 2 types of incentive spirometry
- Flow sensitive
2. Volume sensitive
What is the evidence for incentive spirometry
- No evidence for the use of IS to prevent post-operative pulmonary complications in upper abdominal surgeries & post CABG
- PT alone or with IS reduces PPC following thoracic surgery BUT can not be replaced with just IS
What is the technique for breath stacking
- Used when deep breathing is too painful
- Take a breath - hold - add another breath - hold and repeat this patten until TLC is reach or as close to TLC as possible
- Relaxed slow exhalation
- Typically repeated 2 or 3 times
What is the evidence for breath stacking
- Aids clients who are hesitance to breath due to pain
What is the technique for SOS for SOB
- Stop and rest in a comfortable position
- Get you head down
- get your shoulders down
- Breath in through you mouth
- Blow out through your mouth
- Breath in and blow out as fast as necessary
- Begin to slow your breathing
- Begin to use your nose
- Begin diaphragmatic breathing
- Stay in position for 5 minutes longer
When is SOS for SOB used
mainly for respiratory distress in COPD patients
What is the technique for Rib Springing
- Chest compression followed by overpressure and quick release at end expiration
- Can be combined with percussion and vibrations
Rib springing is thought to cause…
deeper subsequence inspiration
What is the evidence for ribs springing
none to date
