Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Nov-Dec;22(6):452-458.
doi: 10.1016/j.bjpt.2018.04.005. Epub 2018 Apr 17.

Can diaphragmatic breathing modify chest wall volumes during inspiratory loaded breathing in patients with heart failure?

Susan Martins Lage  1 , Raquel Rodrigues Britto  2 , Daniella Cunha Brandão  3 , Danielle Aparecida Gomes Pereira  2 , Armèle Dornelas de Andrade  3 , Verônica Franco Parreira  4
Affiliations

Can diaphragmatic breathing modify chest wall volumes during inspiratory loaded breathing in patients with heart failure?

Susan Martins Lage et al. Braz J Phys Ther. 2018 Nov-Dec.

Abstract

Background: Some inspiratory muscle training protocols for patients with heart failure report the request of diaphragmatic breathing during inspiratory loaded breathing. However, it is unclear whether this condition modifies the chest wall volumes.

Objective: The primary purpose was to evaluate chest wall volumes during inspiratory loaded breathing as well as during inspiratory loaded breathing associated with diaphragmatic breathing in patients with heart failure.

Methods: Sixteen men with heart failure functional class I to III, aged 50(SD=7) years were evaluated. Volumes of the pulmonary rib cage, abdominal rib cage and abdomen, as well as other breathing pattern variables, were assessed by optoelectronic plethysmography during quiet breathing, inspiratory loaded breathing, and inspiratory loaded breathing associated with diaphragmatic breathing.

Results: Chest wall tidal volume significantly increased from quiet breathing 0.53(SD=0.14)L to inspiratory loaded breathing 1.33(SD=0.48)L and to inspiratory loaded breathing associated with diaphragmatic breathing 1.36(SD=0.48)L. A significant volume variation was observed on the three compartments (p<0.05 for all). During inspiratory loaded breathing associated with diaphragmatic breathing, patients showed increased abdominal volume compared to quiet breathing [0.28(SD=0.05) to 0.83(SD=0.47)L, p<0.001]; as well as from inspiratory loaded breathing [0.63(SD=0.23) to 0.83(SD=0.47)L, p=0.044]. No significant changes were observed between the two inspiratory loaded breathing conditions on the percentages of the contribution of each chest wall compartment for the tidal volume, respiratory rate, minute ventilation, and duty cycle.

Conclusion: When inspiratory loaded breathing was associated with diaphragmatic breathing, a higher volume in the abdominal compartment was obtained without significant changes in other breathing pattern variables.

Keywords: Breathing exercises; Breathing pattern; Inspiratory muscle training; Optoelectronic plethysmography.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Three-dimensional model of the chest wall obtained by optoelectronic plethysmography during a data collection. (A) Anterior view; (B) lateral view; (C) posterior view. In blue: pulmonary rib cage; in green: abdominal rib cage; in orange: abdomen.
Figure 2
Figure 2
Volumes of chest wall compartments during quiet breathing, inspiratory loaded breathing and inspiratory loaded breathing associated with diaphragmatic breathing. QB, quiet breathing; ILB, inspiratory loaded breathing; ILBdi, inspiratory loaded breathing associated with diaphragmatic breathing. (A) Vrcp, volume of the pulmonary rib cage; (B) Vrca, volume of the abdominal rib cage; (C) Vab, volume of the abdomen. *p < 0.05 (vs QB). #p < 0.05 (vs ILB).
Figure 3
Figure 3
Chest wall volume distribution between ILB and ILBdi. ILB, inspiratory loaded breathing; ILBdi, inspiratory loaded breathing associated with diaphragmatic breathing. Vrcp, volume of the pulmonary rib cage; Vrca, volume of the abdominal rib cage; Vab, volume of the abdomen; Δ (delta), difference on the chest wall volume between ILB and ILBdi. *p > 0.05 (ILB vs ILBdi, post hoc LSD).
See this image and copyright information in PMC

References

    1. Ribeiro J.P., Chiappa G.R., Callegaro C.C. The contribution of inspiratory muscles function to exercise limitation in heart failure: pathophysiological mechanisms. Rev Bras Fisioter. 2012;16(4):261–267. - PubMed
    1. Kasahara Y., Izawa K.P., Watanabe S., Osada N., Omiya K. The relation of respiratory muscle strength to disease severity and abnormal ventilation during exercise in chronic heart failure patients. Res Cardiovasc Med. 2015;4(4):e28944. - PMC - PubMed
    1. Laoutaris I.D., Adamopoulos S., Manginas A., Panagiotakos D.B., Cokkinos D.V., Dritsas A. Inspiratory work capacity is more severely depressed than inspiratory muscle strength in patients with heart failure: novel applications for inspiratory muscle training. Int J Cardiol. 2016;221:622–626. - PubMed
    1. Lin S.J., McElfresh J., Hall B., Bloom R., Farrell K. Inspiratory muscle training in patients with heart failure: a systematic review. Cardiopulm Phys Ther J. 2012;23(3):29–36. - PMC - PubMed
    1. Montemezzo D., Fregonezi G.A., Pereira D.A., Britto R.R., Reid W.D. Influence of inspiratory muscle weakness on inspiratory muscle training responses in chronic heart failure patients: a systematic review and meta-analysis. Arch Phys Med Rehabil. 2014;95(7):1398–1407. - PubMed