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Breathing Effort in those with COPD
COPD, or Chronic Obstructive Pulmonary Disease, is a lung condition that’s used to describe a number of conditions, including emphysema and chronic bronchitis where you have difficulty breathing due to long-term damage to your lungs.
If you have been diagnosed with COPD you will have weak inspiratory muscles, the muscles you use to breathe. This is because COPD damages the airways to your lungs, making them narrower and causing difficulty breathing, making it harder for you to get air in and out of your lungs. Dyspnoea (difficult, laboured breathing or shortness of breath) is a common feature of many disorders including COPD. Its source may be respiratory, cardiovascular, neuromuscular or even psychological. Inspiratory muscle weakness has been identified as a contributory factor in the perception of dyspnoea (Killian, 1998).
Inspiratory Muscle Training has been shown to generate:
- Improvements in inspiratory muscle strength of 55%
- Improvements in inspiratory muscle endurance of 86%
- Improvements in quality of life by 21%
- Improvements in dyspnoea by 36%
- Reduction in primary care consultations by 23%
Training of the inspiratory muscles has been demonstrated to increase their strength, resistance to fatigue and, most importantly, to reduce exertional dyspnoea (Lisboa, 1994; Copestake & McConnell, 1995; Lisboa, 1997; McConnell et al., 1998).
Analysis and controlled trials have reported improvements following the use of inspiratory muscle training (IMT) and guidelines such as those issued by NICE for the management of COPD acknowledge that this form of breathing training has a part to play in the treatment of COPD.
In laboratory studies and randomised controlled trials, inspiratory muscle training was shown to generate:
- Improvements in inspiratory muscle strength of 55% (Newall et al 1998)
- Endurance of 86% (Newall et al 1998)
- Improvements in quality of life by 21%1
- Improvements in dyspnoea by 36%1
- Reduction in primary care consultations by 23%1
POWERbreathe inspiratory muscle training is a clinically-proven method of reducing your COPD symptoms. It can be used alongside your regular COPD treatment and will complement or work together with your mainstream therapies as it is drug-free and has no side effects or drug interactions; just speak to your GP, nurse or therapist.
Chronic bronchitis is inflammation of the bronchi i.e. tubes or airways that carry the oxygen you breathe from the air to your lungs. As a result of this inflammation mucus production is increased in the airways and produces phlegm which causes you to cough.
Emphysema is where the air sacs, or alveoli, in the lungs lose their elasticity which reduces the support of your airways and causes them to narrow. The result of this is that your lungs aren’t quite as efficient at getting oxygen into your body making it difficult for you to breathe and causing a shortness of breath.
The upshot of this is that your airways that carry air in and out of your lungs become blocked because of inflammation and an excess of mucus or phlegm. The small airways and air sacs in your lungs can also become damaged and lose their stretchiness which in turn can cause your airways to collapse and trap air in your lungs when you breathe out.
The British Lung Foundation and NHS Improvement have published a guide explaining what COPD is, how you are referred for assessment, what happens during assessment and what the results show. Download ‘What Should I Expect From Assessment And Diagnosis of COPD?’
Managing your Breathlessness for COPDshow
Taking part in regular exercise and relaxation could improve your breathlessness, as could breathing techniques that include breath control and breathing exercises, such that POWERbreathe breathing training provides. Speak to your GP, nurse or therapist about improving your exercise capacity to get the most out of your breathing.
Assessing your level of breathlessness is something specialists and GPs need to do in order to help you manage your breathlessness, and the most commonly used process for this is the Medical Research Council dyspnoea score, which assesses your breathlessness within a scale where 0 is with no breathlessness, to 5 where you feel too breathless to leave the house.
Medical Research Council Dyspnoea Score:
- 0 No breathlessness
- 1 Breathless on vigorous exertion, such as running, swimming, cycling
- 2 Short of breath on hurrying or walking up slopes
- 3 Breathless on walking at normal pace on the flat – has to stop from time to time
- 4 Stopping for breath after walking about 100yds or for a few minutes on the level
- 5 Too breathless to leave the house
- The Effects of 1 Year of Specific Inspiratory Muscle Training in Patients With COPD.
- Entrenamiento muscular inspiratorio en el paciente con enfermedad pulmonar obstructiva crónica (Inspiratory muscle training in patients with chronic obstructive pulmonary disease)
- Inspiratory muscle training for patients with chronic obstructive pulmonary disease: a practical guide for clinicians