THE EFFECTS OF CHINESE TRADITIONAL BREATHING TRAINING ON THE EXERCISETEST, RESISTANCE BREATHING AND QUALITY-OF-LIFE IN CHRONIC OBSTRUCTIVEPULMONARY-DISEASE PATIENTS

Objective To evaluate the effects of breathing training (Qigong) on th e exercise test, resistance breathing as well as quality of life in ch ronic obstructive pulmonary disease (COPD) patients and to elucidate i ts mechanism. Methods Ten patients with COPD were assigned to 16-week rehabilitation program of Qigong. Their lung function was as follows: FEV1 1109 +/- 34.4 ml, FEV1/FVC 56.9 +/- 6.5%, RV/RV Pred 171.8 +/- 46 .7%, RV/TLC 58.9 +/- 6.5%. The patients did the breathing exercise for 45 minutes twice a day. The efficacy of practice was checked Ly the r espiratory inductive plethysmograph (RIP) once a week. Before and afte r the program, the patients were examined as follows: 1, incremental e xercise test, subjects exercised on a bicycle ergometer for 6 minutes. The workload (Watt) was increased 1/70 FEV1 (ml) every a minute. The breath rate, tidal volume and oxygen saturation were monitored. 2, Est imating dyspnea, during the incremental. exercise test the subjects we re asked to quantify their feeling of breathlessness every a minute us ing a modified Borg scale. Borg score 0.5 was defined as the threshold of dyspnea. 3, Evaluation of duality of life (QOL), a questionnaire o f QOL for COPD was used to evaluate the change of QOL contained 4 part s, namely daily activity, social activity, depression and anxiety. 4, Resistance breathing test, the rib cage (RC) and abdominal (AB) belts of the respiratory inductive plethysmograph were positioned around the chest and the abdomen respectively. Tidal volume, breath rate, TCD/VT (TCD; total compartmental displacement) were recorded at resting and resistance breathing with 60% maximal inspiratory pressure as the insp iring pressure load. Results. After the program, the breath rates decr eased (P < 0.05) during incremental exercise test in comparison with t hose before program. At the fifth degree of workload the heart rate re duced (P < 0.05) and oxygen saturation in creased (P < 0.05). Borg sco res improved at the 2nd, 3rd, 4th and 5th degree (P < 0.05). The thres hold of dyspnea increased from degree 1.7 +/- 0.48 to degree 2.4 +/- 0 .52 (P < 0.01). After 16-week training the tidal volume increased at r esting (P < 0.05). Both breath rate and tidal volume did not change si gnificantly at resistance breathing. interestingly, TCD/VT decreased s ignificantly (from 1.49 +/- 0.19 to 1.27 +/- 0.12, P < 0.05) during re sistance breathing, indicating the improved synchronization of thoraci c and abdominal respiration. The scores of QOL were also improved stat istically (P<0.001). Conclusions It was suggested that Qigong could im prove the breathing: pattern at resting and during incremental exercis e, abate the extent of paradoxical thoraco-abdominal motion at the res istance breathing. Therefore Qigong could ameliorate dyspnea, raise th e threshold of dyspnea. It might be physiological basis of the improve ment of QOL in the patients with COPD after the program.