- Improve overall ventilation of respiration
- Decrease accumulation of secretions and prevent complications
- Improve chest wall mobility
- Strengthening respiratory muscles
- Decrease the work of breathing
- Attempts to enhance movement of the diaphragm upon inspiration and expiration and diminish accessory muscle use.
- Position the patient in bed with head and trunk elevated to 45*
- Place dominant hand over the rectus abdominis muscles
- Direct the patient to inspire slowly and feel the dominant hand rise
- Instruct the patient to control both inspiration and expiration
- The non dominant hand should have only minimal movement
Inspiratory Muscle Training:
- IMT attempts to increase ventilating capacity and decrease dyspnea through the strengthening of the diaphragm and intercostal muscles. This is commonly used with paitents that exhibit decreased chest expansion, shortness of breath, bradypnea, and decreased breath sounds.
- Treatment Protocol
- Teach the patient proper use of inspiratory muscles
- Two to four session of 30 to 60 minutes of deep breathing with proper diaphragmatic breathing
- Use "sniffing" to increase awareness regarding the proper use of diagphragmatic breathing
- Strength training through active breathing exercises (for patients that have tidal volumes less than 500ml)
Low Frequency Breathing is slow deep breathing designed to improve alveolar ventilation and oxygenation.
- Instruct the patient to breathe slowly, taking long and deep breaths
- Ensure the patient is not a risk for hyper ventilation.
Incentive Spirometry is used to increase inspiration using a device that provides immediate feedback to the patient regarding performance. This type of intervention is commonly utilized to treat patients status post surgery in order to strengthen weak inspiratory muscles and to prevent alveolar collapse.
- Position the patient in a comfortable setting
- Instruct the patient to breathe into the spirometer by performing a maximal inhalation.
- Repeat 7-10 times per session and repeat 3-4 times per day
- Increase the volume expectations on regular intervals until the patient is within normal range
Pursed Lip Breathing:
- To improve ventilation by decreasing the respiratory rate and increasing the tidal volume. This technique assists with shortness of breath that is commonly encountered in patients with COPD.
- Instruct patient to avoid using bdominals
- slowly inhale, relax and loosely purse lips during exhalation
- Expiration should be twice as long as inspiration
Segmental Breathing is used to prevent accumulation of fluid and to increase chest mobility by directing inspired air to predetermined areas