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Author: U. S. Department of Health and Human Services Publisher: Createspace Independent Pub ISBN: 9781490324326 Category : Medical Languages : en Pages : 52
Book Description
An estimated 8.2 percent of the United States population has asthma including 9.6 percent of children and 7.7 percent of adults. In 2010, the Agency for Healthcare Research and Quality commissioned the Oregon Evidence-based Practice Center to conduct a comparative effectiveness review (CER) on the effectiveness of breathing exercises and/or retraining in the treatment of asthma. Alternative and complementary treatment methods such as breathing retraining techniques have been advocated for the control of asthma given the range of asthma severity and concerns about long-term medication use. Specific breathing retraining approaches include those related to hyperventilation reduction (e.g., the Buteyko and Papworth methods) or nonhyperventilation-targeted methods (e.g., yoga breathing techniques, other physical therapy methods, biofeedback, and inspiratory muscle training [IMT]). These methods are assumed to be adjunctive to guideline-based care, with the primary goals of improving asthma control and reducing the use of medication. 1. Does the use of breathing exercises and/or retraining techniques improve health outcomes, including: symptoms (e.g., cough, wheezing, dyspnea); health-related quality of life (general and/or asthma-specific); acute asthma exacerbations; reduced use of quick-relief medications or reduced use of long-term control medications, when compared with usual care and/or other breathing techniques alone or in combination with other intervention strategies? In this review, we addressed the following Key Questions: 2. Does the use of breathing exercises and/or retraining techniques improve pulmonary function or other similar intermediate outcomes when compared with usual care and/or other breathing techniques alone or in combination with other intervention strategies? 3. What is the nature and frequency of serious adverse effects of treatment with breathing exercises and/or retraining techniques, including increased frequency of acute asthma exacerbations? Our review sought to include studies that addressed the use of breathing techniques in adults and children 5 years of age and older with asthma and explored whether the effectiveness differed between different population subgroups (e.g., males/females; various types and severities of asthma; and/or different coexisting conditions). Additionally, we evaluated whether the effectiveness of these interventions varied by differences in intervention implementation or components. The review identified 22 studies published between 1990 and December 2011 that examined the effectiveness or comparative effectiveness of breathing techniques on intermediate and/or health outcomes. In general, the evidence was low-to-moderate or insufficient to address the Key Questions adequately as it was based primarily on small, methodologically limited trials of heterogeneous populations with short followup and inconsistent outcome reporting. The objective of this Future Research Needs project was to engage a diverse set of stakeholders to confirm, provide more detail, and prioritize the research needs that we identified in the CER. We also sought to provide information on ongoing studies of relevance to the prioritized list of research questions and study design considerations for the highly prioritized questions.
Author: U. S. Department of Health and Human Services Publisher: Createspace Independent Pub ISBN: 9781490324326 Category : Medical Languages : en Pages : 52
Book Description
An estimated 8.2 percent of the United States population has asthma including 9.6 percent of children and 7.7 percent of adults. In 2010, the Agency for Healthcare Research and Quality commissioned the Oregon Evidence-based Practice Center to conduct a comparative effectiveness review (CER) on the effectiveness of breathing exercises and/or retraining in the treatment of asthma. Alternative and complementary treatment methods such as breathing retraining techniques have been advocated for the control of asthma given the range of asthma severity and concerns about long-term medication use. Specific breathing retraining approaches include those related to hyperventilation reduction (e.g., the Buteyko and Papworth methods) or nonhyperventilation-targeted methods (e.g., yoga breathing techniques, other physical therapy methods, biofeedback, and inspiratory muscle training [IMT]). These methods are assumed to be adjunctive to guideline-based care, with the primary goals of improving asthma control and reducing the use of medication. 1. Does the use of breathing exercises and/or retraining techniques improve health outcomes, including: symptoms (e.g., cough, wheezing, dyspnea); health-related quality of life (general and/or asthma-specific); acute asthma exacerbations; reduced use of quick-relief medications or reduced use of long-term control medications, when compared with usual care and/or other breathing techniques alone or in combination with other intervention strategies? In this review, we addressed the following Key Questions: 2. Does the use of breathing exercises and/or retraining techniques improve pulmonary function or other similar intermediate outcomes when compared with usual care and/or other breathing techniques alone or in combination with other intervention strategies? 3. What is the nature and frequency of serious adverse effects of treatment with breathing exercises and/or retraining techniques, including increased frequency of acute asthma exacerbations? Our review sought to include studies that addressed the use of breathing techniques in adults and children 5 years of age and older with asthma and explored whether the effectiveness differed between different population subgroups (e.g., males/females; various types and severities of asthma; and/or different coexisting conditions). Additionally, we evaluated whether the effectiveness of these interventions varied by differences in intervention implementation or components. The review identified 22 studies published between 1990 and December 2011 that examined the effectiveness or comparative effectiveness of breathing techniques on intermediate and/or health outcomes. In general, the evidence was low-to-moderate or insufficient to address the Key Questions adequately as it was based primarily on small, methodologically limited trials of heterogeneous populations with short followup and inconsistent outcome reporting. The objective of this Future Research Needs project was to engage a diverse set of stakeholders to confirm, provide more detail, and prioritize the research needs that we identified in the CER. We also sought to provide information on ongoing studies of relevance to the prioritized list of research questions and study design considerations for the highly prioritized questions.
Author: Carrie D. Patnode Publisher: ISBN: Category : Languages : en Pages :
Book Description
The objective of this Future Research Needs (FRN) project was to engage a diverse set of stakeholders to confirm, provide more detail, and prioritize the research needs that were identified in a comparative effectiveness review (CER) on the effectiveness of breathing exercises and/or retraining in the treatment of asthma. We also sought to provide information on ongoing studies of relevance to the prioritized list of research questions and study design considerations for the highly prioritized questions.
Author: U. S. Department of Health and Human Services Publisher: Createspace Independent Pub ISBN: 9781483925608 Category : Medical Languages : en Pages : 222
Book Description
In 2009, an estimated 8.2 percent of Americans (9.6 percent of children and 7.7 percent of adults) had asthma, and the prevalence of asthma has increased substantially in recent years. In 2007, asthma accounted for 456,000 hospitalizations and more than 3,447 deaths. The goal of asthma treatment is to achieve asthma control, as evidenced by normal or near normal pulmonary function, maintenance of normal activity levels, and minimal need for shortacting beta2-agonist inhalers for “quick relief” of asthma symptoms. Persistent asthma treatment includes the use of long-term control medications (most commonly inhaled corticosteroids [ICS]) to reduce airway inflammation and quick-relief medications for acute exacerbations. While the benefits of asthma treatment generally outweigh the potential risks, these medications can be associated with adverse effects. Additionally, some asthma patients have concerns about asthma medications, and some patients would likely prefer to reduce their use of medication if alternative treatments were available. A number of nonpharmacologic methods for asthma management involve breathing retraining. Some of these, such as the Buteyko and Papworth methods, are predicated on the theory that asthma is related to hyperventilation. These treatments seek to reduce hyperventilation by encouraging shallow or slow nasal breathing, breath-holding at the end of expiration, and minimizing sighs and yawns and related breathing patterns that are characterized as “over-breathing.” The idea behind these treatments is that hyperventilation leads to a reduction in blood and alveolar carbon dioxide (CO2), to which the airways respond by constricting to prevent further loss of CO2. The evidence supporting the hyperventilation theory of the pathophysiology of asthma is mixed. People with asthma do appear to have lower endtidal CO2 levels (i.e., blood levels of CO2 at the end of exhalation) than those without asthma. A reduction in end-tidal CO2 levels has been shown to increase airway resistance in people with asthma and a history of bronchial hyperresponsiveness to histamine, but not in matched controls without asthma. Further, airway resistance decreases when hypercapnia (high level of CO2 in the blood) is induced. Another study, however, found that longer breath-holding time was associated with a reduction in end-tidal CO2, which is counter to Buteyko's theory. The current review examines the effect of breathing retraining methods on asthma symptomatology, medication use, quality of life, and pulmonary function in both adults and children. We also examine adverse effects of these techniques. The analytic framework we developed to guide our review is shown in Figure A. The Key Questions for this review are as follows: In adults and children 5 years of age and older with asthma, does the use of breathing exercises and/or retraining techniques improve health outcomes, including symptoms (e.g., cough, wheezing, dyspnea); health-related quality of life (general and/or asthmaspecific); acute asthma exacerbations; and reduced use of quick-relief medications or reduced use of long-term control medications, when compared with usual care and/or other breathing techniques alone or in combination with other intervention strategies? In adults and children 5 years of age and older with asthma, does the use of breathing exercises and/or retraining techniques improve pulmonary function or other similar intermediate outcomes when compared with usual care and/or other breathing techniques alone or in combination with other intervention strategies? What is the nature and frequency of serious adverse effects of treatment with breathing exercises and/or retraining techniques, including increased frequency of acute asthma exacerbations?
Author: Publisher: ISBN: Category : Languages : en Pages :
Book Description
OBJECTIVES: To examine evidence for whether breathing exercises and retraining techniques lead to improvements in asthma symptoms, reductions in asthma medication use, improved quality of life, or improved pulmonary function in asthma sufferers. DATA SOURCES: MEDLINE; PsycInfo; Embase; Cumulative Index to Nursing and Allied Health Literature; Physiotherapy Evidence Database; Cochrane Central Register of Controlled Trials; AltHealthWatch; Allied and Complementary Medicine; Manual, Alternative and Natural Therapy Index System; and Indian Medical Journals from 1990 through December 2011. Searches were supplemented with manual searching of reference lists and grey literature, including regulatory documents, conference abstracts, clinical trial registries, and Web sites of professional organizations. METHODS: Analytic framework, Key Questions, and review protocol were developed with input from Key Informants and technical experts. Two independent reviewers screened identified abstracts against predefined inclusion/exclusion criteria. Two investigators reviewed full-text articles and independently quality-rated those meeting inclusion criteria. Data from fair-and good-quality trials were abstracted into standardized forms and checked by another investigator. We summarized data qualitatively and, where possible, used random effects meta-analysis. RESULTS: We identified four types of interventions: hyperventilation reduction breathing techniques, yoga breathing techniques, inspiratory muscle training (IMT), and other nonhyperventilation reduction breathing techniques. We found the most robust body of evidence for hyperventilation reduction breathing techniques in adults, including the only large-scale trial (n=600, aged 14+). Hyperventilation reduction interventions (particularly those with 5 hours or more of patient contact) achieved medium to large improvements in asthma symptoms and reductions in reliever medication use of approximately 1.5 to 2.5 puffs per day, but did not improve pulmonary function. These trials also were more applicable to the U.S. setting than trials examining other interventions due to similarities in applicable treatment guidelines to U.S. guidelines and similar levels of development in the countries in which these studies were conducted, although applicability was still somewhat limited since none were conducted in the United States. Limited evidence suggested yoga breathing may improve pulmonary function in adults in addition to reducing asthma symptoms, but medication use was rarely reported and applicability to the United States was very low. Evidence for IMT and other breathing retraining techniques was limited to small, heterogeneous trials providing insufficient evidence to determine effectiveness. The only harms of breathing retraining techniques identified were minor annoyances associated with mouth-taping. Almost all trials were limited entirely or primarily to adults. CONCLUSIONS: Behavioral approaches that include hyperventilation reduction techniques can improve asthma symptoms or reduce reliever medication use over 6 to 12 months in adults with poorly controlled asthma and have no known harmful effects. However, available evidence is limited in its strength and applicability to the United States. Evidence supporting yoga breathing is weaker and applicability to the United States is very low.
Author: Claudio Donner Publisher: CRC Press ISBN: 1351015583 Category : Medical Languages : en Pages : 526
Book Description
Pulmonary rehabilitation programmes are a fundamental part of the clinical management of patients with chronic respiratory diseases. This comprehensive reference book places pulmonary rehabilitation within the wider framework of respiratory disease. Now in six parts, it includes new sections on the development of PR as a discipline, global perspectives on quality control, new chapters on early PR post exacerbation and personalized rehabilitation, innovative approaches to exercise, PR in interstitial lung disease and lung transplantation, and the latest research into the application of music, dance and yoga. Key Features Global contributions compare practice around the world where differences have developed. New six Part structure covers new approaches to exercise testing, interstitial lung diseases and other diseases, and add-on interventions drawing on new technologies. Contains recommendations of the large collaborative ERS/ATS task forces on guidelines for PR as well as suggested policies for its implementation and use. Covers the important topic of balance impairment as a focus of rehabilitation for the at-risk patient and a new chapter on monitoring physical activity. The voices of patients and caregivers describe the impact of chronic respiratory disease on their lives. Features an exclusive chapter on COVID-19 that discusses the short- and long-term pathophysiological consequences, provides information about the potential role of physiotherapy in the management of hospitalized patients with confirmed or suspected COVID-19, and details on who, where, and how to deliver programs to COVID-19 and non COVID-19 patients in the lockdown and post lockdown era.
Author: R. Ley Publisher: Springer Science & Business Media ISBN: 1475793839 Category : Psychology Languages : en Pages : 331
Book Description
We start life with a breath, and the process continues automatically for the rest of our lives. Because breathing continues on its own, without our awareness, it does not necessarily mean that it is always functioning for optimum mental and physical health. The opposite is true often. The problem with breathing is that it seems so easy and natural that we rarely give it a second thought. We breathe: we inhale, we exhale. What could be simpler? But behind that simple act lies a process that affects us profoundly. It affects the way we think and feel, the quality of what we create, and how we function in our daily life. Breathing affects our psychological and physiological states, while our psychological states affect the pattern of our breathing. For example, when anxious, we tend to hold our breath and speak at the end of inspiration in a high-pitched voice. Depressed people tend to sigh and speak at the end of expiration in a low-toned voice. A child having a temper tantrum holds his or her breath until blue in the face. Hyperven tilation causes not only anxiety but also such a variety of symptoms that patients can go from one specialty department to another until a wise clinician spots the abnormal breathing pattern and the patient is successfully trained to shift from maladaptive to normal breathing behavior.
Author: Christopher Gilbert Publisher: Elsevier Health Sciences ISBN: 0702054275 Category : Medical Languages : en Pages : 321
Book Description
This authoritative, research-based book, written by a team of clinical experts, offers an introduction to the symptoms and causes of disordered breathing as well as the strategies and protocols that can be used to correct and restore normal breathing. Multidisciplinary Approaches to Breathing Pattern Disorders guides readers through a discussion of the current research that links disordered breathing patterns with perceived pain levels, fatigue, stress and anxiety. Basic mechanics, physiology, and biochemistry of normal breathing are outlined to lay a foundation for understanding causes and mechanics of disordered breathing. Self-help strategies with charts and workbook pages that may be photocopied as handouts are designed to help patients overcome specific breathing problems. "...this second edition is particularly outstanding, providing a good basis of practical hands-on techniques, well supported by pictures and the website, and giving specific focus on sports, speech and chronic pain." Reviewed by Janet Rowley on behalf of the New Zealand Journal of Physiotherapy, January 2015 "..a fantastic resource which will help students, clinicians, and physiotherapists to carry out effective evaluation and treatment in an acute care setting." Reviewed by Poonam Mehta on behalf of the New Zealand Journal of Physiotherapy, January 2015 Written by an international team of highly experienced clinicians in the field Addresses all the most effective aspects of therapy - physiotherapy, psychotherapy, osteopathy Includes an introduction to the understanding of the mechanics, physiology and biochemistry of normal breathing Includes self-help measures with charts and workbook material which may be photocopied for using with the patients Video clips on an associated website presents practical examples of the breathing techniques discussed in the book Includes the latest protocols on breathing rehabilitation Includes specialist chapters on breathing dysfunction associated with pain syndromes such as pain of pelvic origin and other unexplained medical conditions Discusses the use of capnography in assessment and rehabilitation Includes discussion of Vojta/Dynamic Neuromuscular Stabilization Therapy
Author: Alison McConnell Publisher: Elsevier Health Sciences ISBN: 0702054550 Category : Medical Languages : en Pages : 403
Book Description
Respiratory Muscle Training: theory and practice is the world’s first book to provide an "everything-you-need-to-know" guide to respiratory muscle training (RMT). Authored by an internationally-acclaimed expert, it is an evidence-based resource, built upon current scientific knowledge, as well as experience at the cutting-edge of respiratory training in a wide range of settings. The aim of the book is to give readers: 1) an introduction to respiratory physiology and exercise physiology, as well as training theory; 2) an understanding of how disease affects the respiratory muscles and the mechanics of breathing; 3) an insight into the disease-specific, evidence-based benefits of RMT; 4) advice on the application of RMT as a standalone treatment, and as part of a rehabilitation programme; and finally, 5) guidance on the application of functional training techniques to RMT. The book is divided into two parts – theory and practice. Part I provides readers with access to the theoretical building blocks that support practice. It explores the evidence base for RMT as well as the different methods of training respiratory muscles and their respective efficacy. Part II guides the reader through the practical implementation of the most widely validated form of RMT, namely inspiratory muscle resistance training. Finally, over 150 "Functional" RMT exercises are described, which incorporate a stability and/or postural challenge – and address specific movements that provoke dyspnoea. Respiratory Muscle Training: theory and practice is supported by a dedicated website (www.physiobreathe.com), which provides access to the latest information on RMT, as well as video clips of all exercises described in the book. Purchasers will also receive a three-month free trial of the Physiotec software platform (via www.physiotec.ca), which allows clinicians to create bespoke training programmes (including video clips) that can be printed or emailed to patients. Introductory overviews of respiratory and exercise physiology, as well as training theory Comprehensive, up-to-date review of respiratory muscle function, breathing mechanics and RMT Analysis of the interaction between disease and respiratory mechanics, as well as their independent and combined influence upon exercise tolerance Analysis of the rationale and application of RMT to over 20 clinical conditions, e.g., COPD, heart failure, obesity, mechanical ventilation Evidence-based guidance on the implementation of inspiratory muscle resistance training Over 150 functional exercises that incorporate a breathing challenge www.physiobreathe.com - access up-to-date information, video clips of exercises and a three-month free trial of Physiotec’s RMT exercise module (via www.physiotec.ca)
Author: U. S. Department of Health and Human Services
Author: U. S. Department of Health and Human Services
Author: 
Author: Carrie D. Patnode
Author: U. S. Department of Health and Human Services
Author: 
Author: Claudio Donner
Author: R. Ley
Author: Christopher Gilbert
Author: 
Author: Alison McConnell