The importance of breathing control & breathing exercises in COPD

Importance of breathing control and breathing exercises

People with COPD often experience (severe) shortness of breath despite medication use. It is one of the most common complaints in COPD patients as it impacts the day-to-day life. Correct breathing and breathing exercises can relieve these shortness of breath symptoms. They also help you regain some control over your breathing.

Secondly, people with COPD produce much more mucus in the airways. A healthy airway normally allows for spontaneous removal of these mucus. With COPD, this does not work as well and you have to cough mainly to remove the mucus.

So there are 2 types of breathing exercises for COPD patients:

• Exercises to help control your breathing when feeling out of breath
• Exercises to loosen and move mucus

Breathing exercises for COPD help you strengthen your breathing muscles, get more oxygen and breathe more easily with less effort. This can improve your physical activity and quality of life.

Integrating breathing exercises in your daily life

In phase 1 of your care journey, you will receive several breathing exercises in the exercise tab. You will receive this exercises several days so you learn the proper techniques.

In phase 2, once your parameters are stable and you know which breathing exercises you can do, the exercises will no longer be activated in the exercise tab. The idea now is that you can apply these exercises independently in your daily life. Try to make the exercises a regular part of your daily routine.

A distinction can be made between exercises that:

1. you can do in your daily life to prevent respiratory problems
2. You can perform when you experience worsening of breathing capacity

There are several breathing techniques and methods, and you don’t have to choose just one to help you manage your COPD. Some studies have shown that combining techniques and practicing different methods can have better benefits for COPD symptoms.

Breathing exercises

Below you can find all the exercises that you will learn during your moveUP care journey. We have summarized the exercises here so they are easy to find back.

1. Deep abdominal breathing

Abdominal breathing is the most efficient way to breathe.

With abdominal breathing, you breathe low in the abdomen (your abdomen bulges when you inhale and flattens out when you exhale), rather instead of breathing high, often with shoulders raised.

Abdominal breathing does not always help when you have severe COPD since it can worsen chest tightness. However, in people with rapid breathing where very little air is breathed in and out, abdominal breathing does work well.

1. Choose a starting position: Sit, stand up or lie down. Put your hand on your belly and relax your shoulders as much as possible. This will help to open the chest.
2. Inhale for 3-4 seconds through the nose.
3. Hold for 2-3 seconds.
4. Exhale through the mouth for 4-5 seconds.
5. Repeat.

TIP: Try this exercise in different positions: sitting, standing or laying down. This will help you to better control your breathing.

2. Deep abdominal breathing while lying

1. Lie down with closed eyes. Place one hand on your stomach and the other hand on your chest.
2. Breath in through your nose for 3 seconds. While breathing in you should feel your belly expand and your hand move upwards. The hand on your chest should remain still.
3. Breathe out through your mouth for 5 seconds. Breathe with pursed lips if more comfortable.
4. Repeat.

TIP: It should feel like you blow up a balloon in your belly.

3. Pursed lip breathing (PLB)

This technique reduces the feeling of tightness. You can apply it when you begin to feel short of breath or during exertion.

With the PLB, you reduce the opening of your mouth when you exhale, keeping a little pressure on your airways. With this, the lung’s alveoli stay more open which allows more air to pass through the lungs during exhalation. Then you can also breathe in deeper again. Thus, you don’t have to breathe in and out as often to get the same amount of air in. Your breathing becomes calmer.

1. Choose a starting position: Sit, stand or lie down. Put your hand on your belly and relax your shoulders as much as possible. This position will help to open the chest.
2. While keeping your mouth closed, breathe in slowly through your nose for 2-3 seconds. Don’t take a deep breath, a normal breath will do.
3. Pucker or ‘purse’ your lips as if you were to whistle or gently blow out a candle.
4. Breathe out slowly for 4-5 seconds through your pursed lips.
5. Repeat.

TIP: Over time you can increase how long you inhale and exhale. Pursed lip breathing can help relieve shortness of breath, help keep the airways open longer and improve ventilation in the lungs.

4. Efficiently removing mucus from the lungs (Huff breathing)

In COPD patients, the lung tissue is less elastic. Coughing then is often not the most efficient way to remove mucus from your lungs, even though it is important to prevent respiratory infections. Better is the “huff technique,” which removes mucus from your lungs by a quick exhalation and moves it into the trachea. To get enough air behind a mucus plug, it is best to take a few deep breaths before using the “huff” technique.

1. Sit on a chair. Relax your shoulders and neck.
2. Take a slightly larger breath than usual through your nose.
3. Open your mouth. Push the inhaled air out as if you are trying to steam up a mirror.
4. Repeat. If you feel the need, you can cough to clear the chest from sputum.

TIP: Hold a hand in front of your mouth as if this were a mirror you would want to steam up.

5. Active Cycle of Breathing Technique (ACBT)

Active cycle of breathing technique (ACBT) combines different breathing techniques that help clear mucus from the lungs in three phases. The first phase helps you relax your airways. The second phase helps you to get air behind mucus and clears mucus. The third phase helps force the mucus out of your lungs.

1. Abdominal breathing control: Sit down and place your hand on your stomach. Take a relaxed breath through your nose and breathe out through your mouth. It can be easier to breathe out with pursed lips instead of an open mouth. You should feel the stomach expanding when you breath in, not the chest. Repeat this 5 times.
2. Deep breathing with thoracic expansion: Place your hands on your lower ribs. Take a long deep breath in. Take a gentle long breath out through the mouth. While breathing in, you should feel your ribs expand outwards.
3. Huffing: Take a slightly larger breath than usual. Open your mouth. Push the inhaled air out as if you were trying to steam up a mirror. Repeat a couple of times. If you feel the need, you can cough.

TIP: Once you’ve read this info module, you can always find it back under the ‘re-read’ button. This way you can always come back and read the info on the exercises again.