Breathing pattern and performance in elderly subjects: a comparison of 3 types of breathing exercise

Abstract

The aim of this study was to compare, in the elderly, the patterns of breathing and the effectiveness of breathing exercise using BM, Triflo II® (TF) and DB.  Fourteen subjects, (4 male and 10 female, aged 69.9 ± 3.6 years) participated in a randomized cross-over trial of the 3 techniques. The exercise was carried out 10 times/set for 3 sets with 1 min rest between sets. Subjects were instructed to breathe as deeply as possible with DB, and maintain a flow against 5 cmH₂O for BM or 900 ml/s for TF.  The breathing patterns and tidal volume (Vt) were measured at rest and while performing the breathing exercise. The results showed that there were significantly (P < 0.01) greater peak and mean inspiratory pressures and flow during TF compared with BM (12.2 ± 5.2 cmH₂O, 7.3 ± 4.0 cmH₂O, 0.7 ± 0.2 L/s, respectively) and DB (19.0 ± 4.1 cmH₂O, 11.6 ± 3.4 cmH₂O, 0.5 ± 0.2 L/s, respectively). Moreover Ti and Ti/Ttot were longer during BM compared to DB by 2.2 ± 1.6 s, 0.11 ± 0.1, respectively and compared to TF (4.4 ± 1.8 s, 0.3 ± 0.1, respectively; P < 0.01). Tidal volumes (Vt) were significantly greater than baseline for all three modes of exercise (P < 0.01), BM resulted in larger changes in Vt than TF by 245 ml (P < 0.05).  With TF only 22 out of 30 breaths reached the target of raising two balls (900 ml/s) and only one subject was able to hold a static contraction following maximal inspiratory effort using accessory muscles of inspiration. In conclusion, the breathing pattern using BreatheMAX is close to the desired therapeutic pattern, with longer sustained maximum inspiration using the diaphragm with lesser accessory muscle use; tidal volume is was larger with BM compared to TF.  Therefore, breathing exercise with BreatheMAX is more effective and beneficial for breathing training in elderly. para�9r @���5(d between groups, respectively. After treatment, the VAS scores reduced in both the PT (-3.64 ± 2.31) and TTM (-4.64 ± 1.98) groups. Knee extensor strength was increased in both knees of the two groups whereas knee flexor strength was found to be increased only in both knees of the TTM group.  However, there was no statistically significant difference when compared between the two treatment groups except the knee flexor strength where the TTM group showed a significantly greater than those of the PT group (P< 0.05).  This study shows that both the home-self care with a class-based PT and TTM programs for 8 weeks could yield positive effects on knee pain and knee muscles strength.