Respiratory muscle fatigue can occur in patients with chronic pulmonary heart disease, causing or worsening respiratory failure. Respiratory muscle exercises can enhance the muscle strength and endurance of patients’ respiratory muscles, thus preventing respiratory failure caused by respiratory muscle fatigue. Respiratory muscle exercises include abdominal breathing, lip reduction breathing and whole body respiratory gymnastics. Recent studies have shown that respiratory muscle exercises can improve lung function, increase respiratory amplitude, and help improve alveolar ventilation, thereby increasing the patient’s oxygen saturation.
Abdominal breathing
Patients with chronic pulmonary heart disease often breathe superficially and briefly, which is superficial breathing with chest breathing as the main feature, which can not only ensure effective alveolar ventilation, but also easily cause respiratory muscle tension and increase oxygen consumption leading to respiratory muscle fatigue. Through abdominal breathing training, increase septal muscle tension and coordination with abdominal muscles in respiratory movements, thus increasing tidal volume and alveolar ventilation and reducing functional residual air volume.
Training method: can be lying, semi-recumbent or sitting position, put both hands on the abdomen and front chest, relax the whole body muscles, calm breathing, inhalation through the nose, exhalation from the mouth, breathing slowly and evenly. At the beginning of the exercise, you can consult a professional physician and do demonstration guidance, twice a day, 10-15 minutes each time; when the action is skilled, you can increase the number and time.
Lip retraction breathing
Lip retraction breathing exercises can improve alveolar ventilation and gas exchange. The mechanism may be related to the following factors.
1, reduction in respiratory rate and increase in tidal volume, resulting in a decrease in the dead space (volume where gas exchange does not take place) in the airway and an increase in respiratory efficiency.
2. increased pressure in the airway, which prevents dynamic trapping and closure of the airway, facilitates the expulsion of alveolar gas and improves ventilation efficiency
3. a decrease in functional residual air volume, thereby reducing the dilution of inhaled fresh gas by increasing functional residual air volume, increasing alveolar oxygen partial pressure and decreasing carbon dioxide partial pressure, thereby improving gas exchange.
Lip constriction breathing is a component of abdominal breathing. Constricting the lips during exhalation increases the resistance during exhalation, and this resistance can be transmitted to the bronchi, which keeps a certain tension in the bronchi and prevents premature trapping of the small airways. Lip contraction breathing can increase the pressure in the airway by an average of 0.5 kPa (5 cm water column), which is conducive to the expulsion of gas in the lungs.
Training method: When exhaling, the lips are gathered in a “fish mouth” shape, and the degree of lip reduction is as good as the patient can tolerate. Generally, the degree of lip reduction and expiratory flow is indicated by the ability to make the flame of a candle blow tilted at a distance of 15-20 cm without extinguishing.
Whole-body respiratory gymnastics
Whole-body respiratory gymnastics is based on abdominal breathing, plus chest expansion, bending, squatting and other actions to further improve lung function and increase physical strength.
Training methods: can be lying, sitting or standing position, the specific steps are as follows.
1, the first section: long breathing body standing upright, the whole body muscles relaxed, inhale through the nose, mouth exhale. First, practice deep and long exhalation until the gas is exhausted, and then natural inhalation, the ratio of exhalation to suction time is 2:1 or 3:1 to not dizzy, the breathing rate of about 16 times per minute is appropriate.
2, the second section: abdominal breathing, standing position, one hand on the chest, one hand on the abdomen, abdominal breathing, inhalation, try to hold the abdomen, the chest does not move, exhale when the abdominal muscles slowly active contraction, in order to increase intra-abdominal pressure, so that the diaphragm up, and breathing according to the rhythm.
3, section 3: power breathing With exhalation and inhalation to do both arms down and up.
4, section 4: chest breathing standing position, two arms crossed in front of the chest to compress the chest, the body leaning forward, exhale; two arms gradually lifted up to expand the chest, inhale.
5, the fifth section pressure abdominal breathing; take the standing position, hands crossed, thumbs facing back, the remaining four fingers pressed in the upper abdomen, the body leaning forward, exhale, two arms slowly up, inhale.
6, section 6: chest breathing, take the standing position, arms crossed in front of the chest to press the chest, the body leans forward slightly, exhale, both arms slowly lift up, expand the chest, inhale.
7, the seventh section: squat breathing, standing position, feet together, body leaning forward to squat, both hands clutching the knees and exhale, restore when inhaling.
8, the eighth section: flexion breathing, take the standing position, arms crossed in front of the abdomen, bending forward when exhaling, the upper body to restore the two arms to the side of the inhalation. Each section of the above natural breathing 30 seconds, a full set of exercises to do 10 to 20 times a day.
Terminology explanation.
Tidal volume: the amount of air inhaled or exhaled during each breath.
Residual air volume: the amount of air that remains in the lungs at the end of maximum expiration and cannot be exhaled again.
Functional residual air volume: the amount of air that remains in the lungs at the end of a calm expiration.
Alveolar ventilation: The amount of fresh air inhaled into the alveoli per minute.