Training modalities to re-establish normal breathing patterns, enhance respiratory muscle function, improve pulmonary ventilation, reduce respiratory distress and improve lung function through various breathing exercises and therapeutic techniques.
I. Abdominal breathing training
1.Definition
A training method based on training abdominal breathing and emphasizing diaphragm movement. To improve abnormal breathing patterns, effectively reduce the use of auxiliary respiratory muscles, to improve respiratory efficiency and reduce respiratory energy consumption.
2.Indications and contraindications
(1) Indications: spinal cord injury, chronic emphysema or obstructive lung disease, severe scoliosis or kyphosis resulting in respiratory dysfunction, etc.
(2) Contraindications: unstable clinical condition, uncontrolled infection, respiratory failure, other clinical conditions that may lead to deterioration during training, severe cognitive deficits and mental illnesses that affect memory and compliance.
3. Equipment and appliances
No equipment is required.
4.Operating methods and steps
(1) General method: The patient is in the supine or sitting position (leaning forward to leaning position). Relax the abdomen, inhale slowly and deeply through the nose, augmenting the abdomen; when exhaling, shrink the lips to blow out the air slowly, while contracting the abdominal muscles to promote the diaphragm upward. Inhalation and exhalation time ratio of about 1:2, when you first start practicing, a practice 1 to 2 minutes, gradually increase to 10-15 minutes each time, twice a day exercise.
(2) Hip lift and exhalation method: supine position, both feet on the bed frame, exhale by raising the hips, using the weight of the abdominal organs to push the diaphragm to the chest cavity, forcing the diaphragm to lift up; inhalation restored to increase the tidal volume.
(3) blowing candle method: sitting position, the flame of the candle and the mouth with the same height, and then shrink the mouth with abdominal breathing method to blow the flame to tilt the flame and not extinguish.
5, precautions
(1) Training environment is quiet, to avoid excessive interference with the patient.
(2) Teach the patient the skill of relaxation, especially the relaxation of the inspiratory assist muscles.
(3) Avoid holding the breath and excessively slowing down the respiratory rate to avoid inducing respiratory acidosis.
(4) The principles of rehabilitation therapy for pulmonary diseases are perseverance, gradual progress, and individualized.
(5) Gradually increase the amount of exercise, according to the ability, in order not to cause obvious fatigue, otherwise it may induce or aggravate the onset of pulmonary disease.
Second, resistance expiratory training
1. Definition
Respiratory training method that applies resistance during expiration. To appropriately increase airway resistance to reduce or prevent premature closure of the small airway in the lesion during expiration, so as to improve ventilation and air exchange and reduce the amount of residual air in the lungs.
2.Indications and contraindications
(1) Indications: chronic obstructive pulmonary disease (chronic bronchitis, emphysema, asthma and cystic fibrosis), spinal cord injury, etc.
(2) Contraindications: unstable clinical condition, uncontrolled infection, respiratory failure, other clinical conditions that may lead to deterioration during training, severe cognitive deficits and mental illnesses that affect memory and compliance.
3. Equipment and appliances
No equipment is required.
4.Operating methods and steps
Lip retraction and exhalation, bottle blowing and articulatory breathing can be used. Here, take lip reduction and exhalation as an example, introduce the operation method and steps: when training, let the patient be in a comfortable and relaxed position, shut up and inhale deeply through the nose, and when exhaling, close the mouth into a whistle shape, so that the gas slowly passes through the narrowed mouth shape, and the ratio of inhalation to exhalation is 1:2; when exhaling, the size of the lip reduction is adjusted by the patient’s own choice, not too big or too small; usually there are many patients with dyspnea who can improve shortness of breath with this method. In most cases, patients can stop using the lip retraction and exhalation method after mastering abdominal breathing.
5.Cautions
(1) The training environment should be quiet to avoid excessive disturbance to the patient.
(2) Let the patient wear loose clothing and adopt a comfortable and relaxed position.
(3) Avoid holding the breath and excessively slowing down the respiratory rate to avoid inducing respiratory acidosis.
(4) The principles of rehabilitation treatment for pulmonary diseases are persistent, gradual and individualized.
(5) Gradually increase the amount of exercise, according to the ability, in order not to cause obvious fatigue, otherwise it may induce or aggravate the onset of pulmonary disease.
(6) In addition to respiratory exercises, patients can also carry out moderate physical training, such as walking, climbing steps, tai chi, etc., in order to enhance physical fitness, reduce the number of disease attacks and reduce the degree of attacks. In addition, patients should also pay attention to make corresponding adjustments in nutrition, psychological state and living habits (such as quitting smoking).