Breathing Exercises

Question 1

Diaphragmatic Breathing

Answer 1

Position pt in Semi-Fowlers position: head elevated 45 degrees with pillow under knees
Hand on chest and abdomen: instruct pt to breathe in slowly through the nose and feel the abdomen gently rise while chest hand stays relatively still. Breathe out through pursed lips and feel the abdomen descend

Question 2

Inspiratory Muscle training

Answer 2

Strengthens the diaphragm and intercostal muscles

2 devices/training modes: flow resistive breathing and threshold breathing

Question 3

Flow Resistive Breathing

Answer 3

Pt breathes in through a mouthpiece and adapter with an adjustable diameter
Decreased diameter = increased resistance

Question 4

Threshold Breathing

Answer 4

Requires a buildup of negative pressure before flow occurs through a valve that opens at a critical pressure
Provides a consistent and specific pressure for IMT regardless of pt’s speed of breathing
Begin training with setting that elicits 30-40% of the patient’s (calculated) maximum inspiratory pressure (MIP)

Question 5

Paced breathing

Answer 5

Done to decrease the work of breathing and prevent dyspnea with activity
Helps pts with SOB to become less fearful of activity and exercise

Question 6

Exhale with Effort

Answer 6

Done to prevent breath holding
Inhaling during the rest/less active phase of movement and exhalation with the effort phase i.e. exhale during ascent from squat position

Question 7

Paced breathing with walking

Answer 7

Inhale two steps, pause, exhale through pursed lips for 4 steps

Question 8

Paced breathing with stairs

Answer 8

Inhale while standing on step

Exhale through pursed lips when stepping up/down one or two stairs

Question 9

Paced breathing with lifting

Answer 9

Inhale with standing, exhale with pursed lips with bending

Inhale with grabbing object, exhale with pursed lips with lifting

Question 10

Segmental Breathing

Answer 10

Done to prevent and treat pts with pulmonary complications after surgery
PT applies firm pressure to chest wall (at place to be expanded) at end of exhalation, pt inhales deeply and slowly expands rib cage under PT’s hands while PT simultaneously reduces pressure

Question 11

Sustained Maximal Inspiration (SMI) aka Incentive Spirometry

Answer 11

Breathe in slowly through the mouth while encouraging pt to move the diaphgram and expand the lower chest (not upper)
Hold breath for at least 3 seconds and note highest level piston reaches
Perform for 5-10 breaths every hour pt is awake