Heart rate and cardiac autonomic responses to concomitant deep breathing, hand grip exercise, and circulatory occlusion in healthy young adult men and women

BACKGROUND: Deep breathing (DB) and handgrip (HG) exercise -with and without circulatory occlusion (OC) in muscle-, have been shown to have beneficial effects on cardiovascular function; however, the combination of these maneuvers on heart rate (HR) and cardiac sympathovagal balance have not been previously investigated. Therefore, the aim of the present study was to evaluate the effect of simultaneous DB, HG, and OC maneuvers on the sympathovagal balance in healthy women and men subjects. METHODS AND RESULTS: Electrocardiogram and ventilation were measured in 20 healthy subjects (Women: n = 10; age = 27 ± 4 years; weight = 67.1 ± 8.4 kg; and height = 1.6 ± 0.1 m. Men: n = 10; age = 27 ± 3 years; weight = 77.5 ± 10.1 kg; and height = 1.7 ± 0.1 m) at baseline and during DB, DB + HG, or DB + HG + OC protocols. Heart rate (HR) and respiratory rate were continuously recorded, and spectral analysis of heart rate variability (HRV) were calculated to indirectly estimate cardiac autonomic function. Men and women showed similar HR responses to DB, DB + HG and DB + HG + OC. Men exhibited a significant HR decrease following DB + HG + OC protocol which was accompanied by an improvement in cardiac autonomic control evidenced by spectral changes in HRV towards parasympathetic predominance (HRV High frequency: 83.95 ± 1.45 vs. 81.87 ± 1.50 n.u., DB + HG + OC vs. base-line; p < 0.05). In women, there was a marked decrease in HR after completion of both DB + HG and DB + HG + OC tests which was accompanied by a significant increase in cardiac vagal tone (HRV High frequency: 85.29 ± 1.19 vs. 77.93 ± 0.92 n.u., DB + HG vs. baseline; p < 0.05). No adverse effects or discomfort were reported by men or women during experimental procedures. Independent of sex, combination of DB, HG, and OC was tolerable and resulted in decreases in resting HR and elevations in cardiac parasympathetic tone. CONCLUSIONS: These data indicate that combined DB, HG and OC are effective in altering cardiac sympathovagal balance and reducing resting HR in healthy men and women.

The impact of music guided deep breathing exercise on blood pressure control - A participant blinded randomized controlled study

Introduction: As pharmacological treatment of hypertensionhas become a burden worldwide, the study looked into nonpharmacological ways of reducing blood pressure. Theobjective was to determine if music guided, slow and deepbreathing will reduce the blood pressure among patientswith hypertension in eight weeks.Methods: A participant blinded, multi-centre, randomisedcontrolled trial was conducted in which the participants inthe intervention group (IG) practiced deep breathingexercise guided by sound cues and those in the controlgroup (CG) listened to the music. The primary end point wasreduction in blood pressure at eight weeks.Results: 87 patients, 46 males and 41 females with mean ageof 61.1 years were recruited and 93.1% of them successfullycompleted the study. There was significant reduction insystolic and diastolic Blood Pressure from baseline by 8weeks in both groups. The reduction in Mean systolic bloodpressure (SBP) in the control arm was 10.5mmHg comparedto 8.3mmHg (p<0.001) in intervention group. Diastolic bloodpressure (DBP) reduction in control and intervention groupswere 5.2 mmHg (p<0.001) and 5.6 mmHg (p<0.001)respectively. The absolute difference in SBP reduction frombaseline in IG & CG was -2.2 (95%CI: -7.8 to 3.5) and DBPwas -0.4 (95%CI: -2.9 to 3.6). However, blood pressurereduction between the two groups was not significant.Conclusions: Both listening to music and deep breathingexercise were associated with a clinically significantreduction in SBP and DBP. However, deep breathingexercise did not augment the benefit of music in reducingBP.

Study on the effect of inspiratory muscle training of heavy load of deep breathing trainer for exercise tolerance and breathing difficulty level of patient with COPD in stable stage / 中国医学装备

Objective: To explore the effect of adopting inspiratory muscle training of heavy load of deep breathing trainer for exercise tolerance and breathing difficulty level of patient with chronic obstructive pulmonary disease COPD in stable stage.Methods: 108 patients with COPD in stable stage were divided into observation group(54 cases)and control group(54 cases).Patients of control group received resistance training of inspiratory muscle of low load(9 cm H2O)of deep breathing trainer.And that of observation group received inspiratory muscle training of heavy load(the maximum inspiratory pressure was 60％)of deep breathing trainer,and this training was arranged at morning and evening(the time of each training was 15 min)of every day,and the training included 6 times in each week,and the total training time was 6 months.And then the exercise tolerance(6 min walk distance,6MWD),the step number of pedometer,the score of breathing scale of modified medical British research council(mMRC)and lung function were compared.Results: The 6MWD and step number of pedometer of observation group of 1 month,3 months and 6 months post training were significantly higher than that of control group(t=12.365,t=13.254,t=12.845,P＜0.05),respectively.And the score of dyspnea of mMRC of observation group of 1 month,3 months and 6 months post training were significantly better than that of control group(t=4.365,t=4.021,t=4.325,P＜0.05),respectively.And the forced expiratory volume in one second(FEV1),FEV1％and the ratio of FEV1 and FVC％of lung function of 1 month,3 months and 6 months post training were significantly better than that pre training(F=3.265,F=2.985,F=2.963,P＜0.05).And the differences of the three indicators between observation group and control group were significant(F=3.474,F=3.146,F=3.271,P＜0.05).Conclusion: For patients with COPD in stable stage,the inspiratory muscle training of heavy load of deep breathing trainer can enhance exercise tolerance of patient,and relieve their symptom of dyspnea and improve lung function of patients.

Acute effects of deep breathing for a short duration (2-10 minutes) on pulmonary functions in healthy young volunteers.

Breathing is the most vital function for maintenance of life. Slow and deep breathing is an integral part of Pranayama and it reduces dead space ventilation and renews air throughout the lungs. The reported beneficial effects of deep breathing as a part of either long term or short term practice of pranayama are well documented. However our knowledge about the effects of a few minutes’ of deep breathing on human ventilatory parameters is poor. In the present study, we examined the relationship between exposure to short duration of deep breathing and performance on Pulmonary Function Tests before and after the deep breathing. The study was conducted in a homogenous group of 12 volunteers containing 4 females and 8 males who were well trained in pulmonary function testing (PFT) before the start of the study. The volunteers performed deep breathing (DB) exercise for 2, 5 and 10 minutes at the rate of 6 breaths per minute under guidance, and the duration of DB exercise for that day was randomly selected for each group. PFT was done before and after the DB exercise. There was a significant (P<0.05) increase in vital capacity (VC) after 2 and 5 minutes’ DB exercise and a consistent improvement in tidal volume (TV) and minute ventilation (MV) after the DB exercise in all the three groups, though it wasn’t statistically significant. There was a significant (P<0.05) increase in forced vital capacity (FVC) after 2 minutes’ of DB exercise and a consistent increase in all the three groups in forced inspiratory vital capacity (FIVC) and peak inspiratory flow rate (PIFR), though this increase was not statistically significant. This shows that deep breathing exercise, even for a few minutes’ duration is beneficial for the lung functions.

Breathing tests: a measure of the regulation of the maternal cardiovascular activity during pregnancy.

The study was the response to breathing test in 30 healthy pregnant volunteers in 20th to 29th weeks of singleton pregnancy with a mean of 25.2 gestational weeks. Deep breathing difference (DBD) was similar in both the groups. The heart rate variability was significantly lower in the second trimester of pregnancy reflected by the smaller standard deviation of R-R interval (SD R-R) during the quiet breathing test.

Relationship Between Obesity And Parasympathetic Nerve Function.

Back ground: Obesity is a potential risk factor for cardiovascular morbidity and mortality. As certain cardiovascular disorders associated with autonomic nerve which dysfunction often coexist in obese persons, investigations of autonomic nerve function especially parasympathetic nerve function in obese, for detection of early autonomic impairment can be potentially important to prevent complications. Objective: The present study was done to observe the parasympathetic nerve function status in obese persons in order to investigate the relationship of autonomic nerve function with obesity. Study design: This study was conducted in the department of Physiology of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh during July 2006-June 2007. For these 40 apparently healthy obese subjects of both sexes with BMI > 25 kg/sqm. were included in study group. Age and sex matched 40 apparently healthy non obese subjects with BMI range 18.5-22.9 kg/ sqm. were taken as control for comparison. Methods: To assess parasympathetic nerve function status, heart rate response to valsalva(valsalva ratio), heart rate response to deep breathing and heart rate response to standing (30th:15th ratio) were determined by 3 noninvasive cardiovascular reflex tests . Data were collected by recording ECG of all subjects under test condition. The correlations of these parasympathetic nerve function parameters with BMI were also studied. Unpaired Student‘t’ test and Pearson correlation coefficient test were used for statistical analysis. Results: Valsalva ratio (1.47±0.24 vs 1.67±0.31), HR response to deep breathing (19.62±5.55 vs 27.59±6.51) and HR response to standing (1.07±0.07 vs 1.13±0.018) were significantly decreased in obese subjects than those of non obese control. All these parameters were negatively correlated with BMI. and these relatioship were statistically significant. Conclusion: The results of this study indicate that parasympathetic nerve function may be reduced in apparently healthy obese subjects.

The Effects of Deep Breathing Methods on Pulmonary Ventilatory Function of Pneumothorax Patients undergoing a Thoracotomy / 간호학회지

PURPOSE: This study was to examine the effects of deep breathing exercises with Incentive Spirometer on the pulmonary ventilatory function of pnemothorax patients undergoing a thoracotomy. METHOD: This experiment used anonequivalent control group non-synchronized design which compared pre-experimental measures with post-experimental ones. The subjects of this study were 34 inpatients who were scheduled for a thoracotomy and classified into the experimental group (17 patients) or control group (17 patients) by using an Incentive Spirometer or not. The collected data was analyzed by a SPSS Win / PC (percentage, mean, standard deviation, chi-square test, t-test, repeated measured two-way ANOVA). RESULT: The Pulmonary Ventilatory Function of the experimental and control group were significantly increased on the first day, third day, and fifth day after the thoracotomy, but the group interaction period was not significant. CONCLUSION: This study showed that the deep breathing exercises with an Incentive Spirometer and deep breathing exercise without an Incentive Spirometer were both effective for recovering the pulmonary ventilatory function after a thoracotomy.

The Effects of Deep Breathing Methods on Pulmonary Ventilatory Function of Pneumothorax Patients undergoing a Thoracotomy / 간호학회지

PURPOSE: This study was to examine the effects of deep breathing exercises with Incentive Spirometer on the pulmonary ventilatory function of pnemothorax patients undergoing a thoracotomy. METHOD: This experiment used anonequivalent control group non-synchronized design which compared pre-experimental measures with post-experimental ones. The subjects of this study were 34 inpatients who were scheduled for a thoracotomy and classified into the experimental group (17 patients) or control group (17 patients) by using an Incentive Spirometer or not. The collected data was analyzed by a SPSS Win / PC (percentage, mean, standard deviation, chi-square test, t-test, repeated measured two-way ANOVA). RESULT: The Pulmonary Ventilatory Function of the experimental and control group were significantly increased on the first day, third day, and fifth day after the thoracotomy, but the group interaction period was not significant. CONCLUSION: This study showed that the deep breathing exercises with an Incentive Spirometer and deep breathing exercise without an Incentive Spirometer were both effective for recovering the pulmonary ventilatory function after a thoracotomy.

Comparison of Tidal Volume Breathing and Deep Breathing Preoxygenation Techniques for a Cesarean Section / 대한마취과학회지

BACKGROUND: Preoxygenation is routine prior to rapid sequence induction of general anesthesia for a cesarean section. The aim of this study was to evaluate the preoxygenation techniques of tidal volume breathing (TVB) and deep breathing (DB) for a cesarean section. METHODS: One hundred twenty ASA I and II patients scheduled for a cesarean section under general anesthesia participated in the study. Preoxygenation was performed with 5, 7, and 10 L/min 100% oxygen. The following techniques were tested: 1) normal TVB for a 5-min period (TVB/5 min) and 2) DB for a 2-min period (4 DB/0.5 min, 8 DB/min, 12 DB/1.5 min and 16 DB/2 min). Inspired (FIO2) and end-tidal oxygen fraction (FETO2), end-tidal carbon dioxide pressure (ETCO2) and oxygen saturation (SpO2) were measured at 0.5-min intervals. RESULTS: During TVB, FETO2 increased rapidly between 0.5 and 3.5 min and plateaued by 3.5 min at 78.5%, 83.3% and 90.8% with 5, 7 and 10 L/min 100% oxygen, respectively. Four DB/0.5 min increased FETO2 to 64.7%, 67.2% and 72.3% at 5, 7, and 10 L/min 100% oxygen, respectively. As compared with four DB/0.5 min, the values of FETO2 with TVB/1.5 min and TVB/2 min were high at 7, 10 and 5 L/min 100% oxygen. CONCLUSIONS: We concluded that TVB/2 min was more effective than four DB/0.5 min in achieving preoxygenation but eight DB/min could be used in case of an emergent operation.

The Effect of Deep Breathing Exercise and Incentive Spirometry to Prevent Postoperative Pulmonary Complications after Abdominal Surgery in Geriatric Patients / 대한마취과학회지

BACKGROUND: The purpose of this clinical study was to evaluate the Incentive Spirometry (IS) and Deep Breathing Exercises (DBE) to prevent postoperative pulmonary complications after abdominal surgery in patients over 60 years of age. METHODS: We prospectively randomized 90 patients into 1 of 3 groups: the control group (30 patients) received no respiratory treatment, the IS group (30 patients) was treated with incentive spirometry 4 times daily and DBE group (30 patients) carried out deep breathing exercises under supervision for 15 min 4 times daily. ABGA was taken at ward, PR (preop.room), RR (recovery room), POD1 day and POD2 day. Roentgenographic changes observed at 24 h. and 48 h. after surgery. Pulmonary complications were defined as the development of 3 or more of 6 new findings: cough, sputum, dyspnea, chest discomfort, temperature greater than 38oC, pulse rate more than 100 beats/min. RESULTS: PaO2 in the DBE group and IS group at PR were significantly increased than the values at ward, and the values of the PaO2 in the DBE group at RR and POD1 day, and those of IS group at PR and POD2 day were significant higher than those of the control group (p<0.05). The frequency of development of pulmonary complications (43.3% in the control group, 20% in the DBE group, 20% in the IS group) and roentgenographic changes were comparable in the 3 groups (26.7%, 16.7%, 20% respectively). The DBE group showed the different incidence of postoperative pulmonary complications between upper and lower abdominal surgery (upper: lower= 35.7: 6.3%). CONCLUSIONS: We concluded that DBE and IS were effective in preventing postoperative pulmonary complications after abdominal surgery and lower abdominal surgery causes lesser postoperative pulmonary complications than upper abdominal surgery.

The Effect of Exercise with Deep Breathing on the Pulse, Blood Pressure and Peripheral Circulation / 日本東洋医学雑誌

The effects of Qi Gong health maintenance exercises were compared with a control group of walkers considered to have an equivalent amount of exercise, by measuring the changes in the pulse, systolic blood pressure, diastolic blood pressure and peripheral circulation.<br>Although no significant differences were seen in either the pulse or blood pressure of the control group of walkers when the before and after exercise values were compared, in the Qi Gong group, a decrease in these values was seen over time, with significant decreases from the pre-exercise values indicated in all values 30 minutes after exercise. This is consistent with the findings in a previous report that there was a significant reduction in catecholamine in the Qi Gong group 30 minutes after performing Qi Gong exercises.<br>When the flow rate of the peripheral circulation was measured using Doppler ultrasound equipment, in comparison with the lack of notable change over time seen in the control group, a significant improvement in the peripheral circulation was suggested for the Qi Gong group when the pre- and post- exercise values were compared. It has also been suggested that Qi Gong health maintenance exercises lower stress hormones and act to improve the peripheral blood circulation; a discussion of which is also included in this paper.

The Effect of Exercise with Deep Breathing(Qi-Gong) on Stress-Related Hormones in the Blood / 日本東洋医学雑誌

The levels of stress-related hormones in the blood were measured before and after doing Qi Gong health-maintenance exercises, and a control group of walkers with a similar level of movement selected for the basis of a comparative study. The adrenaline, noradrenaline and growth hormone responses of the Qi Gong group were compared with the pre-exercise values. Although no significant difference was observed immediately after exercise, there was a significant drop in all values 30 minutes after exercising. Similar changes in the blood cortisol were noted in the Qi Gong group and walker group. Compared with the pre-exercise value, both group exhibited significant reduction in blood cortisol both immediately following exercise and 30 minutes after exercise, with the lowest value occurring 30 minutes after exercise. In contrast to the increase in stress-related hormones typical after light exercise that was seen in the walker group, the significant reduction response seen in the stress-related hormones of the Qi Gong group with the similar amount of movement was seen as unusual. This suggested that Qi Gong may be a positive means of stress-reduction and a useful health-maintenance method in today's stressful society.

The Influence of Deep Breathing and Encouraged Cough on the Arterial Oxygen Saturation in Patients Following Upper Abdominal Surgery / 대한마취과학회지

To investigate the effect of deep breathing and encouraged coughing on the arterial oxygenation in patients following upper abdominal surgery under general anesthesia, 80 patients were chosen and divided into 4 groups according to the therapy modalities given during the recovery mom care ; group 1: spontaneous recovery, group 2: oxygen, group 3: cough with deep breathing, and group 4: oxygen plus cough with deep breathing. Oxygen saturation (SpO2 by pulse oximeter) was monitored before anesthesia (control) and over a 24 hour period after operation. S values decreased on arrival in the recovery room after anesthesia in all groups (p<0.05). As patients awakened from anesthesia in the recovery room, SpO2 values were progressively increased to near preanesthetic values in the non-oxygen groups (Group 1, 3) and increased even above preanesthtic values in the oxygen groups (Group 2, 4) SpO2 values at 24-hours after operation were 97.0% in Group 1, 96.9% in Group 2, 97.8% in Group 3, and 97.5% in GRoup 4; therefore Group 3 had the highest value of SpO2 (p<0.05), In conclusion, deep breathing with cough encouragement in the recovery room seemed to be associated with better oxygenation 24 hours postanesthetically than supplemental oxygen or natural recovery groups.