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- W2198003454 abstract "To the Editor: The article by Jones et al titled “Comparison of the Oxygen Cost of Breathing Exercises and Spontaneous Breathing in Patients With Stable Chronic Obstructive Pulmonary Disease” in the May 2003 issue adds valuable evidence to aid our decision on when to teach (or not to teach) breathing exercises to patients with chronic obstructive pulmonary disease (COPD). Their methods were clear and straightforward, and the patients were representative of the age (mean age=68.5 years) and severity of COPD in patients seen in many pulmonary rehabilitation programs (mean percentage of predicted forced expiratory volume in 1 second [FEV1]=39%). However, the article did raise some concerns.First, much of the introduction discusses the topics of work of breathing (WOB) and ventilatory muscle efficiency and how these 2 factors may be affected in patients with COPD; however, WOB and ventilatory muscle efficiency are not adequately defined in relation to each other. The authors correctly define WOB, but not the rate of WOB, which is arguably more important; the rate of WOB is the product of WOB (for single breath) and respiratory rate (RR) (the rate of WOB=P·Vt·RR, where P=inspiratory pressure and Vt=tidal volume). Ventilatory muscle efficiency, or mechanical efficiency of breathing, was not defined, but is directly related to the rate of WOB by the following equation: ventilatory muscle efficiency=the rate of WOB/Vo2·100%, where Vo2 is oxygen consumption.1,2 Therefore, interventions such as pursed lip breathing (PLB) and diaphragmatic breathing (DB) that decrease RR also will decrease the rate of WOB, and if ventilatory muscle efficiency does not change, then Vo2 will decrease, which is what Jones and colleagues' results indicate.Second, given the wide range of body mass index (BMI) values (13.7–28.1 kg/m2; …" @default.
- W2198003454 created "2016-06-24" @default.
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- W2198003454 date "2003-10-01" @default.
- W2198003454 modified "2023-09-27" @default.
- W2198003454 title "Breathing Exercises for Patients With COPD: To Teach or Not to Teach" @default.
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- W2198003454 doi "https://doi.org/10.1093/ptj/83.10.948" @default.
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