5 Evidence-Based Breathing Exercises for Dyspnea
Dyspnea, also called shortness of breath, is one of the most important symptoms affecting engagement in activities of daily living (ADLs), occupational performance, and quality of life (Smith-Gabai & Holm, p. 272, 2017). Breathing exercises including diaphragmatic and pursed lip breathing improve dyspnea (shortness of breath) symptoms and promote improved respiratory function.
Information adapted from (Smith-Gabai & Holm, p. 272, 2017). (you can purchase this resource on the AOTA website here).
During participation in these breathing exercises, it is essential to:
Find a stable position, whether sitting or lying down, that allows for ease of breathing.
Breathing should be slow, deep, and continuous.
Exhalation should be 2 to 3 times longer than inspiration.
Avoid forceful expiration; exhalations should be gentle.
Avoid holding breath during activity.
Inspiration occurs with body movements against gravity.
Diaphragmatic or abdominal breathing
Position your hands on your abdomen.
Visualize a balloon inflating as air is introduced and deflating when the air is released.
Concentrate on your abdomen elevating as you inhale, similar to how the balloon expands as it fills with air.
With your hand on your abdomen, lightly tap or apply gentle pressure while exhaling to encourage the abdomen to contract or draw inward, mirroring the way the balloon deflates when air is released.
Pursed lip breathing
Inhale through the nose as if smelling flowers.
Exhale gently and slowly through pursed lips as if blowing bubbles through a bubble want or blowing kisses. Exhalations should not be forceful.
Coordinate abdominal and pursed lip breathing together.
Lower-rib breathing
Hands are placed on both sides of the body, on the lower section of the rib cage.
With each exhalation, tactile resistance is provided to the ribs (to ease rib expansion with inhalations).
Relaxation breathing
Exhale (breathe out) longer than inhale (breathe in).
For example, if breathing in to a count of 2, breath out to a count of 3, 4, or 5, finding your own rhythm and repeat. It is a constant rhythm devoid of holding ones breath. Relaxation breathing is helpful in slowing down respiratory rate.
”The Accordion”
Tuck elbows in at sides of body.
Place hands with palms parallel to each other.
As you inhale, move hands out to sides (as if pulling an accordion out)
As you exhale, move hands back toward each other (as if pressing in a bellows)
Breathing should be slow and relaxed.
Listed below are a few important occupational therapy intervention ideas for patients experiencing shortness of breath.
Educating patients about their diagnosis.
Increasing activity tolerance through graded activity.
Improving upper body strength and ROM.
Engage patient in meaningful occupations.
Instructing patients in controlled breathing (diaphragmatic and pursed lip breathing).
Encouraging energy conservation principles.
Reference
H, Smith-Gabai, S, Holm. (2017). Occupational therapy in acute care, 2nd Ed. p. 272.