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    Breathing With COPD

    Tips for pursed lip breathing and pulmonary rehabilitation.

    Pursed Lip Breathing: A Technique That Helps continued...

    In COPD patients with advanced emphysema, pursed lip breathing can also open up airways enough to release more air, Criner says. "That may allow some air that's trapped in the lungs to exhale out, so it decreases the amount of gas trapped in your chest," Criner says.

    When shortness of breath occurs, other tactics can help, too. Patients should try putting cold water on the face or flowing cold air over the face with a fan. Such measures will stimulate body responses that decrease the sensation of breathlessness, according to Criner.

    Pulmonary Rehabilitation Programs to Consider

    While diaphragmatic breathing may not work well, other techniques taught through a pulmonary rehabilitation program may be more effective, Criner says. Some pulmonary rehab programs use breathing devices, called inspiratory muscle trainers, that train patients to increase the pressure that breathing muscles have to generate per breath.

    "You can't really train the lungs, but you could train your respiratory muscles to be stronger or to have greater endurance," Criner says. Training the respiratory muscles may make them stronger by about 20% to 25%, he says.

    "It's hard to show, though, if you make them stronger, that it relates to an improvement in your ability to do work. But you can make them stronger and that may be helpful in clearing secretions and coughing," as well as giving the breathing muscles greater reserves from which to draw, he says.

    It's important to get good advice from a pulmonary rehab program about effective devices, Criner says. Lung trainers and other devices promoted on the Internet often don't work.

    "They're like kazoos," he says. "Rather than searching the Web and buying things out of pocket that may not be useful, go to a pulmonary rehab program. They can tell you about the best things and approaches. They'll customize it to you to make you feel better and do more."

    Pulmonary rehab programs also teach patients exercises to strengthen their arms and legs, a therapy that Edelman says is valuable to COPD patients. Typically, patients do aerobic and isotonic exercises, the latter designed to strengthen muscles.

    "Old-fashioned exercise training -- the evidence for that is pretty good," Edelman says. "You can make the muscles and the circulatory system more efficient so that it delivers oxygen to the exercising muscles better. And of course, that reduces the burden on the lungs because you need to deliver less oxygen to the blood."

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