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Breathing Exercises for COPD: How to Increase Body O2

Breathing exercises for COPD are vital since acute COPD exacerbations are accompanied by increased lung ventilation: breathing becomes faster and usually deeper. This causes losses in alveolar CO2 and constriction of airways. Studies also show that, when COPD patients are in stable condition, they also exhibit heavy breathing at rest.

Table. Over breathing in COPD

Condition Minute
Number of
All references or
click below for abstracts
Normal breathing 6 l/min - 0 % Medical textbooks
Healthy Subjects 6-7 l/min >400 0 % Results of 14 studies
COPD 14 (2) l/min 12 100% Palange et al, 2001
COPD 12 (2) l/min 10 100% Sinderby et al, 2001
COPD 14 l/min 3 100% Stulbarg et al, 2001

Man with acute COPD breathing heavyIncreased ventilation reduces alveolar CO2, a powerful bronchodilator (see links below). Continued over-breathing further reduces CO2 levels in airways causing bronchospasm, increased friction of air moving in constricted airways, extra mucus production (that further worsens air movement), increased hypoxemia, and reduced oxygen levels in cells. Furthermore, studies have found injurious effects of alveolar hypocapnia (low CO2 in the lungs) (see links below.) Therefore, it is not a surprise that severity of acute COPD exacerbations can be greatly reduced if the patients slow down their breathing and accumulate CO2 in airways in order to expand them using special COPD breathing exercises. This can be accomplished with Buteyko reduced breathing exercises. An introduction to these exercises and accompanying lifestyle changes can be found in the Section "Learn here".

Can breathing exercises for COPD normalize lung function test results?

MDs smilingAnother option of the COPD breathing exercise is to increase alveolar CO2 using a breathing device such as the Frolov breathing device. Over 500 medical doctors endorse and use the Frolov breathing device in Russia. After testing hundreds of people with COPD, Russian Buteyko MDs suggested that COPD patients require more than 20 seconds for the body-oxygen test in order to prevent acute COPD exacerbations and improve their fitness and symptoms. However, if people with COPD get more than 40 seconds they can achieve clinical remission with normal lung function results. COPD patients need to slow down their heavy breathing back to the medical norm using both breathing exercises and lifestyle changes.

The following section describes a clinical trial which evaluated the effects and safety of breathing exercises with the Frolov breathing device on respiratory function of COPD patients with a moderate degree of the disease who were hospitalized following an exacerbation.

In this clinical trial, breathing exercises for COPD patients were continued after their discharge from the hospital. The therapy, breathing with the Frolov device from 10 minutes up to 30 minutes per day maximum, was used in addition to standard medication. Final measurements (lung function tests) were done after 90 days of breathing exercises. Here is a partial translation of this medical study.

Clinical Investigation of Frolov Breathing Device (TDI-01) in Complex Therapy
of Patients with Chronic Obstructive Pulmonary Disease

Scientific Research Institute of Physiology, Siberian Division, Russian Academy of Medical Sciences
Sergey Georgievich Krivoschekov, MD, PhD, Professor, Manager of the Laboratory of Functional Reserves of the Human Organism
Irina Vladimirovna Savitskaya, MD, Chief Physician of the Clinic of the Institute of Physiology
Doctors and patients (Siberian Division, Russian Academy of Medical Sciences)
Olga Vladimirovna Gilinskaya, MD, Pulmonary Physician

This controlled randomized study was conducted from March 10, 1998 to May 15, 2000. The objectives of the research were:
- to investigate the influence of the individual device TDI-01 (Frolov breathing device) exercises on the respiratory system of patients with COPD
- to compare efficiency and safety of this therapy for this group of patients
- to investigate the possibility of reduction (elimination) of medication as a result of the Frolov breathing exercises therapy
- to investigate criteria of efficiency and safety of the method.

Experimental group

Woman coughingThe experimental group had 40 hospitalized patients with COPD of moderate severity, 55-60 years old, with COPD duration from 5 to 8 years. (This was a group of typical COPD patients.)

The initial duration of breathing exercises was 10 minutes with 1 additional minute increase after each 2 days. On the 42nd day, the duration of the breathing exercises was 30 min and then it remained unchanged until the end of the study (day 90). Initial duration of the breathing cycle was 4-7 seconds and after the patients achieved 30 s, it was suggested to keep it unchanged.

All patients were discharged from the hospital on the 18th day. Their medication reduction (day 18) was 20%. Additional investigations were conducted on days 42, 60 and 90. By day 90, the reduction of the medication dose was about 60% (40% of the initial dose). The results of lung function and other tests are provided below (see the Table).

Control group

The control group had 42 patients with COPD of moderate severity, 55-60 years old, duration of the disease was from 4.7 to 9.2 years.

These patients did not practice breathing exercises and were also discharged from the hospital on the 18th day. Reduction in medication: 10% at the time of their discharge from the hospital and 30-40% at days 60 and 90.

The respiratory system1. During investigation of the Frolov breathing device therapy (TDI-01) on patients with COPD (stable state, moderate severity), there were no complications or side effects which could be dangerous for health. Clinical observations showed the safety of its application. This can be explained by that fact that this method is drug-free and is based on activation of physiological processes.

2. Breathing exercises with the TDI-01 have a positive effect on the lung function test in COPD and this effect increases with the duration of the therapy and duration of the breathing cycle.

3. The most informative parameters of effectiveness and control during application of the TDI-01 for patients with COPD are: FEV1 (forced expiratory volume in 1 second); RV (residual volume); EVC (expiratory vital capacity); FEV\FVC, end tidal O2, and end-tidal CO2.

4. The TDI-01 therapy for patients with COPD (stable state, moderate severity) is effective and this has been confirmed by better lung function tests and reduction in medication for patients of the experimental group in comparison with patients of the control group who had only medication therapy.

5. The positive effect of the TDI-01 lung function test results in patients with COPD could be explained by positive air pressure during exhalations and improved bronchial conductivity.

6. One of the positive effects of the TDI-01 is a favorable positive effect of systematic breathing exercises, and this improves the respiratory function at rest and during exercise.

Lungs alveoli7. During systematic application of the TDI-01, there is an improvement in ventilation-perfusion parameters, optimization of gas exchange, long-term adaptation to systematic training in conditions of alveolar hypoxia / hypercapnia. This simultaneously helps the anti-infective host defense, increased resistance of the organism, and stable improvements in the health of patients with reduction in medication.

8. Application of the TDI-01 for patients with COPD is economically effective and can be used in hospitals, clinics, and rehabilitation centers.

9. Effective application of the TDI-01 for treatment of patients with moderate severity of COPD shows its effectiveness for patients with light severity of COPD.

Dynamics of Lung Function Parameters in Patients with
COPD (Control and Experimental Groups)
Parameter Group Initial Day 22 Day 42 Day 60 Day 90
Control 62,11,8 62,81,9 63,92,2 64,82,4 65,43,7
Experimental 61,31,6 61,31,2 65,8 1,2 67,11,4 67,91,3
FEV1 Control 61,62,4 63,03, 64,22,9 65,54,2 66,26,1
Experimental 62,1 2,1 64,6 1,8 66,91,6 67,21,7 67,72,3
PEF Control 46,95,9 51,15,5 55,26,0 57,36,2 60,97,5
Experimental 47,55,4 53,95,3 58,25,8 60,15,2 63,45,1
RV Control 132,25,7 128,14,3 125,55,3 122,25,8 119,06,4
Experimental 130,95,1 122,84,6 117,53,2 115,83,5 113,23,8
TLC Control 107,37,4 106,57,2 105,36,8 104,97,2 104,28,1
Experimental 106,97,8 105,16,9 104,95,8 104,76,1 104,36,9
FRC Control 103,43,8 102,83,5 102,13,7 102,53,9 102,94,8
Experimental 102,93,6 102,63,1 102,92,8 101,53,3 101,73,4
FEV/FVC,% Control 53,43,6 58,24,8 60,24,5 58,13,4 58,85,2
Experimental 55,23,6 57,44,2 58,46,4 64,85,6 64,74,4

Table abbreviations: VC (vital capacity); FEV1 (forced expiratory volume in 1 second); PEF (Peak Expiratory Flow);  RV (residual volume); TLC (total lung capacity); FRC (Functional residual capacity); FEV/FVC ratio ,%

/ Translated by Artour Rakhimov, February 2011

Observation. It is possible to notice that if the control group had a certain improvement in some lung function parameter (VC, FEV, and so on), the improvement in the experimental group was about 2 times larger.

Other pages of this site explain details of Buteyko breathing exercises (see "Learn" Section) that are to be used as breathing exercises for COPD.

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