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
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|
Increased 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?
Another 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
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.
The 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).
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.
1. 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.
7. 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|
|Experimental||62,1 ±2,1||64,6 ±1,8||66,9±1,6||67,2±1,7||67,7±2,3|
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.
Reference pages: Breathing norms and medical facts:
- Breathing norms: Parameters, graph, and description of the normal breathing pattern
- 6 breathing myths: Myths and superstitions about breathing and body oxygenation (prevalence: over 90%)
- Hyperventilation: Definitions of hyperventilation: their advantages and weak points
- Hyperventilation syndrome: Western scientific evidence about prevalence of chronic hyperventilation in patients with chronic conditions (37 medical studies)
- Normal minute ventilation: Small and slow breathing at rest is enjoyed by healthy subjects (14 studies)
- Hyperventilation prevalence: Present in over 90% of normal people (24 medical studies)
- HV and hypoxia: How and why deep breathing reduces oxygenation of cells and tissues of all vital organs
- Body-oxygen test (CP test) : How to measure your own breathing and body oxygenation (two in one) using a simple DIY test
- Body oxygen in healthy: Results for the body-oxygen test for healthy people (27 medical studies)
- Body oxygen in sick : Results for the body-oxygen test for sick people (14 medical studies)
- Buteyko Table of Health Zones: Clinical description and ranges for breathing zones: from the critically ill (severely sick) up to super healthy people with maximum possible body oxygenation
- Morning hyperventilation: Why people feel worse and critically ill people are most likely to die during early morning hours
References: pages about CO2 effect:
- Vasodilation: CO2 expands arteries and arterioles facilitating perfusion (or blood supply) to all vital organs
- The Bohr effect: How and why oxygen is released by red blood cells in tissues
- Cell oxygen levels: How alveolar CO2 influences oxygen transport
- Oxygen transport: O2 transport is controlled by vasoconstriction-vasodilation and the Bohr effects, both of which rely on CO2
- Free radical generation: Reactive oxygen species are produced within cells due to anaerobic cell respiration caused by cell hypoxia
- Inflammatory response: Chronic inflammation in fueled by the hypoxia-inducible factor 1, while normal breathing reduces and eliminates inflammation
- Nerve stabilization: People remain calm due to calmative or sedative effects of carbon dioxide in neurons or nerve cells
- Muscle relaxation: Relaxation of muscle cells is normal at high CO2, while hypocapnia causes muscular tension, poor posture and, sometimes, aggression and violence
- Bronchodilation: Dilation of airways (bronchi and bronchioles) is caused by carbon dioxide, and their constriction by hypocapnia (low CO2)
- Blood pH: Regulation of blood pH due to breathing and regulation of other bodily fluids
- CO2: lung damage: Elevated carbon dioxide prevents lung injury and promotes healing of lung tissues
- CO2: Topical carbon dioxide can heal skin and tissues
- Synthesis of glutamine in the brain, CO2 fixation, and other chemical reactions
- Deep breathing myth: Ignorant and naive people promote the idea that deep breathing and breathing more air at rest is beneficial for health
- Breathing control: How is our breathing regulated? Why hypocapnia makes breathing uneven, irregular and erratic.
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