Factors Discriminating Spontaneous Pursed-Lips Breathing Use in Patients with COPD

ABSTRACTPursed-lips breathing (PLB) is often spontaneously performed by chronic obstructive pulmonary disease (COPD) patients. The aim of this study was to evaluate spontaneous PLB prevalence and to identify factors discriminating its use. Fifty-seven patients with COPD (FEV1 = 44.3 ± 17.4%pred) underwent pulmonary function testing and two incremental bicycle exercise tests. Peak workload (Wpeak), oxygen uptake (VO2peak), breathing pattern, and dyspnea (Borg scale) were measured in the first exercise test and spontaneous PLB performance in the second. Six patients spontaneously performed pursed-lips breathing during rest (PLBrest), exercise and recovery, 18 during exercise and recovery (PLBex), 7 during recovery only (PLBrec), 20 not at all (PLBno), and 6 performed other expiratory resistive maneuvers. PLBrest and PLBex patients exhibited a lower Wpeak, O2 uptake, and minute ventilation (VE), greater expiratory flow limitation and higher slopes relating dyspnea to VE or W (%predicted). PLBrest patients we...