Positive Expiratory Pressure Breathing Increases the Recovery of Dyspnea in Patients with COPD

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Khajonsak Pongpanit Chulee Jones David Jones Watchara Boonsawat


Dyspnea is a major factor delaying post-exercise recovery in patients with chronic obstructive pulmonary disease (COPD). The aim of this study was to evaluate the effectiveness of positive expiratory pressure (PEP) breathing on dyspnea recovery in COPD patients. A randomized cross-over trial was conducted with 12 stable COPD patients with an average age of 58.9±6.7 years. The participants exercised with spot brisk marching until moderate to severe dyspnea. Then immediately after the end of exercise, they were exhaled for 6 breaths through PEP device with an expiratory load of 5 cmH2O in the Experimental and 0 cmH2O in the Sham condition. Ratings of dyspnea with Borg’s scale, respiratory rate (RR), pulse oxygen saturation (SpO2), and end-tidal carbon dioxide pressure (PETCO2) were measured before and every minute during exercise and 10 minutes of recovery period. The results show that the recovery rate of dyspnea was twice as fast following the Experimental compared to the Sham condition (1.31±0.36 vs 0.70±0.09 units/min; p < 0.001). Dyspnea returned to baseline in 3 minutes in the Experimental compared to 5 minutes in the Sham condition. SpO2, and PETCO2 were not different between the two conditions at any time point. RR was not different between condition at rest or during exercise, but was lower in the recovery period following use of PEP (p < 0.05). We concluded that PEP breathing at least 5 cmH2O accelerates the rate of dyspnea recovery and decreases recovery time after exercise in COPD.


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Pongpanit K, Jones C, Jones D, Boonsawat W. Positive Expiratory Pressure Breathing Increases the Recovery of Dyspnea in Patients with COPD. Thai Journal of Physical Therapy [Internet]. 16Apr.2015 [cited 24Mar.2018];37(1):41-3. Available from: https://www.tci-thaijo.org/index.php/tjpt/article/view/114459
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