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Vol. 22. Issue 6.
Pages 452-458 (01 November 2018)
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Vol. 22. Issue 6.
Pages 452-458 (01 November 2018)
Original Research
DOI: 10.1016/j.bjpt.2018.04.005
Can diaphragmatic breathing modify chest wall volumes during inspiratory loaded breathing in patients with heart failure?
Susan Martins Lagea,1, Raquel Rodrigues Brittob,1, Daniella Cunha Brandãoc,1, Danielle Aparecida Gomes Pereirab,1, Armèle Dornelas de Andradec,1, Verônica Franco Parreirab,1,
Corresponding author

Corresponding author at: Departamento de Fisioterapia, Avenida Antônio Carlos, 6627, Pampulha, CEP: 31270-901 Belo Horizonte, MG, Brazil.
a Universidade Federal de Minas Gerais (UFMG), Rehabilitation Sciences Post Graduation Program, Belo Horizonte, MG, Brazil
b Universidade Federal de Minas Gerais (UFMG), Department of Physical Therapy, Belo Horizonte, MG, Brazil
c Universidade Federal de Pernambuco (UFPE), Department of Physical Therapy, Recife, PE, Brazil

  • Inspiratory loaded breathing (ILB) modifies chest wall volumes in patients with heart failure (HF).

  • ILB associated with diaphragmatic breathing (ILBdi) increases abdominal volume in these patients.

  • Chest wall tidal volume and breathing pattern variables are similar between ILB and ILBdi.

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Tables (2)
Table 1. Characteristics of participants (n=16).
Table 2. Chest wall volume and breathing pattern data obtained during quiet breathing and inspiratory loaded breathing conditions (n=16).
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Some inspiratory muscle training protocols for patients with heart failure report the request of diaphragmatic breathing during inspiratory loaded breathing. However, it is unclear whether this condition modifies the chest wall volumes.


The primary purpose was to evaluate chest wall volumes during inspiratory loaded breathing as well as during inspiratory loaded breathing associated with diaphragmatic breathing in patients with heart failure.


Sixteen men with heart failure functional class I to III, aged 50(SD=7) years were evaluated. Volumes of the pulmonary rib cage, abdominal rib cage and abdomen, as well as other breathing pattern variables, were assessed by optoelectronic plethysmography during quiet breathing, inspiratory loaded breathing, and inspiratory loaded breathing associated with diaphragmatic breathing.


Chest wall tidal volume significantly increased from quiet breathing 0.53(SD=0.14)L to inspiratory loaded breathing 1.33(SD=0.48)L and to inspiratory loaded breathing associated with diaphragmatic breathing 1.36(SD=0.48)L. A significant volume variation was observed on the three compartments (p<0.05 for all). During inspiratory loaded breathing associated with diaphragmatic breathing, patients showed increased abdominal volume compared to quiet breathing [0.28(SD=0.05) to 0.83(SD=0.47)L, p<0.001]; as well as from inspiratory loaded breathing [0.63(SD=0.23) to 0.83(SD=0.47)L, p=0.044]. No significant changes were observed between the two inspiratory loaded breathing conditions on the percentages of the contribution of each chest wall compartment for the tidal volume, respiratory rate, minute ventilation, and duty cycle.


When inspiratory loaded breathing was associated with diaphragmatic breathing, a higher volume in the abdominal compartment was obtained without significant changes in other breathing pattern variables.

Breathing exercises
Inspiratory muscle training
Breathing pattern
Optoelectronic plethysmography


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