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Respiratory Dynamics: Function and Breath Management

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Image-Guided Management of COVID-19 Lung Disease

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Abstract

Oral communication and activities of daily living require efficient respiratory function to couple with downstream subsystems of phonation and resonance/articulation. Respiratory function also helps maintain a clear airway. Deficits in respiration may arise from disease states, posture changes, or deconditioning following a medical event. Optimum management is essential to provide the patient with healthy oxygen exchange necessary for other body organs (circulation, renal, hepatic, and hematological systems) and to set up necessary aerodynamics to protect the airway and permit phonation.

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References

  1. Chatterjee P, Bandyopadhyay A, Chatterjee P, Nandy P. Assessment and comparative analysis of different lung capacities in trained athletes according to somatotype. Am J Sports Sci. 2019;7(2):72–7. https://doi.org/10.11648/j.ajss.20190702.14.

    Article  Google Scholar 

  2. Supinski GS, Clary SJ, Bark H, Kelsen SG. Effect of inspiratory muscle fatigue on perception of effort during loaded breathing. J Appl Physiol. 1987;62(1):300–7. https://doi.org/10.1152/japp.1987.62.1.300.

    Article  CAS  PubMed  Google Scholar 

  3. Suzuki S, Suzuki J, Ishii T, Akahori T, Okubo T. Relationship of respiratory effort sensation to expiratory muscle fatigue during expiratory threshold loading. Am Rev Respir Dis. 1992;145(2 Pt 1):461–6. https://doi.org/10.1164/ajrccm/145.2_Pt_1.461.

    Article  CAS  PubMed  Google Scholar 

  4. Tiller NB, Turner LA, Taylor BJ. Pulmonary and respiratory muscle function in response to 10 marathons in 10 days. Eur J Appl Physiol. 2019;119(2):509–18. https://doi.org/10.1007/s00421-018-4037-2.

    Article  PubMed  Google Scholar 

  5. Dempsey JA, Babcock MA. An integrative view of limitations to muscular performance. Adv Exp Med Biol. 1995;384:393–9. https://doi.org/10.1007/978-1-4899-1016-5_31.

    Article  CAS  PubMed  Google Scholar 

  6. McKenzie DK, Bellemare F. Respiratory muscle fatigue. Adv Exp Med Biol. 1995;384:401–14. https://doi.org/10.1007/978-1-4899-1016-5_32.

    Article  CAS  PubMed  Google Scholar 

  7. DelGaudio JM. Steroid inhaler laryngitis: dysphonia caused by inhaled fluticasone therapy. Arch Otolaryngol Head Neck Surg. 2002;128(6):677–81. https://doi.org/10.1001/archotol.128.6.677.

    Article  PubMed  Google Scholar 

  8. Li X, Ma X. Acute respiratory failure in COVID-19: is it “typical” ARDS? Crit Care. 2020;24(1):198. https://doi.org/10.1186/s13054-020-02911-9.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Pérez CA. Looking ahead: the risk of neurologic complications due to COVID-19. Neurol Clin Pract. 2020;10(4):371–4. https://doi.org/10.1212/CPJ.0000000000000836.

    Article  PubMed  Google Scholar 

  10. Lechien JR, Chiesa-Estomba CM, Cabaraux P, et al. Features of mild-to-moderate COVID-19 patients with dysphonia [published online ahead of print, 2020 Jun 4]. J Voice. 2020;S0892-1997(20)30183–1. https://doi.org/10.1016/j.jvoice.2020.05.012.

  11. Li Y, He F, Zhou N, Wei J, Ding Z, Wang L, et al. Organ function support in patients with coronavirus disease 2019: Tongji experience. Front Med. 2020;14(2):232–48. https://doi.org/10.1007/s11684-020-0774-9.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Hardin M, Silverman EK. Chronic obstructive pulmonary disease genetics: a review of the past and a look into the future. Chronic Obstr Pulm Dis. 2014;1(1):33–46. https://doi.org/10.15326/jcopdf.1.1.2014.0120.

    Article  PubMed  PubMed Central  Google Scholar 

  13. Wada N, Fukunaga K, Obata T, Saito Y, Tamaki H, Kobayashi S, Ka et al. [The respiratory function in children with collagen disease]. Rymachi. 1991;31(5):488–92.

    Google Scholar 

  14. Tachikawa R, Tomii K, Ueda H, Nagata K, Nanjo S, Sakurai A, et al. Clinical features and outcome of acute exacerbation of interstitial pneumonia: collagen vascular diseases-related versus idiopathic. Respiration. 2012;83(1):20–7. https://doi.org/10.1159/000329893.

    Article  PubMed  Google Scholar 

  15. Nagao T, Nagai S, Kitaichi M, Hayashi M, Shigematsu M, Tsutsumi T, et al. Usual interstitial pneumonia: idiopathic pulmonary fibrosis versus collagen vascular disease. Respiration. 2001;68(2):151–9. https://doi.org/10.1159/000050485.

    Article  CAS  PubMed  Google Scholar 

  16. Richardson AE, Warrier K, Vyas H. Respiratory complication of the rheumatological diseases in childhood. Arch Dis Child. 2016;101(8):752–8. https://doi.org/10.1136/archdischild-2014-306049.

    Article  PubMed  Google Scholar 

  17. Grzywa-Celinska A, Dyczko M, Rekas-Wojcik A, Szmygin-Milanowska K, Witczak A, Ostrowski S, et al. [Ventilatory disorders in patients with chronic heart failure]. Pol Merkur Lekarski. 2015;39(232):248–50.

    Google Scholar 

  18. Vitali C, Viegi G, Tassoni S, Tavoni A, Paoletti P, Bibolotti E, et al. Lung function abnormalities in different connective tissue diseases. Clin Rheumatol. 1986;5(2):181–8. https://doi.org/10.1007/BF02032355.

    Article  CAS  PubMed  Google Scholar 

  19. Dong X, Zheng Y, Wang L, Chen WH, Zhang YG, Fu Q. Clinical characteristics of autoimmune rheumatic disease-related organizing pneumonia. Clin Rhuematol. 2018;37(4):1027–35. https://doi.org/10.1007/s10067-017-3694-6.

    Article  Google Scholar 

  20. Maclean J, Singh RB, Sayeed ZA. Polymyositis presenting with respiratory failure. Indian J Chest Dis Allied Sci. 2011;53(4):229–31.

    PubMed  Google Scholar 

  21. Belafsky PC, Mims JW, Postma GN, Koufman JA. Dysphagia and aspiration secondary to polymyositis. Ear Nose Throat J. 2002;81(5):316.

    Article  Google Scholar 

  22. Ji S, Zeng F, Guo Q, Tan G, Tang H, Luo Y, et al. Predictive factors and unfavourable prognostic factors of interstitial lung disease in patients with polymysitis or dermatomyositis: a retrospective study. Chin Med J (Eng). 2010;123(5):517–22.

    CAS  Google Scholar 

  23. Demoruelle MK, Solomon JJ, Fischer A, Deane KD. The lung may play a role in the pathogenesis of rheumatoid arthritis. Int J Clin Rheumtol. 2014;9(3):295–309. https://doi.org/10.2217/ijr.14.23.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  24. Klareskog L, Padyukov L, Ronnelid J, Alfresson L. Genes, environment and immunity in the development of rheumatoid arthritis. Curr Opin Immunol. 2006;18(6):650–5. https://doi.org/10.1016/j.coi.2006.06.004.

    Article  CAS  PubMed  Google Scholar 

  25. Klareskog L, Stolt P, Lundberg K, Kallberg H, Bengtsson C, Grunewald J, et al. A new model for an etiology of rheumatoid arthritis: smoking may trigger HLA-DR (shared epitope)-restricted immune reactions to autoantigens modified by citrullination. Arthritis Rheum. 2006;54(1):38/46. https://doi.org/10.1002/art.21575.

    Article  CAS  Google Scholar 

  26. Steen VD, Conte C, Owens GR, Medsgeer TA. Severe restrictive lung disease in systemic sclerosis. Arthritis Rheum. 1985;37:1283–9. https://doi.org/10.1002/art.1780370903.

    Article  Google Scholar 

  27. Solomon JJ, Olson AL, Fischer A, Bull T, Brown KK, Raghu G. Scleroderma lung disease. Eur Respir Rev. 2013;22(127):6–19. https://doi.org/10.1183/09059180.00005512.

    Article  PubMed  PubMed Central  Google Scholar 

  28. Tyndall AJ, Bannert B, Vonk M, Airo P, Cozzi F, Carreira PE, et al. Causes and risk factors for death in systemic sclerosis: a study from the EULARR Scleroderma Trials and Research (EUSTAR) database. Ann Rhuem Dis. 2010;69:1809–15. https://doi.org/10.1136/ard.2009.114264.

    Article  Google Scholar 

  29. Palm O, Garen T, Berge Enger T, Jensen JL, Lund M-B, Aaløkken TM, et al. Clinical pulmonary involvement in primary Sjogren’s syndrome: prevalence, quality of life and mortality—a retrospective study based on registry data. Rheumatology (Oxford). 2013;52(1):173–9. https://doi.org/10.1093/rheumatology/kes311.

    Article  Google Scholar 

  30. Mavragani CP, Moutsopoulos NM, Moutsopoulos HM. The management of Sjogren’s syndrome. Nat Clin Pract Rheumatol. 2006;2(5):252–61. https://doi.org/10.1038/ncprheum0165.

    Article  CAS  PubMed  Google Scholar 

  31. Nielepkowicz-Gozdzinska A, Fendler W, Robak E, Kulczycka-Siennicka L, Gorski P, Pietras T, et al. Exhaled IL-8 in systemic lupus erythematosus with and without pulmonary fibrosis. Arch Immunol Ther Exp. 2014;62(3):231–8. https://doi.org/10.1007/s00005-014-0270-5.

    Article  CAS  Google Scholar 

  32. Fava A, Petri M. Systemic lupus erythematosus: diagnosis and clinical management. Autoimmunity. 2019;96:1–13. https://doi.org/10.1016/j.jaut.2018.11.001.

    Article  Google Scholar 

  33. Fortuna G, Brennan MT. Systemic lupus erythematosus: epidemiology, pathophysiology, manifestations, and management. Dent Clin N Am. 2013;57(4):631–55. https://doi.org/10.1016/j.cden.2013.06.003.

    Article  PubMed  Google Scholar 

  34. Alexander FM. The use of self. London: Methuen; 1932.

    Google Scholar 

  35. Hoit JD, Hixon TJ. Body type and speech breathing. J Speech Hear Res. 1986;29(3):313–24. https://doi.org/10.1044/jshr.2903.313.

    Article  CAS  PubMed  Google Scholar 

  36. Carroll LM. The role of the voice specialist in the non-medical management of benign voice disorders. In: Rubin J, Sataloff RT, Korovin GS, editors. Diagnosis and treatment of voice disorders. 2nd ed. Clifton Park, NY: Delmar Learning; 2003.

    Google Scholar 

  37. Mailander E, Muhre L, Barsties B. Lax Vox as a voice training program for teachers: a pilot study. J Voice. 2017;31(2):262.e13–22. https://doi.org/10.1016/j.jvoice.2016.04.011.

    Article  Google Scholar 

  38. Guzman M, Laukkanen AM, Krupa P, Horacek J, Svec J, Geneid A. Vocal tract and glottal function during and after vocal exercising with resonance tube and straw. J Voice. 2013;27(4):523.e19–34. https://doi.org/10.1016/j.jvoice.2013.02.007.

    Article  Google Scholar 

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Author information

Authors and Affiliations

  1. The Children’s Hospital of Philadelphia, Philadelphia, PA, USA

    Linda Carroll

  2. Department of Communication Sciences and Disorders, University of New Hampshire, Durham, NH, USA

    Linda Carroll

Authors
  1. Linda Carroll
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Editor information

Editors and Affiliations

  1. Bard Cancer Center, New York, NY, USA

    Robert L. Bard

Appendices

Appendix 1: Aerodynamic Resistance Exercises

These exercises can be performed while sitting or standing.

Breathe in/out, slowly, trying to use 5–10 beats for inhalation and 5–10 beats for exhalation, with 2 cycles during each probe. You should sense the breath being driven low into the lung cavity. Avoid “starving” yourself for the breath, but seek to trust the breath as it fills and empties the lungs. Observe the sensations in the side ribs and lower ribs, as well as the sensation in the larynx.

Posture 1: cupped hand over mouth and nose (fingers tightly together, creating firm seal over mouth and nose).

Posture 2: pursed lips with three fingers (held together) occluding the lips.

Posture 3: pursed lips with two fingers (held together) occluding the lips (fake cigarette position).

Posture 4: pursed lips with one finger occluding the lips.

Posture 5: pursed, puckered lips (similar to sip** a thick shake or sucking spaghetti).

Posture 6: “f” position (upper teeth contacting lower lip).

Posture 7: tongue tip up behind upper front teeth, mouth fairly closed (“seething” position).

Determine the two posture resistance strategies that work the best for you each day. Use those two postures every 2–3 h, using five breath cycles for each posture.

Note: If you have a diagnosis of laryngospasm, do not pause at the end of the exhalation. If you have a diagnosis of chronic cough, do not pause at the top of the inhalation.

Appendix 2: Physical Stretches: Perform While Standing

  1. 1.

    Arching: Extend right arm and arc to opposite side (right arm extended, leaning over left shoulder, with body bent toward the left), and take a slow breath to maximally expand the right rib cage. Repeat, taking two breath inhalations with each arc position. Then change to opposite arc, expanding the left rib cage. Repeat sequence three to four times.

  2. 2.

    Hangman: With arms extended and forearms at right angles (like a hangman), inhale and try to maximally expand movement in the front upper chest. Exhale as you bring forearms together in front of you, letting upper chest cave in a bit. Repeat 4×, then relax the shoulder joints. Now, reverse the inhale/exhale posture. With forearms together in front (bend slightly forward so that your back will be slightly rounded), take a breath and maximally expand upper back region. Exhale as you bring your arms outward and open upper chest forward (like a hangman). Repeat 4 times.

  3. 3.

    Ragdoll: Place hands at waist, thumbs forward and fingers touching posterior rib region, and bend over. Take a slow full breath, driving the breath into your hands (not up your back), and then hold the full inhalation for a few beats. Exhale and feel the ribs come inward. Repeat. When breath expansion feels secure in that position, while holding the breath at full inhalation, change posture to one that is closer to regular standing position. Exhale and repeat. Continue until standing upright. Take breath while standing straight, still feeling lower posterior rib expansion with breath.

  4. 4.

    Discus Gumby: Twist to the left, extending arms behind you: inhale. Sense the transverse and lateral expansion. Repeat. Twist to the right, extending arms behind you: inhale. Repeat. Repeat sequence 3 – 4 times.

  5. 5.

    Figure 8s: Place fists on shoulders, elbows forward; using elbows as “paintbrush,” trace the number “8” high, wide and high/low, with 4 tracings clockwise, and 4 tracings counter-clockwise. Then stand, place hand at waist thumbs forward, and sense expansion into your hands.

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Carroll, L. (2021). Respiratory Dynamics: Function and Breath Management. In: Bard, R.L. (eds) Image-Guided Management of COVID-19 Lung Disease. Springer, Cham. https://doi.org/10.1007/978-3-030-66614-9_9

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  • DOI: https://doi.org/10.1007/978-3-030-66614-9_9

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