Efficacy of breathing exercises and relaxation techniques for patients with neurological disorders

Efficacy of breathing exercises and relaxation techniques for patients with neurological disorders Delphine Herrmann Rachael Katz Svetlana Piliavsky Shelley Rice ASHA 2008-CHICAGO

WHAT IS THE BENEFIT OF BREATHING EXERCISES AND RELAXATION TECHNIQUES IN EVERYDAY LIFE?

BENEFITS OF BREATHING EXERCISES AND RELAXATION TECHNIQUES Stressful day; help emotions Improve immune system and prevent medical conditions Digestion Blood pressure Endurance; activity tolerance Brain activity; thinking better and quicker! Kim and Murray, 2004

DO BREATHING EXERCISES AND RELAXATION TECHNIQUES BENEFIT PATIENTS WITH NEUROLOGICAL DISORDERS?

What common neurological disorders would benefit from breathing exercises? DEMENTIA PARKINSON S DISEASE MULTIPLE SCLEROSIS STROKE TRAUMATIC BRAIN INJURY BRAIN TUMOR Other medical conditions: Apraxia Dysphagia

DEMENTIA DECREASE ANXIETY AND FRUSTRATION ATTENTION AND CONCENTRATION FOLLOWING DIRECTIONS RECALL OF INFORMATION REASONING AND PROBLEM SOLVING Yesage, 1985 Rankin, Gilner & Feller, 1993

PARKINSON S DISEASE VOICE COGNITIVE LINGUISTIC SKILLS FLUENCY ARTICULATION DYSPHAGIA Johnson and Pring, 1990 Ramig et al. 1995

MULTIPLE SCLEROSIS VOICE FLUENCY ABILITY TO EXPRESS NEEDS AND WANTS COGNITIVE LINGUISTIC SKILLS DYSPHAGIA Laures and Shisler, 2004

STROKE ABILITY TO EXPRESS NEEDS AND WANTS THOUGHT ORGANIZATION WORD FINDING AND RETRIEVAL COMPREHENSION COGNITIVE LINGUISTIC SKILLS DYSPHAGIA ARTICULATION FLUENCY APRAXIA Murray and Ray, 2001 Sapir and Aronson, 1990

TRAUMATIC BRAIN INJURY COGNITIVE LINGUISTIC SKILLS EXPRESSIVE AND RECEPTIVE LANGUAGE SKILLS APRAXIA DYSPHAGIA Murray and Kim 2004

BRAIN TUMORS COGNITIVE IMPAIRMENTS RECEPTIVE AND EXPRESSIVE LANGUAGE SKILLS DYSPHAGIA Laures and Shisler 2004 Rankin, Gilner and Feller 1993

CONSIDERATIONS THINK OF PRECAUTIONS CONSULT WITH DOCTOR AND RESPIRATIVE THERAPIST SOME BREATHING EXERCISES MAY INTERFERE WITH CERTAIN MEDICAL CONDITIONS

KEY CONSIDERATIONS FOR BREATHING EXERCISES EXHALATION! BODY POSTURE! BODY MOVEMENT!

Breathing Exercises Blow out as slowly as possible (5 repetitions) Say/Repeat, out loud 1 word at a time (Automatic sequences: counting 1-10, days of the week, months of the year, etc.) Shrug shoulders with inhalation, lower shoulders with exhalation Raise chin with inhalation, lower chin toward neck with exhalation Raise arm with inhalation, lower arm with exhalation (use one or both arms)

Yoga Exercises Body position automatically makes you breathe with diaphragm Client may sit quietly in position or use automatic sequences Positions Thinker s position: sitting in a chair or on the edge of a bed put head in hands, elbows on knees, feet on the floor Both feet on the floor, sitting in a chair. Both hands are resting slightly above hips, elbows slightly back.

How do I get my Client to Understand diaphragmatic breathing? Sometimes a client may need to feel the difference between shallow clavicular breathing versus diaphragmatic. During deep breathing exercises Client places one hand on chest and one hand on stomach. Cross control: client places one hand on their chest or stomach, one hand on clinician s chest or stomach

Visual and Kinesthetic Feedback Exercises Straw to blow bubbles Napkin, sheet of paper Blow a pencil across the table Pinwheel Blowing balloons (getting them ready for OT) Spirometer Oximeter

These are practical exercises because therapists don t need materials Many of the exercises we can do with client lying down in bed, sitting in a chair, or standing up Exercises help to build endurance and rapport.

Keep In Mind Encourage the patient to do breathing exercises as many times as they can remember. Client can determine appropriate amount of time to perform breathing exercises Clients don t have to do all the breathing exercises at once Don t do breathing exercises after the meals (either 40 minutes after the meal, or before the meal) Contact client s doctor if you are unsure if breathing exercises are safe for your client

Client Testimonies Breathing exercises is a tremendous thing for all. I usually gain more energy and makes me feel better. It lifts my spirits if I am down. Breathing exercises make it easier for me to find words and use them in conversation.

Breathe in breathe out That s what life is all about Or so it seemed to be Until one day it did not work My Breathing bothered me. I ve always known the enemies Like smoking and obesity But friends are out there too Like doctors, nurses and speech therapy So I m on my way to health again Due to their abilities W.G.

QUESTIONS AND ANSWERS

Thank you for your support! Cambridge Health Alliance Community Rehab Care Emerson College Hebrew Eldercare Services University of Central Arkansas

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