Pulmonary Fibrosis News Forums Forums PF Communities PF Life: 50+ Is Pursed Lip Breathing the Most Effective Technique to Use when Participating in Pulmonary Rehabilitation?

  • Is Pursed Lip Breathing the Most Effective Technique to Use when Participating in Pulmonary Rehabilitation?

    Posted by mark-koziol on January 12, 2021 at 8:00 pm

    When ILD patients participate in pulmonary rehabilitation, we are introduced to a specific breathing technique. The rehabilitation center will typically encourage the patient to use the clinicians favorite breathing technique. I have participated in phase 2 pulmonary rehabilitation twice (pre and post-transplant) and used a different pulmonary rehabilitation center each time. During my pre-transplant participation, the Pursed Lip Breathing method was the respiratory therapists’ preferred choice. However, post-transplant, the Buteyko Breathing Method was modelled and used by the respiratory therapist. I had more success using the Buteyko Breathing Method. My respiratory therapist, Lynn Gorton, introduced the Buteyko Breathing Method. She is an incredible resource and passionate about her patients’ breathing. I have devoted a column and forum topic to her.

    I was contemplating topics for today’s post, and an article appeared on my Twitter feed that I felt would interest our members. “Effects of Pursed Lip Breathing on Exercise Capacity and Dyspnea in Patients with Interstitial Lung Disease.” The article appears in abstract form, but the reader can determine the study results. The results of this study “cast doubt on the usefulness of this technique in ILD patients and should be taken into account when tailoring pulmonary rehabilitation programs to this population.” The study included thirty-five participants in the study. I do feel more patients should have been included to broaden the results. I included the study because it appeared in the Journal of Cardiopulmonary Rehabilitation and Prevention. The journal is a respected organization of cardio and pulmonary medical professionals.

    I am interested to know if any of our members have used either the Pursed Lip Breathing or Buteyko Breathing Method. Please state which method you used and if you felt the technique successfully facilitated your breathing.

    mark-koziol replied 3 years, 1 month ago 8 Members · 15 Replies
  • 15 Replies
  • larry-travis

    January 14, 2021 at 1:05 pm

    PLB is easier because it doesn’t induce coughing. However I am trying breathing in nose out mouth and find that actually increases my walking distance.

    • mark-koziol

      January 14, 2021 at 1:23 pm

      Thank you Larry for sharing.

  • jonathan-poland

    January 14, 2021 at 2:55 pm

    Hi Mark,

    My pulmonary fibrosis (PF) is still relative mild, as measured by pulmonary function tests (PFT).  And I have significantly improved my PFT results after starting daily cardio exercise in pulmonary rehab.  Also shortly after finishing pulmonary rehab, I read the book “Breath” by James Nestor where different breathing methods are thoroughly discussed.  I can’t say for certain, but I believe that both cardio exercise and breathing technique have improved my PFT’s and my well-being.  The best thing I ever did was start pulmonary rehab early and I am extremely grateful to the physician’s assistant who wrote the order!

    I tried pursed-lip breathing during rehab.  It is simple enough to do while exercising and consciously making an effort.  But I didn’t really feel any benefit.  And it is not something I can do without making a conscious effort, such as when I’m laying in bed falling asleep.  I exercise and sleep with oxygen where nose breathing is essential.  To inhale through the nose and exhale from the mouth requires mental effort.  If I’m sick, congested, or coughing I simply can’t make the pursed-lip breathing effort.

    I now practice Buteko-style breathing during exercise, but also throughout the day.  (Also, I’m now a 100% nose-breather – even when congested.)  I make an effort to take slow-deliberate breaths with prolonged pauses between inhale, exhale, inhale, etc.  I try to make the most of every breath.

    Now to be technical for a moment:  PF is a “restrictive” lung disease while COPD, bronchiechtasis, etc. are “obstructive” diseases.  The difference is extremely significant.  What is good for one, may not be for the other.  Buteko Breathing Method has been shown to be beneficial for obstructive lung disease.  I’m not aware that any study has shown benefits for restrictive diseases.  Your mileage my vary.

    – jon

    • mark-koziol

      January 14, 2021 at 5:44 pm

      Hello Jonathan, thank you for sharing. I’m going to respond to you a little more tomorrow morning. I want to look up a couple things on the Buteyko method. Take care, Mark.

    • mark-koziol

      January 15, 2021 at 8:09 am

      Hi Jonathan, I looked up a couple studies on the Buteyko method. Couldn’t find any relating to restrictive lung disease. The studies were devoted to asthma sufferers. I do feel nasal breathing is an excellent technique to use in our daily normalcy. As a former collegiate athlete this was indoctrinated into my head on a continuous basis. I used to use nasal breathing when I had extended coughing periods pre-transplant. Keep staying physically active. Thank you for sharing your knowledge. I feel you made several great points and others will benefit from your sharing. Best wishes, mark.

  • ben-robinson

    January 14, 2021 at 4:22 pm

    Pursed lip breathing saved me on my first airplane flight at 30,000 feet when my oxygen dropped like a rock and I had not brought a concentrator back in 2015.  It worked and raised my sats back up several points. I was glad to have remembered it from rehab. My Johns Hopkins doctor looked astonished when I told him of the affect of the high altitude but he seemed astonished at a lot of things I said. I was his curious case who wouldn’t drink his transplant koolaid.  Hey I am still here and kickin. He said I would be dead in two years. I wonder if he told Trump that LoL I don’t think so.

    • mark-koziol

      January 14, 2021 at 4:58 pm

      Hello Ben, thanks for sharing. Your comments are appreciated but we are not a political site. Please refrain from making political references. It may bother some. Our members come here to communicate about fibrotic lung disease. Take care, Mark.

  • rthorntonbresnan-net

    January 14, 2021 at 5:50 pm

    Afternoon, well almost evening. I am not sure what is meant by pursed lip or Buteko style(sp) but my lung doc and the rehab center I was at keep telling me to smell the roses and  blow out the candle. It took me awhile to figure it out and get the right sequence, but it works, at least for me.  I can get my oxygen level back up and my pulse to the correct area. Beside IPF, I also have afib, so between the 2 and some other problems, I keep my finger instrument handy so when ever I am not feeling right, I can check and do whatever needs to be done. Well, that’s it for me today. Nothing exciting, just thought I would put my 2 cents worth in. Have a good one.

  • Charlene Marshall

    January 15, 2021 at 12:10 pm

    Hi Randy,

    Thanks so much for writing and sharing your thoughts on this topic. For more information on the breathing techniques @mark-koziol references in his post, feel free to check out the following articles:

    Pursed Lip Breathing

    Buteyko Breathing Method 

    It’s interesting that different rehabilitation centers use different methods, but likely they’re tailored to the specific patient experience. Please keep up with the recommendations of your team, as I’m glad to hear it seems to be working for you 🙂 I just wanted to share the links in case they were of interest.

    Take care,

  • pete-besio

    January 16, 2021 at 7:02 am


    Hey Mark,

    This is a cool post. Pursed lip breathing was part of a pulminary rehab program I participated in.  I did find it helpful, but didn’t have the discipline to incorporate it into my daily life.  I was previously unfamiliar with the Buteyko Method, thanks to Charlene for posting that link.  Ever heard of the 3 6 5 method? I just read about it yesterday. Basically, three (3) times a day spend five (5) minutes takin six (6) breaths.

    Funny, like all things “there is an app for that”.  Just searched the Apple App store, there is a Buteyko Breathing app.  When I searched for “pursed lip breathing” a few results came back, including games to help children learn to do it to help deal with asthma, anxiety and such.

    Thanks for adding to my knowledge base,

    Pete Besio

    • mark-koziol

      January 18, 2021 at 8:31 am

      Hello Pete, thanks for sharing. I feel the same way as you; there is an app for everything under the sun. I do feel some of the breathing methods that are modeled make you consciously aware of your breathing. Some are more tedious than others but the main goal is for the patient to be comfortable with the method. The end result would for the patient reducing their anxiety at times of breathing distress. Pre transplant I experienced much of this. I would daily coughing periods exceeding 30 minutes several times a day. Take care, Mark.

  • ben-robinson

    January 17, 2021 at 12:59 pm

    My doctor was on national  tv treating president trump with corticosteroids for Covid lung  I had mentioned this in a previous post. But so he wouldn’t give them to me due to side effects stance he had taken at the time.  I guess Connelly and the other doctors set him straight on the needed dexamethasone. He told me I would be dead in two years in 2015.  That is why the Trump reference. Nothing political just the basis for my doctor wars self advocacy. I guess you can see why. I do refrain from Political discussions at all times anyway.

    • mark-koziol

      January 18, 2021 at 8:24 am

      Thank you Ben.

  • ron-leeaspenwebs-com

    January 20, 2021 at 1:08 am

    Thanks so much for beginning this thread. I have been following this forum for at least two years and there has been a lot of great info shared. Breathing techniques have not been extensively discussed to my knowledge.

    You started a thread which I think will help all of us understand this aspect of rehab much better. Thanks for bringing that into the conversation!

    I (and others) had not heard of the Buteyko Method before. Although I haven’t yet read the links, I know I’m going to learn something new and useful. This is a great thread and I look forward to reading the links.

    FYI My rehab some ten years ago espoused the pursed lips method. Since I have been on the green tea regimen I haven’t needed to use it, but prior it helped me on stair climbing, and other extreme sports (for my age of 80).


    • mark-koziol

      January 20, 2021 at 8:32 am

      Hi Ron, I’m pleased you found the thread helpful. The breathing methods can help you relieve anxiety. I look at it as a sort of yoga exercise. I know of some who practice both methods I have mentioned in the topic. There is no wrong or right method. I hope you have great breathing day! Mark

Log in to reply.