Name: investigation into deep breathing through measurement of ventilatory parameters and observation of breathing patterns
Uploaded: 2019-09-16T13:30:00
Description: Watch this Scientific Journal Video about Investigation into Deep Breathing through Measurement of Ventilatory Parameters and Observation of Breathing Patterns at JoVE.com

The authors thank Dr. Shimpachiro Ogiwara, former Professor at the University of Kanazawa, and Mrs. Sandra M. Ogiwara, CSP (UK), BScPT (C), for English editing of the manuscript.

This protocol was in accordance with the ethical principles of the Declaration of Helsinki. The procedure was explained to all participants before commencement of the study.
1. Participant screening
<ol>
	<li>Recruit 15 healthy women in their twenties through convenience sampling. Check medical history verbally. Exclude participants with cardiopulmonary disease.</li>
	<li>Explain the procedure to the participant.</li>
	<li>Ask the participant to refrain from eating and drinking 2 h prior to ...

<ol>
	<li>Yokogawa, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Comparison+of+two+instructions+for+deep+breathing+exercise:+non-specific+and+diaphragmatic+breathing.">Comparison of two instructions for deep breathing exercise: non-specific and diaphragmatic breathing.</a> Journal of Physical Therapy Science. 30, 614-618 (2018).</li><li>Lewis, L. K., Williams, M. T., Olds, T. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Short-term+effect+on+outcomes+related+to+the+mechanism+of+intervention+and+physiological+outcomes+but+insufficient+evidence+of+clinical+benefits+for+breathing+control:+a+systematic+review.">Short-term effect on outcomes related to the mechanism of intervention and physiological outcomes but insufficient evidence of clinical benefits for breathing control: a systematic review.</a> Australian Journal of Physiotherapy. 53, 219-227 (2007).</li><li>Cahalin, L. P., Braga, M., Matsuo, Y., Hernandez, E. D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Efficacy+of+diaphragmatic+breathing+in+persons+with+chronic+obstructive+pulmonary+disease:+A+review+of+the+literature.">Efficacy of diaphragmatic breathing in persons with chronic obstructive pulmonary disease: A review of the literature.</a> Journal of Cardiopulmonary Rehabilitation. 22, 7-21 (2002).</li><li>Sackner, M. A., Gonzalez, H. F., Jenouri, G., Rodriguez, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effects+of+abdominal+and+thoracic+breathing+on+breathing+pattern+components+in+normal+subjects+and+in+patients+with+chronic+obstructive+pulmonary+disease.">Effects of abdominal and thoracic breathing on breathing pattern components in normal subjects and in patients with chronic obstructive pulmonary disease.</a> The American Review of Respiratory Disease. 130, 584-587 (1984).</li><li>Gosselink, R. A., Wagenaar, R. C., Rijswijk, H., Sargeant, A. J., Decramer, M. L. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Diaphragmatic+breathing+reduces+efficiency+of+breathing+in+patients+with+chronic+obstructive+pulmonary+disease.">Diaphragmatic breathing reduces efficiency of breathing in patients with chronic obstructive pulmonary disease.</a> American Journal of Respiratory and Critical Care Medicine. 151, 1138-1142 (1995).</li><li>Adachi, H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cardiopulmonary+Exercise+Test.">Cardiopulmonary Exercise Test.</a> International Heart Journal. 58, 654-665 (2017).</li><li>Guazzi, M., Bandera, F., Ozemek, C., Systrom, D., Arena, R. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Cardiopulmonary+Exercise+Testing:+What+Is+Its+Value.">Cardiopulmonary Exercise Testing: What Is Its Value.</a> Journal of the American College of Cardiology. 70, 1618-1636 (2017).</li><li>Jones, A. Y., Dean, E., Chow, C. C. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Comparison+of+the+oxygen+cost+of+breathing+exercises+and+spontaneous+breathing+in+patients+with+stable+chronic+obstructive+pulmonary+disease.">Comparison of the oxygen cost of breathing exercises and spontaneous breathing in patients with stable chronic obstructive pulmonary disease.</a> Physical Therapy. 83, 424-431 (2003).</li><li>Ito, M., Kakizaki, F., Tsuzura, Y., Yamada, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Immediate+effect+of+respiratory+muscle+stretch+gymnastics+and+diaphragmatic+breathing+on+respiratory+pattern.">Immediate effect of respiratory muscle stretch gymnastics and diaphragmatic breathing on respiratory pattern.</a> Internal Medicine. 38, 126-132 (1999).</li><li>Jansson, E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=On+the+significance+of+the+respiratory+exchange+ratio+after+different+diets+during+exercise+in+man.">On the significance of the respiratory exchange ratio after different diets during exercise in man.</a> Acta Physiologica Scandinavica. 114, 103-110 (1982).</li><li>Yokogawa, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effects+of+food+intake+on+physiological+responses+to+cardiopulmonary+exercise+testing.">Effects of food intake on physiological responses to cardiopulmonary exercise testing.</a> Journal of Physical Therapy Science. 19, 145-150 (2007).</li><li>Romei, M., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effects+of+gender+and+posture+on+thoraco-abdominal+kinematics+during+quiet+breathing+in+healthy+adults.">Effects of gender and posture on thoraco-abdominal kinematics during quiet breathing in healthy adults.</a> Respiratory Physiology &amp; Neurobiology. 172, 184-191 (2010).</li><li>Binazzi, B., et al. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Breathing+pattern+and+kinematics+in+normal+subjects+during+speech,+singing+and+loud+whispering.">Breathing pattern and kinematics in normal subjects during speech, singing and loud whispering.</a> Acta Physiologica. 186, 233-246 (2006).</li><li>Faul, F., Erdfelder, E., Lang, A. -. 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By the use of this protocol, effective instruction for deep breathing can be examined through oxygen consumption, ventilatory parameters, and chest wall excursion. The participants had a mean age of 21.6 years, mean body mass of 51.9 kg, mean height of 159.3 cm and a body mass index of 20.5 kg/m2. No incentives were offered to partake in this protocol. There are three critical steps within the protocol. First, concerning the control of food intake, the&#160;ratio of carbon dioxide output to oxygen uptake provi...

The cardiopulmonary physical therapist normally treats the patient according to the individual&#39;s needs and requirements. However, in general, the patient is left to carry out preoperative deep breathing exercise by him/herself. Therefore, it is imperative to find a simple and effective instruction method for the patient to carry out deep breathing exercises1.
Diaphragmatic breathing is such a breathing exercise and one method of breathing control2,3. The therapeutic outcome of this method includes a reduction in work of breathing and improvement in efficiency of breathing2,3, and this brings about an increase in tidal volume, resulting in a reduction in respiratory rate. However, some researchers have pointed out that diaphragmatic breathing exercise may cause asynchronous and paradoxical motion of the rib cage due to abdominal excursions in some patients4,5. In such cases, the use of a patient&#39;s natural breathing pattern may be efficacious. Regarding the question of deep breathing being effective as a means of a reduction in the mechanical work of breathing and improvement of ventilatory efficiency, it may be useful to quantify ventilatory parameters by the use of a&#160;gas analyzer.
It is well known that cardiopulmonary exercise testing is carried out using a gas analyzer6,7. Some investigators8,9 have reported measurement for diaphragmatic breathing with a gas analyzer in&#160;patients with chronic obstructive pulmonary disease. Jones et al.8 compared diaphragmatic breathing, pursed-lip breathing, and a combination of both, with that of spontaneous breathing. During these three methods of breathing, oxygen consumption (VO2) and respiratory rate (f) were measured, which showed that a&#160; higher resting VO2 may be explained by the increased mechanical work of breathing8. Ito et al.9 examined the immediate effect of diaphragmatic breathing or respiratory muscle stretch on VO2, f and tidal volume (VT). We may expect from the results of the aforementioned studies that similar evidence could be obtained by application of similar breathing exercises to confirm an effective deep breathing method of instruction.
This protocol describes the method for measurement of ventilatory parameters and chest wall excursion in deep breathing with two breathing patterns, together with their results and analysis. Continuous and quantitative sampling of ventilatory parameters can measure breathing precisely compared to alternative techniques. VO2 obtained in this protocol can be regarded as an indicator of work of breathing8. Further, f, VT, and minute ventilation are related to ventilatory efficiency.&#160;Information on breathing pattern can also be obtained from these ventilator parameters plus inspiratory and expiratory time. This protocol also involves assessment of chest wall excursion through video capture, which corresponds to observation by a physical therapist of the patient&#39;s chest wall excursion during breathing exercise. The overall goal of this study was to find a viable and efficient method of deep breathing exercise based on analysis of oxygen consumption, ventilatory parameters, and chest wall excursion.

<table>
	<tbody>
		<tr>
			<td>Expired gas analyzer</td>
			<td>Minato Medical Science, Osaka, Japan</td>
			<td>AE-300S</td>
			<td></td>
		</tr>
		<tr>
			<td>Expired gas analyzing software</td>
			<td>Minato Medical Science, Osaka, Japan</td>
			<td>AT for Windows</td>
			<td></td>
		</tr>
		<tr>
			<td>Medical telemetry sensor for electrocardiograph</td>
			<td>Nihon Kohden, Tokyo, Japan</td>
			<td>BSM-2401</td>
			<td></td>
		</tr>
		<tr>
			<td>Spreadsheet program</td>
			<td>Microsoft, https://www.microsoft.com/ja-jp</td>
			<td>Excel</td>
			<td></td>
		</tr>
		<tr>
			<td>SPSS Statistical Software</td>
			<td>IBM, https://www.ibm.com/jp-ja/analytics/spss-statistics-software</td>
			<td>Version 23.0</td>
			<td></td>
		</tr>
		<tr>
			<td>Video camera</td>
			<td>Sony, Tokyo, Japan</td>
			<td>DCR-SR 100</td>
			<td></td>
		</tr>
		<tr>
			<td>Video editing software 1</td>
			<td>Sony, Tokyo, Japan</td>
			<td>PlayMemories Home</td>
			<td></td>
		</tr>
		<tr>
			<td>Video editing software 2</td>
			<td>Adobe, https://www.adobe.com/jp/</td>
			<td>Premiere Elements 11</td>
			<td></td>
		</tr>
	</tbody>
</table>

investigation into deep breathing through measurement of ventilatory parameters and observation of breathing patterns

In this protocol, two deep breathing patterns were shown to 15 participants to determine an easy yet effective method of breathing exercise for future application in a clinical setting. The women in their twenties were seated comfortably in a chair with back support. They were fitted with an airtight mask connected to a&#160;gas analyzer. Three electrodes were placed on the chest connected to a wireless transmitter for relaying to the electrocardiograph. They executed a 5 min rest phase, followed by 5 min of deep breathing with a natural breathing pattern, terminating with a 5 min rest phase. This was followed by a 10 min intermission before commencing the second instruction phase of substituting the natural breathing pattern with the diaphragmatic breathing pattern. Simultaneously, the following took place: a) continuous collection, measurement and analysis of the expired gas to assess the ventilatory parameters on a breath-by-breath basis; b) measurement of the heart rate by an electrocardiograph; and c) videotaping of the participant&#8217;s thoracoabdominal movement from a lateral aspect. From the video capture, the investigators carried out visual observation of the fast-forward motion-images followed by classification of the breathing patterns, confirming that the participants had carried out the method of deep breathing as instructed. The amount of oxygen uptake revealed that, during deep breathing, the work of breathing decreased. The results from the expired minute ventilation, respiration rate and tidal volume confirmed increased ventilatory efficiency for deep breathing with the natural breathing pattern compared to that with the diaphragmatic breathing pattern. This protocol suggests a suitable method of instruction for assessing deep breathing exercises on the basis of oxygen consumption, ventilatory parameters, and chest wall excursion.

The Ventilatory Parameters and Heart Rate 
Based on the data (Figure 5), the NB and DB patterns were analyzed statistically (Figure 6 and Table 1). The f, VT and Te were found to have a significant interaction (p&#60;0.05, respectively). A significant decrease in the f was found for both the NB and DB patterns during deep breathing compared to the initial rest phases (p&#60;0.05, respectively), and, during deep b...

Watch this Scientific Journal Video about Investigation into Deep Breathing through Measurement of Ventilatory Parameters and Observation of Breathing Patterns at JoVE.com

Investigation into Deep Breathing through Measurement of Ventilatory Parameters and Observation of Breathing Patterns

Here, we present a protocol to assess two deep breathing patterns of natural and diaphragmatic breathing for their effectiveness and ease of execution. Fifteen participants were selected, utilizing an electrocardiograph and expired gas analyzer for measurement of the ventilatory parameters, together with visual assessment by video capture of thoracoabdominal movement.

In this protocol, two deep breathing patterns were shown to 15 participants to determine an easy yet effective method of breathing exercise for future ...

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Single-pulse transcranial magnetic stimulation over the primary motor cortex, neuronavigation, and registration of electromyographic activity of hand muscles were used in this study to explore corticospinal excitability while participants were observing action sequences.

This study used the transcranial magnetic stimulation/motor evoked potential (TMS/MEP) technique to pinpoint when the automatic tendency to mirror someone ...

Measurement of Neurophysiological Signals of Ignoring and Attending Processes in Attention Control

Attention control is the ability to selectively attend to some sensory signals while ignoring others. This ability is thought to involve two processes: enhancement of sensory signals that are to be attended and the attenuation of sensory signals that are to be ignored. The overall strength of attentional modulation is often measured by comparing the amplitude of a sensory neural response to an external input when attended versus when ignored. This method is robust for detecting attentional modulation, but precludes the ability to assess the separate dynamics of attending and ignoring processes. Here, we describe methodology to measure independently the neurophysiological signals of attending and ignoring using the intermodal attention task (IMAT). This task, when combined with electroencephalography, isolates neurophysiological sensory responses in auditory and visual modalities, when either attending or ignoring, with respect to a passive control. As a result, independent dynamics of attending and of a ignoring can be assessed in either modality. Our results using this task indicate that the timing and cortical sources of attending and ignoring effects differ, as do their contributions to the attention modulation effect, pointing to unique neural trajectories and demonstrating sample utility of measuring them separately.

Attention control comprises enhancement of target signals and attenuation of distractor signals. We describe an approach to measure separately but concurrently, the neurophysiology of attending and ignoring in sustained intermodal attention, utilizing a passive control condition during which neither process is continuously engaged.

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A General Method for Evaluating Deep Brain Stimulation Effects on Intravenous Methamphetamine Self-Administration

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This article describes the delivery of intracranial electrical stimulation that is temporally and spatially separate from the drug-use environment for the treatment of IV methamphetamine dependence.

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A Novel Approach to Assess Motor Outcome of Deep Brain Stimulation Effects in the Hemiparkinsonian Rat: Staircase and Cylinder Test

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Deep brain stimulation (DBS) is an effective treatment option for Parkinson's disease. We established a study design to screen novel stimulation paradigms in rats. The protocol describes the use of the staircase test and cylinder test for motor outcome assessment in DBS treated hemiparkinsonian rats.

Deep brain stimulation of the subthalamic nucleus is an effective treatment option for Parkinson&#39;s disease. In our lab we established a protocol to ...

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Here, we present a protocol for using the Acupuncture Manipulation Education System (AMES) in the training of acupuncture manipulation skills using phantom acupoints.

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The object recognition test (ORT) is a simple and efficient assay for evaluating learning and memory in mice. The methodology is described below.

The object recognition test (ORT) is a commonly used behavioral assay for the investigation of various aspects of learning and memory in mice. The ORT is ...

Using Clicker Training and Social Observation to Teach Rats to Voluntarily Change Cages

Cage cleaning is a routinely performed husbandry procedure and is known to induce stress in laboratory rats. As stress can have a negative impact on well-being and can affect the comparability and reproducibility of research results, the amount of stress experienced by laboratory animals should be minimized and avoided when possible. Further, the direct contact between the rat and animal caretaker during the cage change bears hygiene risks and therefore possibly negatively impacts the well-being of the rats and the quality of the research. 
Our protocol aims to improve the routinely performed cage changing procedure. For this reason, we present a feasible protocol that enables rats to learn via clicker training and observation to voluntarily change to a clean cage. This training helps to reduce stress caused by the physical disturbance and handling associated with the cage changes and concurrently enables a reduction in direct contact between animal and animal caretaker after the training phase is completed.
The implementation of clicker training to rats is fast and easy. Rats are generally interested in the training and efficiently learn the desired behavior, which entails changing cages through a pipe. Even without training, the rats learn to perform the desired behavior by observation, as 80% of the observational learning group successfully changed cages when tested. The training further helps to establish a relationship of trust between trainer and animal. As hygiene and well-being are both very important in animal experiments, this protocol might also help to improve high-quality research.

This protocol introduces a method of cage change for rats via clicker training. Rats learn the desired behavior not only by direct training but also by observational learning. The implementation of this fast and easy protocol might help to improve well-being and hygiene in rodent facilities.

Cage cleaning is a routinely performed husbandry procedure and is known to induce stress in laboratory rats. As stress can have a negative impact on ...

Method to Obtain Pattern of Breathing in Senescent Mice through Unrestrained Barometric Plethysmography

Unrestrained barometric plethysmography (UBP) is a method for quantifying the pattern of breathing in mice, where breathing frequency, tidal volume, and minute ventilation are routinely reported. Moreover, information can be collected regarding the neural output of breathing, including the existence of central apneas and augmented breaths. An important consideration for UBP is obtaining a breathing segment with a minimal impact of anxious or active behaviors, to elucidate the response to breathing challenges. Here, we present a protocol that allows for short, quiet baselines to be obtained in aged mice, comparable to waiting for longer bouts of quiet breathing. The use of shorter time segments is valuable, as some strains of mice may be increasingly excitable or anxious, and longer periods of quiet breathing may not be achieved within a reasonable timeframe. We placed 22 month-old mice in a UBP chamber and compared four 15 s quiet breathing segments between minutes 60&#8211;120 to a longer 10 min quiet breathing period that took&#160;2&#8211;3 h to acquire. We also obtained counts of central apneas and augmented breaths prior to the quiet breathing segments, following a 30 min familiarization period. We show that 10 min of quiet breathing is comparable to using a much shorter 15 s duration. Additionally, the time leading up to these 15 s quiet breathing segments can be used to gather data regarding apneas of central origin. This protocol allows investigators to collect pattern-of-breathing data in a set amount of time and makes quiet baseline measures feasible for mice that may exhibit increased amounts of excitable behavior. The UBP methodology itself provides a useful and noninvasive way to collect pattern-of-breathing data and allows for mice to be tested over several time points.

Unrestrained barometric plethysmography is used to quantify the pattern of breathing in awake mice. We show that 15 s segments under a standardized protocol display similar values to an extended duration of quiet breathing. This methodology also allows for the quantification of apnea and augmented breaths during the first hour in the chamber.

Unrestrained barometric plethysmography (UBP) is a method for quantifying the pattern of breathing in mice, where breathing frequency, tidal volume, and ...

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3D printing has been widely applied in the medical field since the 1980s, especially in surgery, such as preoperative simulation, anatomical learning and surgical training. This raises the possibility of using 3D printing to construct a neurosurgical implant. Our previous works took the construction of the burr hole ring as an example, described the process of using softwares like computer aided design (CAD), Pro/Engineer (Pro/E) and 3D printer to construct physical products. That is, a total of three steps are required, the drawing of 2D-image, the construction of 3D-image of burr hole ring, and using a 3D printer to print the physical model of burr hole ring. This protocol shows that the burr hole ring made of carbon fiber can be rapidly and accurately molded by 3D printing. It indicated that both CAD and Pro/E softwares can be used to construct the burr hole ring via integrating with the clinical imaging data and further applied 3D printing to make the individual consumables.

Here, we present a protocol to demonstrate 3D printing in the construction of deep brain stimulation implants.

3D printing has been widely applied in the medical field since the 1980s, especially in surgery, such as preoperative simulation, anatomical learning and ...

Measurement of Spatial Stability in Precision Grip

The purpose of the protocol is to indirectly evaluate the direction of the finger force during manipulation of a handheld object based on the biomechanical relationships in which deviated force direction causes center of pressure (COP) replacement. To evaluate this, a thin, flexible, and high spatial resolution pressure sensor sheet is used. The system allows measurement of the COP trajectory in addition to the force amplitude and its temporal regulation. A series of experiments found that increased trajectory length reflected a sensorimotor deficit in stroke patients, and that decreased COP trajectory reflects a compensatory strategy to avoid an object slipping from the hand grip in the elderly. Moreover, the COP trajectory could also be decreased by dual task interference. This article describes the experimental procedure and discusses how finger COP contributes to an understanding of the physiology and pathophysiology of grasping.

The goal of this protocol is to measure the center of pressure (COP) replacement using a high spatial resolution sensor sheet to reflect the spatial stability in a precision grip. The use of this protocol could contribute to greater understanding of the physiology and pathophysiology of grasping.