Pursed-lips breathing (PLB) is a maneuver that is frequently taught to patients with chronic obstructive pulmonary disease (COPD) in respiratory physiotherapy programs to improve breathing efficiency and better manage dyspnea during activities of daily living. Researchers first became interested in PLB when emphysema patients were clinically observed to breathe instinctively with the lips semi-closed in an attempt to minimize dyspnea. Although this technique had been described and recommended in the mid-1950s and beginning of the 1960s, the first studies designed to establish the benefits and physiological effects of PLB were not published until the mid-1960s. Even now—forty years later—there are few studies on PLB in the literature and the factors underlying its efficacy are not well understood. While most studies have focused on patients with COPD, some have found that PLB may be beneficial in certain neuromuscular diseases and exercise-induced asthma. In this paper, we review the published studies (Table) in which PLB was evaluated individually or compared to other techniques.1-15 For clarity, we have divided this review into separate sections in which the effects of PLB on lung function and arterial gases, breathing pattern, and respiratory muscles are discussed.

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