Overall, 64 patients (82%) had a baseline FVC below normal function (at <80% of predicted volume) and 63 patients (80%) had a baseline PCF insufficient for airway clearance (at <270 L/min [4.5 L/s]).  Measurements following lung volume recruitment were obtained in 39 patients with an FVC <80% of predicted and, at their request, in 2 patients with an FVC of 81.4% and 87.6% of predicted respectively.

What is lung volume recruitment?

Lung volume recruitment (LVR) is a technique used to improve PCF by inflating the lungs to their maximal insufflation (inhaling) capacity (MIC) (i.e. taking in as much air as physically possible).  Lung volume recruitment, commonly referred to as breath-stacking, may be conducted with a manual resuscitation bag.  The patients in this study were instructed to squeeze the bag a sufficient number of times until they felt their lungs were full, repeating the procedure for 5 full lung inflations in each session.  Patients were prescribed LVR therapy at least twice daily if it improved pulmonary function in the laboratory.

In reading the study, I was drawn to the idea of lung volume recruitment as it reminded me of a technique I learned in college to help increase my own lung capacity and to stretch the muscles in and around the ribcage.  How it is done is by breathing in as much air as you can (do not breathe out yet), raise your arms over your head and breathe in a bit more air (do not breathe out yet), lower your arms, pause, and feel the sensation of your overinflated lungs before slowly breathing out completely.  This can be uncomfortable the first few times tried, but with practice you are able to take in more air on command.

In the present study during the follow-up time period, a significant decline in pulmonary function (measured by FVC) and cough (measured by PCF) was observed in this select group of MS/respiratory patients. The good news is, however, that lung volume recruitment was associated with a slower decline in lung function (p<0.0001) and peak cough flow (p = 0.042).  Authors suggest that more research is needed.

Perhaps something as simple as practicing deep breathing can help us keep in better physical condition and protect against some types of pulmonary decline.  Now before you try to stretch your lungs, please talk to your doctors about what techniques might be best for your specific needs.  

SOURCES:

Srour N, LeBlanc C, King J, McKim DA (2013) Lung Volume Recruitment in Multiple Sclerosis. PLoS ONE 8(1): e56676. doi:10.1371/journal.pone.0056676

McKim D. Airway Clearance and Lung Volume Recruitment for Neuromuscular Disease (pdf)  Ventilator-assisted Living, August 2011, Volume 25, No. 4. Accessed February 3, 2013.

MS Symptoms: Respiration - National MS Society.  Accessed February 3, 2013 at http://www.nationalmssociety.org/about-multiple-sclerosis/what-we-know-about-ms/symptoms/respiration/index.aspx