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Two studies were conducted to determine whether controlled, abdominally-predominant breathing could be accurately implemented during periods of acute anxiety by speech anxious/phobic individuals, and what effect breathing control has on autonomic and subjective indices of anxiety. Twenty-two moderately speech anxious young adults took part in Study 1. The results of this study indicated that after two weeks of training, only 50% of trainees were able to implement the controlled breathing technique with any degree of accuracy while waiting to deliver an impromptu speech before a small audience. No one were successful at reliably implementing the technique during the speech itself. As in previous research, training had little impact on autonomic arousal but was associated with improvements in self-reported anxiety. Similar findings emerged for Study 2, which differed from Study 1 in that it involved a larger (N = 48) and more highly speech anxious sample who participated in a longer (4-week), more intensive training program. Although training had little effect on subjective or autonomic arousal during speech anticipation and speech delivery, it did result in significantly higher predictions of speech aptitude and emotional control relative to no treatment. Such findings suggest that breathing control is not a useful emotion-focused coping strategy on its own, but may add to the effectiveness of exposure-based therapies by enhancing patients' self-efficacy and willingness to expose themselves to feared situations. / Arts, Faculty of / Psychology, Department of / Graduate

This study addressed slowed, paced, diaphragmatic breathing as an adaptive technique for persons in stressful life circumstances. Ninety-six U.S. Army National Guard and Reserve trainees on active duty voluntarily participated over 12 days according to one of three conditions: (1) The treatment group (n=35) was instructed in and given four 10 minute sessions of slowed, diaphragmatic breathing paced to the flashing of two lights (one red and one green) which cued a 4 second inspiration and a 4 second exhalation; (2) The attention control group (n=31) counted flashes on an identical light apparatus for four 10 minute sessions; (3) The no treatment control group (n=30), was given four 10 minute breaks during concurrent periods. All subjects were pretested and posttested with the A-State form of the StateTrait Anxiety Inventory and the Mooney Problem Checklist. These scores were the two dependent variables. Analysis ofvariance of pretest scores indicated no significant differences among group means. Two univariate analyses were used to test the hypotheses. Null hypothesis 1, that there would be no difference among posttest means for A-State Anxiety, was rejected. Null hypothesis 2, that there would be no difference among posttest means for Mooney Total, was upheld. Post hoc comparisons (Sheffe) between groups on the A-State measure revealed that the treatment group reported significantly less anxiety than the attention control group. But no significant difference was found between the treatment group and the no treatment group. Similar findings were reported by Holmes, et al. (1978). Procedural and nonspecific effects on the outcome and implications for future research were discussed.

The present study trained three adult male stutterers to increase speech fluency using relaxed breathing and a-x; biofeedback. A one group time-series design with 2 treatments was used. After an initial baseline phase (A) all 3 subjects received a relaxed breathing procedure (B), followed by a combined procedure featuring relaxed breathing and EMG biofeedback (BC). Results indicated that after 8 sessions stuttering was reduced by 19.1% from baseline levels across the 3 subjects. Despite these promising results , however, methodological questions in the baseline phase make conclusions regarding a clear relationship between the variables tentative.

Respiratory-swallow coordination (RSC) is critical for safe and efficient swallowing. In healthy adults, RSC is most frequently characterized by an exhale-swallow-exhale pattern initiated within the mid-lung volume range with a respiratory pause of approximately one second. This combination in RSC behaviors is thought to be most optimal for swallowing-related bolus clearance and airway protection. Deviations from these RSC behaviors are observed at disproportionately higher rates in people with Parkinson’s disease (PD) when compared to non-dysphagic, healthy adults. However, little is known about which variables influence RSC in PD, if the RSC behaviors that are most optimal for swallowing in healthy adults are also most optimal for swallowing in PD, and if respiratory-swallow training can be used to successfully rehabilitate suboptimal RSC, swallowing safety, and swallowing efficiency in PD. This dissertation document includes a series of four studies that address these important clinical research questions. Chapter 1 will begin by reviewing the current body of literature as it relates to dysphagia in PD, RSC in healthy adults and PD, respiratory-swallow training as a skill-based treatment for dysphagia rehabilitation, and motor learning considerations for respiratory-swallow skill training in PD. Chapter 2 will be used to examine the relationships among RSC with patient- and swallowing-specific factors in PD. Chapter 2 will also be used to assess the influence of RSC behaviors on measures of swallowing safety (penetration-aspiration) and swallowing efficiency (pharyngeal residue) in PD. Chapter 3 will then evaluate the effects of verbal cueing on RSC in PD as a method of determining if RSC is stimulable for rehabilitative change. Chapter 4 will explore the effects of respiratory-swallow training on swallowing safety and efficiency rehabilitation in a person with mid-stage PD and severe dysphagia within the context of a single-subject experimental design. Chapter 5 will then examine the effects of respiratory-swallow training on dysphagia and RSC rehabilitation within the context of a cohort study. Chapter 5 will also be used to compare the effects of constant versus variable practice in order to explore how principles of motor learning can be used to enhance respiratory-swallow training outcomes. This document will then conclude by synthesizing the results from Chapters 2-5 and by discussing directions for future research.

O envelhecimento é progressivo, seus efeitos no sistema respiratório são alterações na composição dos tecidos conjuntivos do pulmão influenciando na complacência torácica e na complacência pulmonar. O Powerbreathe® K5 é utilizado para o treino dos músculos inspiratórios, com ajuste de resistência adequando ao nível da musculatura inspiratória a ser treinada. O método Pilates promove o reequilíbrio muscular com exercícios que dão ênfase ao powerhouse. O objetivo do estudo foi analisar a influência do treino muscular inspiratório combinado com o método Pilates na função pulmonar em mulheres idosas. Participaram do estudo, indivíduos com 60 anos ou mais de idade, mulheres ativas, sem fraturas recentes e sem uso de dispositivos para a marcha. Foram randomizadas e divididas em Grupo Pilates com treinamento respiratório (n=11), um grupo com o método Pilates (n= 11) e um grupo controle (n=9). Antes e após a intervenção, os procedimentos avaliativos foram: espirometria, manovacuometria, teste de caminhada de 6 minutos, abdominal Curl Up Test e variáveis pulmonares. O protocolo mostrou que houve um incremento na pressão inspiratória máxima e nas forças pulmonares (p<0,0001), força muscular expiratória (p<0,0014), teste de caminhada de seis minutos (p<0,01), teste abdominal crul up (p<0,00001). O grupo controle não apresentou diferença significativa nas variáveis analisadas (p> 0,05). Os resultados desse estudo sugerem que o treinamento muscular inspiratório associado com o método Pilates promovem um incremento na função pulmonar e no condicionamento físico de pacientes idosos. / Aging is progressive, its effects on the respiratory system are changes in the composition of the connective tissues of the lung influencing the thoracic compliance and lung compliance. Powerbreathe® K5 is used for the inspiratory muscle training, with resistance adapted to the level of the inspiratory muscles to be trained. The Pilates method promotes muscle rebalancing exercises that emphasize the powerhouse. The aim of this study was to evaluate the influence of inspiratory muscle training combined with the Pilates method on lung function in elderly women. The participants were sixty-years-old or more, active women, no recent fractures and not users of gait devices. They were randomized and divided into a Pilates Group with Inspiratory Training (n = 11), a Group with the Pilates method (n = 11) and a control group (n = 9). Pre and post twenty intervention with evaluation procedures: spirometry, manovacuometry, six-minute walk test, abdominal Curl Up Test, pulmonary variables. The protocol showed an increase in maximal inspiratory muscle strength, pressure and power pulmonary (p<0,0001), maximal expiratory muscle strength (p<0,0014), six-minute walk test (p<0,01), abdominal curl up test (p <0,00001). The control group showed no difference in the variables analyzed (p> 0,05). The results of this study suggest inspiratory muscle training associated with the Pilates method provides an improvement in lung function and physical conditioning of patients elderly.

The purpose of this current study is to examine the impact of non-pharmacologic pain interventions administered by trained Child Life professionals in an emergency department on pain perception in children. Results showed no significant decrease in children's pain report during the medical procedure compared to before the medical procedure. However, pain after the medical procedure is significantly less than pain during the medical procedure.