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The immediate effect of incorporating short-term slow abdominal respiration into an exercise program on balance and the autonomic nervous system

  • Han, Jaein (Department of Children and Adolescent Rehabilitation, Seoul Rehabilitation Hospital) ;
  • Chae, Yoona (Department of Orthopedics, Musculoskeletal-Rehabilitation Clinic) ;
  • Lee, Na-Kyung (Department of Physical Therapy, College of Medical Science, Konyang University)
  • Received : 2019.11.05
  • Accepted : 2019.12.12
  • Published : 2019.12.31

Abstract

Objective: The purpose of this study was to examine the possible effects of incorporating short-term slow-abdominal respiration (SAR) into an exercise program, on balance and the cardiac-related autonomic nervous system (ANS). Design: Cross-over repeated measures design. Methods: Fifteen young and healthy adults were randomly assigned into two groups (7 in the C-R group, 8 in the R-C group), each of which carried out both control sequence (C) and respiration-experiment sequence (R) in the inverse order. In the C sequence, the subjects performed passive exercises and a general exercise program (P-GEP). In the R sequence, the subjects received a short-term SAR training session and then performed the respiration incorporated general exercises program (R-RGEP). Before and after both C and R sequences, the length and the area of the displacement of the center of pressure (COP) and heart rate variability parameters were measured. Results: The total length of the COP displacement in the left single-leg-standing condition showed a significantly greater reduction after R-RGEP in the respiration-experiment sequence than after the P-GEP in the control sequence (p<0.05). The mean heart rate was significantly reduced only after R-RGEP in the respiration-experiment sequence (p<0.05) Conclusions: The slow-abdominal-respiration, trained in a simple manner and integrated into the exercise program in a single session, showed partially positive immediate effects on balance stabilization. The decrease in heart rate indicated possible involvement of the parasympathetic ANS activation in the stability, although it is not enough to decide whether it is purely due to the controlled respiration.

Keywords

References

  1. Lin FL, Yeh ML, Lai YH, Lin KC, Yu CJ, Chang JS. Two-month breathing-based walking improves anxiety, depression, dyspnoea and quality of life in chronic obstructive pulmonary disease: a randomised controlled study. J Clin Nurs 2019;28:3632-40. https://doi.org/10.1111/jocn.14960
  2. Fiskin G, Sahin NH. Effect of diaphragmatic breathing exercise on psychological parameters in gestational diabetes: a randomised controlled trial. Eur J Integr Med 2018;23:50-6. https://doi.org/10.1016/j.eujim.2018.09.006
  3. Kamath A, Urval RP, Shenoy AK. Effect of alternate nostril breathing exercise on experimentally induced anxiety in healthy volunteers using the simulated public speaking model: a randomized controlled pilot study. Biomed Res Int 2017;2017:2450670.
  4. Dinesh T, Dinesh Kumar E, Rajajeyakumar M, Charumathi V. Effect of short-term breathing exercise training on perceived stress and Stroop effect in chronic smartphone users. Int Arch Integr Med 2018;5:1-7.
  5. Srinivasan B, Rajkumar D. Effects of slow breathing on blood pressure and end tidal carbon dioxide in hypertension: randomised controlled trial. J Clin Diagn Res 2019;13:1-3. https://doi.org/10.1111/crj.12926
  6. Jafari H, Courtois I, Van den Bergh O, Vlaeyen JWS, Van Diest I. Pain and respiration: a systematic review. Pain 2017;158:995-1006. https://doi.org/10.1097/j.pain.0000000000000865
  7. Garrido M, Castano MY, Biehl-Printes C, Gomez MA, Branco JC, Tomas-Carus P, et al. Effects of a respiratory functional training program on pain and sleep quality in patients with fibromyalgia: a pilot study. Complement Ther Clin Pract 2017;28:116-21. https://doi.org/10.1016/j.ctcp.2017.05.013
  8. Goso Y, Asanoi H, Ishise H, Kameyama T, Hirai T, Nozawa T, et al. Respiratory modulation of muscle sympathetic nerve activity in patients with chronic heart failure. Circulation 2001;104:418-23. https://doi.org/10.1161/hc2901.093111
  9. Yong MS, Lee YS, Lee HY. Effects of breathing exercises on resting metabolic rate and maximal oxygen uptake. J Phys Ther Sci 2018;30:1173-5. https://doi.org/10.1589/jpts.30.1173
  10. Wang SZ, Li S, Xu XY, Lin GP, Shao L, Zhao Y, et al. Effect of slow abdominal breathing combined with biofeedback on blood pressure and heart rate variability in prehypertension. J Altern Complement Med 2010;16:1039-45. https://doi.org/10.1089/acm.2009.0577
  11. Beng TS, Jie HW, Yan LH, Ni CX, Capelle DP, Yee A, et al. The effect of 20-minute mindful breathing on the perception of suffering and changes in Bispectral Index Score in palliative care patients: a randomized controlled study. Am J Hosp Palliat Care 2019;36:478-84. https://doi.org/10.1177/1049909118812860
  12. Alaparthi GK, Augustine AJ, Anand R, Mahale A. Comparison of diaphragmatic breathing exercise, volume and flow incentive spirometry, on diaphragm excursion and pulmonary function in patients undergoing laparoscopic surgery: a randomized controlled trial. Minim Invasive Surg 2016;2016:1967532.
  13. Kang JI, Jeong DK, Choi H. The effects of breathing exercise types on respiratory muscle activity and body function in patients with mild chronic obstructive pulmonary disease. J Phys Ther Sci 2016;28:500-5. https://doi.org/10.1589/jpts.28.500
  14. Yokogawa M, Kurebayashi T, Ichimura T, Nishino M, Miaki H, Nakagawa T. Comparison of two instructions for deep breathing exercise: non-specific and diaphragmatic breathing. J Phys Ther Sci 2018;30:614-8. https://doi.org/10.1589/jpts.30.614
  15. Hodges PW, Gandevia SC. Changes in intra-abdominal pressure during postural and respiratory activation of the human diaphragm. J Appl Physiol (1985) 2000;89:967-76. https://doi.org/10.1152/jappl.2000.89.3.967
  16. Tayashiki K, Maeo S, Usui S, Miyamoto N, Kanehisa H. Effect of abdominal bracing training on strength and power of trunk and lower limb muscles. European Journal of Applied Physiology 2016;116:1703-13. https://doi.org/10.1007/s00421-016-3424-9
  17. Kim JG, Kim JH, Do KS, Kim J. Effect of light touch on body sway during a stable posture with blocked visual information. Phys Ther Rehabil Sci 2016;5:138-42. https://doi.org/10.14474/ptrs.2016.5.3.138
  18. Park J, Chung Y. The effects of an additional weight aqatic exercises program on balance and lower extremity strength in persons with stroke: randomized controlled study. Phys Ther Rehabil Sci 2018;7:6-12. https://doi.org/10.14474/ptrs.2018.7.1.6
  19. Asakawa Y, Lee MM, Song CH. The effect of whole body vibration training on postural sway in patients with spinal cord injury: a pilot study. Phys Ther Rehabil Sci 2013;2:70-4. https://doi.org/10.14474/ptrs.2013.2.2.70
  20. Park YH, Lee CH, Kim HJ. A pilot study of augmented reality-based postural control training in stroke rehabilitation. Phys Ther Rehabil Sci 2014;3:13-9. https://doi.org/10.14474/ptrs.2014.3.1.13
  21. Modesti PA, Ferrari A, Bazzini C, Boddi M. Time sequence of autonomic changes induced by daily slow-breathing sessions. Clin Auton Res 2015;25:95-104. https://doi.org/10.1007/s10286-014-0255-9
  22. Kazimierz M, Adam M, Malgorzata C, Jozef L, Artur G, Adam Z. The influence of strength exercises of the lower limbs on postural stability: a possible role of the autonomic nervous system. Isokinet Exerc Sci 2017;25:79-89. https://doi.org/10.3233/IES-160648
  23. Pahra D, Sharma N, Ghai S, Hajela A, Bhansali S, Bhansali A. Impact of post-meal and one-time daily exercise in patient with type 2 diabetes mellitus: a randomized crossover study. Diabetol Metab Syndr 2017;9:64. https://doi.org/10.1186/s13098-017-0263-8
  24. Thompson LA, Badache M, Cale S, Behera L, Zhang N. Balance performance as observed by center-of-pressure parameter characteristics in male soccer athletes and non-athletes. Sports (Basel) 2017;5:E86.
  25. Kim GH, Tak JY, Lim HY, Jeong HS, Woo YK. Effects of various sensory stimulation on surface area and velocity of center of pressure during one leg standing in healthy adults. Phys Ther Korea 2015;22:41-9.
  26. Demura S, Uchiyama M. Influence of anaerobic and aerobic exercises on the center of pressure during an upright posture. J Exerc Sci Fit 2009;7:39-47. https://doi.org/10.1016/S1728-869X(09)60006-X
  27. Jacobs C, Uhl TL, Seeley M, Sterling W, Goodrich L. Strength and fatigability of the dominant and nondominant hip abductors. J Athl Train 2005;40:203-6.
  28. Telles S, Gupta RK, Gandharva K, Vishwakarma B, Kala N, Balkrishna A. Immediate effect of a yoga breathing practice on attention and anxiety in pre-teen children. Children (Basel) 2019;6:E84.
  29. Woollacott M, Shumway-Cook A. Attention and the control of posture and gait: a review of an emerging area of research. Gait Posture 2002;16:1-14. https://doi.org/10.1016/S0966-6362(01)00156-4
  30. Stephens RJ, Haas M, Moore WL 3rd, Emmil JR, Sipress JA, Williams A. Effects of diaphragmatic breathing patterns on balance: a preliminary clinical trial. J Manipulative Physiol Ther 2017;40:169-75. https://doi.org/10.1016/j.jmpt.2017.01.005
  31. Roh H. The effect of abdominal breathing with muscle strength exercise on balance and strength. Neurotherapy 2018;22:33-8.
  32. Hsu CY, Hsieh PL, Hsiao SF, Chien MY. Effects of exercise training on autonomic function in chronic heart failure: systematic review. Biomed Res Int 2015;2015:591708.
  33. da Silva VP, de Oliveira NA, Silveira H, Mello RG, Deslandes AC. Heart rate variability indexes as a marker of chronic adaptation in athletes: a systematic review. Ann Noninvasive Electrocardiol 2015;20:108-18. https://doi.org/10.1111/anec.12237
  34. Kim JS. The effects of breathing exercises on the change of autonomic nervous system activity in female adults. J Korean Assoc Phys Educ Sport Girls Women 2016;30:295-309. https://doi.org/10.16915/jkapesgw.2016.06.30.2.295
  35. Edelhauser F, Minnerop A, Trapp B, Bussing A, Cysarz D. Eurythmy therapy increases specific oscillations of heart rate variability. BMC Complement Altern Med 2015;15:167. https://doi.org/10.1186/s12906-015-0684-6
  36. Montesinos L, Castaldo R, Cappuccio FP, Pecchia L. Day-to-day variations in sleep quality affect standing balance in healthy adults. Sci Rep 2018;8:17504. https://doi.org/10.1038/s41598-018-36053-4
  37. Joseph CN, Porta C, Casucci G, Casiraghi N, Maffeis M, Rossi M, et al. Slow breathing improves arterial baroreflex sensitivity and decreases blood pressure in essential hypertension. Hypertension 2005;46:714-8. https://doi.org/10.1161/01.hyp.0000179581.68566.7d
  38. Ricca-Mallada R, Migliaro ER, Piskorski J, Guzik P. Exercise training slows down heart rate and improves deceleration and acceleration capacity in patients with heart failure. J Electrocardiol 2012;45:214-9. https://doi.org/10.1016/j.jelectrocard.2012.01.002
  39. Music S, Rossell SL. Effects of stress on learning and memory. In: Fink G, editor. Stress: concepts, cognition, emotion, and behavior. Elsevier Inc.; 2016. p. 153-60.