• Physical Therapy Korea
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• v.24 no.2
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• pp.27-36
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• 2017

Background: Research efforts to improve the pulmonary function of people with limited chest function have focused on the diaphragmatic ability to control breathing pattern. Real-time ultrasonography is appropriate to demonstrate diaphragmatic mechanism during breathing. Objective: The purpose of this study was to investigate the effects of diaphragmatic breathing training using real-time ultrasonographic imaging (RUSI) on the chest function of young females with limited chest mobility. Methods: Twenty-six subjects with limited chest mobility were randomly allocated to the experimental group (EG) and control group (CG) depending on the use of RUSI during diaphragmatic breathing training, with 13 subjects in each group. For both groups, diaphragmatic breathing training was performed for 30-min, including three 10-min sets with a 1-min rest interval. An extra option for the EG was the use of the RUSI during the training. Outcome measures comprised the diaphragmatic excursion range during quiet and deep breathing, pulmonary function (forced vital capacity; FVC, forced expiratory volume in 1-sec; FEV1, tidal volume; TV, and maximal voluntary ventilation; MVV), and chest circumferences at upper, middle, and lower levels. Results: The between-group comparison revealed that the diaphragmatic excursion range during deep breathing, FVC, and middle and lower chest circumferences were greater at post-test and that the changes between the pretest and post-test values were greater in the EG than in the CG (p<.05). In addition, the subjects in the EG showed increased post-test values for all the variables compared with the pretest values, except for TV and MVV (p<.05). In contrast, the subjects in the CG showed significant improvements for the diaphragmatic excursion range during quiet and deep breathings, FVC, FEV1, and middle and lower chest circumferences after the intervention (p<.05). Conclusion: These results indicate that using RUSI during diaphragmatic breathing training might be more beneficial for people with limited chest mobility than when diaphragmatic breathing training is used alone.

• Journal of International Academy of Physical Therapy Research
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• v.11 no.1
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• pp.1981-1991
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• 2020

Background: Although various exercises have been performed for patients with chronic low back pain (CLBP), the effects of these exercises including joint mobilization, gym ball exercises, and breathing exercises on flexion relaxation ratio (FRR) have not been compared. Objective: To compare the effects of joint mobilization, gym ball exercises, and breathing exercises on the flexion relaxation phenomenon (FRP) and pain in patients with chronic low back pain. Design: Randomized pretest-posttest control group design. Methods: Thirty-six patients with chronic low back pain who were undergoing rehabilitation at a rehabilitation center were included. The patients were randomly divided into three groups: joint mobilization group (JMG; n=12), gym ball exercise group (GBG; n=12), and breathing exercise group (BEG; n=12). The exercises were performed for 40 minutes a day, twice a week, for a total of 12 weeks. Results: There were no significant differences in FRR between the three groups (P>.05). Significant decreases in the modified visual analog scale (MVAS) scores after intervention between the groups were found (P<.05). The GBG was significantly decreases from the JMG in the MVAS (P<.05). However, there were significant improvements between the pre- and post-interventional findings on FRR and MVAS in the three groups (P<.05). Conclusion: We demonstrated that intervention using joint mobilization, gym ball exercises, and breathing exercises improve FRP and pain in patients with CLBP.

• Journal of International Academy of Physical Therapy Research
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• v.3 no.2
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• pp.458-463
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• 2012

This study is to examine the effects of a feedback breathing device exercise and diaphragm breathing exercise on pulmonary functions of chronic strokes patients. The selection of 20 subjects was divided equally and placed into a experiment group and a control group and the intervention was applied four times per a week for five weeks. In each session, both groups received rehabilitative exercise treatment for 30 minutes, and a feedback breathing device exercise for 15 minutes. In addition, experimental group conducted a combination of diaphragm breathing exercise for 15 minutes. Prior to and after the experiment, patients' pulmonary functions were measured using a spirometer. The pulmonary function tests included FVC, FEV1, FEV1/FVC, PEF, VC, TV, IC, ERV, IRV. With respect to changes in the pulmonary functions of both groups, the experimental group significantly differed in FVC, FEV1, TV, ERV but did not in PEF, FEV1/FVC, VC, IRV. The control group did not significantly differ in any of the tests. There were significant differences in FEV1, FEV1/FVC, TV, ERV between the two groups, but no significant differences in FVC, PEF, FEV1/FVC, VC, IRV between them after the experiment. The experimental group, which conducted a combination of a feedback breathing device exercise and diaphragm breathing exercise, saw their respiratory ability increase more significantly than the control group. The breathing exercise was found to improve pulmonary function in chronic stroke patients.

• Physical Therapy Korea
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• v.9 no.2
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• pp.107-113
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• 2002

This study was conducted to determine the effects of deep breathing exercise and ankle exercise on blood flow velocity in the femoral vein. Sixteen healthy male students were recruited from Yonsei University, at Wonju. The blood flow velocities in the femoral vein were measured under three different conditions: resting, deep breathing, and ankle exercise. All subjects were given a 5-minute relaxing time in supine position prior to the study. Using a doppler ultrasound with a 8 MHz probe, the peak blood flow velocities were collected in a twenty-second-period at each condition. The subjects took a rest in between trials for the blood flow to return to its resting levels. The result showed a significant difference in peak blood flow velocities under those three conditions (p<.001). The peak blood flow velocity was highest in ankle exercise condition. The peak blood velocity was significantly higher in deep breathing condition compared with the resting condition. As a result, it is revealed that not only the muscular contractions but also the deep breathing exercises induced facilitating effects of venous return. Either of the exercise methods can be recommended to prevent blood stasis in patients with risk of deep vein thrombosis after cardiac or lower extremity surgery.

• Journal of the Korean Society of Physical Medicine
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• v.13 no.3
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• pp.81-89
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• 2018

PURPOSE: This study was conducted to monitor the performance of breathing exercises by patients with lumbar instability who had altered breathing patterns. METHODS: To investigate the effects of breathing exercises on spinal posture, mobility, and stabilization in patients with lumbar instability with altered breathing patterns, 30 adult participants were enrolled on the basis of the selection criteria and randomly assigned to the breathing exercise group (BEG) or trunk stabilization exercise group (SEG). A pre-test was performed prior to the intervention exercise program. The intervention exercise program consisted of 15 sessions (three sessions per week for 5 weeks) between August and September of 2016. The post-test was performed on the 6th week of intervention. RESULTS: Pre- and post-test comparisons of BEG and SEG revealed significant improvements in all tested items in the SEG, except for spinal mobility, while significant improvements in spinal postures 1 and 2, spinal mobility, and stabilization were found in the BEG. Between-group comparisons revealed that there were no significant differences in spinal posture 1, spinal posture 2, spinal mobility, or stabilization, whereas significant differences were found in spinal posture 2 and spinal mobility, with the BEG showing greater improvements than the SEG. CONCLUSION: Based on the findings in the present study, it is believed that breathing exercises have important effects on spinal posture, mobility, and stabilization in patients with lumbar instability who have altered breathing patterns.

• Journal of International Academy of Physical Therapy Research
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• v.10 no.2
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• pp.1750-1755
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• 2019

Background: Most of the previous researches on the abnormality of breathing pattern have focused on the silence of functional movements owing to such abnormality, however, have not been clearly identified the relationship between the abnormal breathing pattern on one hand and kinesiophobia and flexion relaxation phenomenon (FRP) on the other hand. Objective: To compare patients with chronic low back pain (CLBP) and healthy person in the abnormality of breathing pattern, kinesiophobia, and FRP during flexion and extension of the trunk. Design: Case-control study. Methods: The research subjects consisted of a group of 15 healthy adults and another group of 15 patients with CLBP. Capnography was used to measure the endtidal $CO_2$ ($EtCO_2$) and respiratory quotient (RQ). The muscle activity of multifidus and erector spinae of the subjects was measured during flexion and extension of the trunk to identify their FRP. The Nijmegen Questionnaire (NQ) and Tampa Scale of Kinesiophobia (TSK) were utilized to measure their breathing patterns and kinesiophobia, respectively. The Kolmogorov-Smirnov (K-S) test was conducted in order to analyze the normal distribution of the measured data. Their general characteristics were identified by the descriptive statistics and the independent t-test was performed to identify the differences between the two groups in terms of abnormality of breathing pattern, kinesiophobia, and FRP. The level of significance was set at ${\alpha}=.05$. Results: The patients with CLBP had significantly less $EtCO_2$ and shorter breathing hold time (BHT) than normal healthy person (p<.05). The patient with CLBP also had significantly greater kinesiophobia than healthy person (p<.05), and had less FRP than the healthy person (p<.01). Conclusions: These results suggest that the CLBP had greater abnormality of breathing pattern and kinesiophobia with less FRP than healthy person.

• Korean Journal of Applied Biomechanics
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• v.23 no.3
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• pp.279-284
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• 2013

The purpose of this study was to determine the effect of head posture and respiratory pattern on muscle activities of sternocleidomastoid (SCM) and scalene during maximal respiration. The seventeen subjects with upper-costal breathing pattern were participated in this study. Surface electromyography was used to measure the muscles activities of SCM and scalene. The volume and velocity of inspiration were monitored by using the spirometer in each subject. Each subject was performed the 3-cycle of respiration in each condition. The mean values of three peak muscle activity in each muscle were used in the data analysis. A2 (head posture: forward head posture: FHP vs. neutral posture) X 2 (breathing pattern: costal vs. diaphragmatic) repeated-measures analysis of variance (ANOVA) was used to compare the normalized muscle activities of the SCM and scalene. The results showed that the muscle activities of SCM and scalene in diaphragmatic breathing were significantly lower than those in costal breathing for each head posture (p<.0125). The muscle activities of SCM in neutral position were lower than those in forward head position during costal breathing (p<.0125). The diaphragmatic breathing in neutral position of head is recommended to decrease the tension of the accessory inspiratory muscles during respiration in neck-pain patients with FHP.

• Journal of the Korean Society of Physical Medicine
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• v.11 no.4
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• pp.1-9
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• 2016

PURPOSE: The aim of this study was to examine the effects of abdominal breathing and thoracic expansion exercises on craniovertebral and cranial rotation angles in patients with rotator cuff injury. METHODS: This study enrolled 19 patients with rotator cuff injury, and ten and nine of the patients were randomly placed in abdominal breathing and thoracic expansion exercise groups, respectively. After pain treatment in each group, breathing exercise was conducted thrice a week for four weeks. The patients were recorded by using a digital camera and Image J (version 1.46, National Institutes of Health, USA), an angle measurement program, was used to analyze changes in the craniovertebral angle, cranial rotation angle, and sagittal shoulder posture. RESULTS: Statistically significant differences in the craniovertebral angle were found in both the abdominal breathing and thoracic expansion exercise groups (p<.05). A significant difference in cranial rotation angle was found in the thoracic expansion exercise group only (p<.05). No statistically significant differences in sagittal shoulder posture were found in both groups (p>.05). CONCLUSION: Although abdominal breathing and thoracic expansion exercises did not effectively change sagittal shoulder posture, the exercises were effective in improving craniovertebral and cranial rotation angles. Therefore, abdominal breathing and thoracic expansion exercises are suggested as effective exercise programs for forward head posture.

• Journal of the Korean Applied Science and Technology
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• v.34 no.4
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• pp.1104-1111
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• 2017

In this study, the authors aimed to give careful consideration to the circulation of bioenergy (Qi) by using cardiorespiratory massage technique. Finding enlightenment in harmony with nature thousands of years ago, our ancestors created Qi using natural breathing and tried to achieve good health and long life by controling the up and down movement. Experiencing the importance of the abdomen during the hungry times, also, grandmothers cured diseases by rubbing the abdomen, which is the ocean of life with their soft, soothing touch of hand. Naval breathing therapy was formed, based on natural breathing, emotional recognition of grandmothers' soft, soothing touch, and the Theory of Unified Reason and Energy that is the key of Oriental medicine. Natural breathing and Yakson massage are kinds of naturopathy to change body and mind, cure diseases naturally, and maintain the improvement in physical functions by taking care of the abdomen through the creation of Qi and the up and down movement and keeping dynamic balance between the natural world and the inside and outside of human body. It is anticipated that this study could contribute to the practical spread for an active application of naval breathing therapy and be broadly used in scientific clinical researches.

• Physical Therapy Korea
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• v.21 no.1
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• pp.63-69
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• 2014

Cross knee curl-up is an ideal variation of abdominal curl up exercise to strengthen abdominal musculature without excessive lumbar flexion which can increase the loads on the disc and ligaments. In addition, slowly forced expiration can facilitate the activation of the abdominal musculature. The purpose of this study was to determine the effects of slowly forced expiration on activity of abdominal muscles, such as rectus abdominis (RA), external oblique (EO), and transverse abdominis/internal oblique (TrA/IO), while cross knee curl-up. Eleven young and healthy subjects (6 males and 5 females) participated. All subjects performed the cross knee curl-up slowly forced expiration and natural breathing. Paired t-test was performed in normalized electromyogram (EMG) muscle activity of the bilateral RA, EO, and TrA/IO to compare the differences between the cross curl-up with slowly forced expiration and natural breathing. Statistical significance was set at .05. There were no significant differences in normalized EMG muscle activity of the bilateral RA, EO, and TrA/IO between the cross curl-up with slowly forced expiration and natural breathing. The finding of this study designates that slowly forced expiration does not induce increasing activity of abdominal muscle in cross knee curl-up; hence, learning step of breathing control might not be necessary to strengthen abdominal muscle in cross knee curl-up.