• Journal of the Korean Society of Physical Medicine
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• v.14 no.1
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• pp.25-33
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• 2019

PURPOSE: This study examined the effective impact of self and resistive and ultrasound-biofeedback diaphragm breathing on the pulmonary function and diaphragm thickening ratio of young adults. METHODS: Thirty normal adults were assigned randomly to three experimental groups (self- diaphragm breathing (n=9), resistive-diaphragm breathing (n=11), ultrasound-biofeedback diaphragm breathing (n=10)). Each group participated for 15 minutes for times with a two minute rest between two sets. The subjects were assessed using the pre- and post- diaphragm thickening ratio and the pulmonary function (forced vital capacity, forced expiratory volume at one second, maximal voluntary ventilation, and respiratory rate) on the thirty subjects. A paired t-test was to determine the difference between before and after the experiment in each group of diaphragm breathing before and after the exercises. One-way ANOVA was used to determine the differences between the groups. RESULTS: The forced vital capacity and maximal voluntary ventilation measurements revealed a significant difference in the resistive-diaphragm breathing group than the other two groups. On the other hand, there was no significant difference between the self-diaphragm breathing and ultrasound-biofeedback breathing groups. CONCLUSION: The resistive-diaphragm breathing group showed greater improvement in the pulmonary function than the other two groups. Therefore, resistive-diaphragm breathing will improve the pulmonary function on normal young adults.

• Journal of the Korean Society of Physical Medicine
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• v.8 no.2
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• pp.263-269
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• 2013

PURPOSE: The purpose of this study was to examine the effects of breathing retraining on asymmetry of diaphragm thickness in stroke patients. METHODS: This study was nonequivalent control group pre-post test design. Subjects were assigned to two different groups(intervention group=10, control group=12). Intervention group conducted breathing retraining program for six-week. Diaphragm thickness was assessed by ultrasound in B-mode with a 7.5 MHz linea probe. The collected data analyzed by Wilcoxon signed rank test and Mann-Whitney U test. RESULTS: The intervention group significantly increased diaphragm thickness ratio on paretic side but the control group showed no significant difference in diaphragm thickness ratio. The control group significantly increased asymmetry of diaphragm thickness, but intervention group showed no significant difference in asymmetry of diaphragm thickness. CONCLUSION: This study showed that breathing retraining increased diaphragm thickness ratio in stroke patients and prevent the increase of asymmetry in diaphragm thickness with stroke patients.

• 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.

• Journal of The Korean Society of Integrative Medicine
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• v.7 no.2
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• pp.181-187
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• 2019

Purpose: The purpose of this study was to investigate the activity of respiratory muscle and lung capacity during deep breathing with electrical stimulation of the vagus nerve. Methods: This study was conducted on 30 healthy adults in their 20s. Subjects were randomly performed to deep breathing or deep breathing with vagus nerve electrical stimulation. All subjects' diaphragm and internal oblique muscle activity were measured during deep breathing by electromyography, and lung capacity was measured by spirometry immediately after beep breathing. In the vagus nerve stimulation method, the surface electrode was cut into the left ear and then electrically stimulated using a needle electric stimulator. Results: The activity of diaphragm was significantly increased in deep breathing with vagus nerve electrical stimulation than in deep breathing. However, lung capacity did not show any significant difference according to the condition. Conclusion: Vagus nerve electrical stimulation could induce diaphragm activity more than deep breathing alone. Deep breathing with vagus nerve electrical stimulation may enhance the activity of the respiratory muscles and is expected to be an effective treatment for the elderly or COPD patients with poor breathing ability.

• Physical Therapy Rehabilitation Science
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• v.12 no.3
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• pp.278-292
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• 2023

Objective: This study was performed to investigate the effects of thoracic joint mobilization and breathing exercises on diaphragmatic thickness, chest expansion, respiratory function, and endurance in patients with chronic stroke. Design: Randomized controlled trial Methods: The study included 24 chronic stroke patients who were randomly divided into two groups. The experimental group (12 people) performed 15 minutes of thoracic joint mobility exercises and 15 minutes of breathing exercises, three times a week for 6 weeks, 30 minutes each time. The control group (12 people) received 15 minutes of conservative physical therapy and 15 minutes of breathing exercises, 3 times a week for 6 weeks, 30 minutes per session, the same as the experimental group. The experimental and control groups performed the same breathing exercises. To assess training effectiveness, changes in diaphragm thickness, chest expansion, respiratory function, and endurance were measured. Results: As a result, the experimental group exhibited significant improvements in diaphragm thickness, chest expansion, and respiratory function. The endurance mode also displayed significant enhancement (p<0.05), a finding consistent with the control group. However, the experimental group displayed more substantial improvements in non-affected diaphragm thickness and thoracic expansion compared to the control group (p<0.05). Conclusions: Drawing from these findings, breathing exercise which combine thoracic mobilization, will be actively utilized in addition to physical therapy interventions in clinical trials as an effective intervention method.

• Journal of Korean Physical Therapy Science
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• v.29 no.2
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• pp.57-65
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• 2022

Background: This study was to determine whether the diaphragmatic breathing exercise using a DiP Belt(Diaphragmatic Pressure Belt) is effective in increasing the diaphragmatic motion and forced vital capacity. Design: Pretest-Posttest design. Methods: A total of 44 subjects(15 male, 29 female) participated in this study. All subjects were measured the diaphragmatic motion with a sonography and the Forced Vital Capacity(FVC) was measured with a digital spirometer. After 4 weeks, the subjects were intervened the diaphragmatic breathing exercise using a DiP belt and were remeasured for diaphragm motion and FVC. Results: After exercise intervention, quiet breathing significantly increased with the change in diaphragmatic motion and showed a moderate effect size (p<.01, Cohen's d = -0.53). In addition, it was significantly increased in deep breathing and showed a high effect size (p<.001, Cohen's d = -1.32). The mean diaphragmatic contraction pressure increased, but there was no significant difference and the peak diaphragmatic contraction pressure increased significantly (p<.05). Both diaphragmatic contraction pressure showed small effect sizes (respectively Cohen's d = -0.28, -0.33). In spirometry, FVC, Forced Expiratory Volume in 1 second (FEV₁), and FEV₁/FVC% all increased, but there was no significant difference. Only peak expiratory flow increased significantly and showed a small effect size (p<.05, Cohen's d = -0.41). Conclusion: The DiP belt diaphragmatic breathing exercise that the principle of visual feedback can correct diaphragm breathing in a short time, so it is a useful breathing exercise device that can help the diaphragm breathing exercise in the right way in clinical practice.

• Physical Therapy Rehabilitation Science
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• v.7 no.3
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• pp.95-101
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• 2018

Objective: To determine if the provision of visual biofeedback using real-time rehabilitative ultrasound imaging (RUSI) enhances the acquisition and retention of diaphragm muscle recruitment during exercise. Design: Two group pretest posttest design. Methods: Thirty healthy subjects were randomly assigned to the verbal feedback group (VG, n=15) or the visual and verbal feedback group (VVG, n=15). The VG performed breathing exercises 10 times with verbal feedback, and the VVG also performed breathing exercises 10 times with verbal feedback and visual feedback with the use of RUSI to measure changes in diaphragm thickness (DT). For DT, the mid-axillary lines between ribs 8 and 9 on both sides were measured in standing, and then the chest wall was perpendicularly illuminated using a linear transducer with the patients in supine to observe the region between rib 8 and 9 and to obtain 2-dimensional images. DT was measured as the distance between the two parallel lines that appeared bright in the middle of the pleura and the peritoneum. After one week, three repetitions (follow-up session) were performed to confirm retention effects. Intra- and between- group percent changes in diaphragm muscle thickness were assessed. Results: In the VVG, the intervention value had a medium effect size compared to the baseline value, but the follow-up value decreased to a small effect size. In the between-group comparisons, during the intervention session, the VVG showed no significant effect on percent change of DT but had a medium effect size compared to the VG (p=0.050, Cohen's d=0.764). During the follow-up session, retention effect did not persist (p=0.311, Cohen's d=0.381). Conclusions: RUSI can be used to provide visual biofeedback and improve performance and retention in the ability to activate the diaphragm muscle in healthy subjects. Future research needs to establish a protocol for respiratory intervention to maintain the effect of diaphragmatic breathing training using RUSI with visual feedback.

• Journal of Life Science
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• v.17 no.9 s.89
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• pp.1266-1271
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• 2007

The purpose of this study was to investigate combined effects of diaphragm breathing and garlic powder intake on body composition, heart rate, blood press and immunoglobulin levels in middle-aged male smokers from the age 40-49. Diaphragm breath training was 2-5 grade intensity on dyspnea scale for 20 minutes four times a week for 4 weeks and subjects were given garlic at 3 g of powder after breakfast and dinner two times a day during the 4 weeks. The conclusions of this study are as follows; Garlic intake group decreased in percentage of body fat, in the comparison between groups, garlic intake group had a lower percentage of body fat than control group. Heart rate was decreased in Diaphragm breathing group at rest. SBP was decreased in Diaphragm breathing+garlic intake group. Garlic intake group and diaphragm breathing+garlic intake group increased in IgG.

• Journal of The Korean Society of Integrative Medicine
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• v.8 no.1
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• pp.137-146
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• 2020

Purpose : The enhancement of abdominal muscles increases the activation and contraction of respiratory muscles, including the diaphragm. Generally, diaphragm exercises are applied to increase the breathing ability of patients with respiratory disease. Previous studies have shown that breathing capacity can be increased through abdominal muscle strengthening exercises. However, studies on breathing ability are rare and it is doubtful whether these affect respiratory ability more than diaphragm exercises. Therefore, this study seeks to compare whether abdominal exercises can improve breathing ability and whether any increase is comparable to diaphragm exercises. Methods : After selecting subjects, the place of intervention was separated for blindness. The plank group was allowed to relax for 30 seconds after 30 seconds of planking; this was set at three and increased by one set each week. Subjects in the draw-in group were allowed to relax for 30 seconds after maintaining the draw-in contraction state for 30 seconds and this was done for 15 minutes. Subjects in the control group underwent abdominal dilation for five seconds of inspiration time and expired air for five seconds by exposing the lips; breathing was performed repeatedly for 15 minutes. Subjects in each group measured their respiration function three times before intervention, three weeks after the commencement of intervention and after intervention. Spirovit SP-1 was used to measure respiratory function. In each group, repeated ANOVA was used to compare the respiratory function over time and one-way ANOVA was used to compare the respiratory function between groups. The post hoc was conducted using the LSD method. Results : There was a significant increase in respiratory ability between the forced vital capacity (FVC), forced expiratory volume in one second (FEV₁) and peak expiratory flow (PEF), forced expiratory volume in one second (FEV₁)/forced vital capacity (FVC) according to the six-week period. However, there was no difference between each group. Conclusion : For patients with low respiratory muscle strength, plank exercises and abdominal draw-in are beneficial exercises for improving respiratory function. These are expected to be widely used in clinical practice for patients with weak respiratory muscles.

• Journal of the Korean Society of Physical Medicine
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• v.1 no.1
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• pp.59-66
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• 2006

Purpose : The purpose of this study was to investigate the effects of diaphragmatic breathing on activation of lumbar paraspinal muscles of normal healthy people. Diaphragmatic breathing may affect activation of trunk muscles. The assumptions are as follows: the crural diaphragm attatches to the lumbar vertebrae from L1 to L3, the voluntary downward pressurization of the diaphragm increases intra-abdominal pressure, and this increases the stiffness of the spine. Methods : Sixty male college students ranging 19 to 34 years were screened and % maximal voluntary contraction(% MVC) of trunk muscles on the four positions of back extension exercise was compared during the pre and post of inspiration of diaphragmatic breathing. Results : 1. % MVC of right and left erector spinae had the statistically significant difference between pre and post inspiration of diaphragmatic breathing in the dynamic right arm and left leg extension position(p<0.05). 2. % MVC of right and left erector spinae had the statistically significant difference between pre and post inspiration of diaphragmatic breathing in the dynamic left arm and right leg extension position(p<0.05). 3. % MVC of right and left erector spinae had the statistically significant difference between pre and post inspiration of diaphragmatic breathing in the static lying prone extension position(p<0.05). 4. % MVC of right and left erector spinae had the statistically significant difference between pre and post inspiration of diaphragmatic breathing in the static lying on prone position(p<0.05). Conclusion : This study will be used as the purpose of data collection of lumbar paraspinal muscles on diaphragmatic breathing and be introduced as the new therapeutic intervention for management of patients with back pain.