• The Journal of Korean Physical Therapy
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• v.17 no.3
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• pp.311-327
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• 2005

The purpose of this study was to investigate the effects of diaphragmatic breathing on activation of trunk muscles of patients with low back pain. 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. Diaphragmatic breathing increases intra-abdominal pressure and the increased intra-abdominal pressure may contribute to the lumbar stability. Sixty patients with low back pain were randomly divided into two groups. Experimental group performed diaphragmatic breathing exercise with six breathing positions and control group performed only the breathing positions for five times per week during six weeks. % maximal voluntary contraction(% MVC) of trunk muscles on six breathing positions of experimental and control group was measured according to testing period of pre test, three weeks, and six weeks. The repeated measures of one-way ANOVA were used to analyze % MVC on trunk muscles of experimental and control group according to testing period. The results of this study were as follows: First, % MVC of right and left erector spinae in the right leg extension position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Second, % MVC of right and left erector spinae in all-four positions indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Third, % MVC of right and left erector spinae, external oblique in the sitting position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Fourth, % MVC of right and left erector spinae, external oblique in the standing position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Fifth, % MVC of right and left erector spinae, external oblique in the supine position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). Sixth, % MVC of right and left erector spinae, external oblique in the lying on prone position indicated the statistically significant difference in experimental group which performed diaphragmatic breathing exercise rather than control group (p<0.05). In conclusion, as experimental group performed diaphragmatic breathing exercise according to the period of pre-test, post three weeks, and post six weeks, experimental group showed the greater significant effect on the activation of right, left erector spinae, and external oblique muscle. Diaphragmatic breathing exercise which resulted in activation of trunk muscles can be effective for managing the patients with back pain and should be utilized as the new therapeutic intervention.

• The Journal of Korean Physical Therapy
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• v.36 no.2
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• pp.67-70
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• 2024

Purpose: This study investigated the effect of virtual reality and Schroth breathing exercises on the lung function characteristics of normal adults in their 20s. Methods: The subjects were randomly divided into groups with ten people each in the experimental groups, namely the virtual reality breathing exercise group (BBEG) and the Schroth breathing exercise group (SBEG), and the control group. The experimental groups performed each breathing exercise for 4 weeks. Subsequently, pulmonary function test indicators such as the forced vital capacity (FVC) and the forced expiratory volume (FEV1) were measured. Results: In the within-group comparison of the subjects before and after the exercises, there was a significant difference in the FVC and FEV1 (p<0.05), but there was no significant difference in FEV1/FVC. The result of the difference test between groups showed that there was a significant difference in FEV1/FVC after exercise (p<0.05). However, there were no significant differences in the remaining items (p>0.05). Conclusion: Improvement in lung function was seen in both exercise groups, and the changes in FEV1/FVC indicated significant improvement in the lung function of the experimental groups compared to the control group.

• 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 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.13 no.1
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• pp.113-123
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• 2024

Objective: The study analyzed the awareness of physical therapists regarding correct breathing methods and the effect of breathing training on patients. Design: A cross-sectional survey study. Methods: Physical therapists who agreed to participate in the study, held a license as a physical therapist, and had training or experience in breathing were included as subjects. A total of 136 questionnaires were collected, out of which 129 were analyzed. The questionnaire consisted of 26 items, divided into several sections covering awareness of breathing methods, breathing and muscles, breathing and mind, breathing and movement, perception of mouth breathing and nose breathing, experience applying respiration as a treatment, perception of breathing and treatment, awareness of breathing and pain, awareness of breathing and chronic diseases and prevention, perceptions related to breathing and sleep, and educational background. Results: The study found that most therapists were aware of diaphragmatic breathing, but not Lamaze breathing. 76.7% claimed to that there is a correct breathing method, and the majority were aware of the reasons for correct breathing. The majority believed in the therapeutic effect of breathing, with core exercise breathing training being the most commonly used in therapy. 81.7% of therapists had taught a specific breathing method to a patient, and diaphragmatic breathing was the most provided treatment. There was no significant difference in perception according to clinical experience, but there was a significant difference in perception according to educational background. Conclusions: The study provided clinical background on Physical Therapists' belief on correct breathing method, and uses of breathing training during treatment. The results suggest there is a need for a coherent education on breathing method and techniques among Physical Therapists.

• The Journal of Korean Physical Therapy
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• v.21 no.3
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• pp.25-32
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• 2009

Purpose: This study examined whether breathing exercises might increase the chest expansion and pulmonary function of stroke patients. Methods: Twenty four patients with stroke were assigned randomly into two groups: a combination of diaphragmatic resistive breathing and pursed-lip breathing exercise (CB) group (n=10) and control group (n=14). The CB group completed a 4-week program of diaphragmatic resistive breathing and pursed-lip breathing exercise. The subjects were assessed using the pre-test and post-test measurements of the chest expansion (length for resting, deep inspiration, deep expiration, deep expiration-inspiration) and pulmonary function (forced vital capacity (FVC), forced expiratory volume at one second (FEV1), FEV1/FVC, peak expiratory flow (PEF), vital capacity (VC), tidal volume (TV), expiratory reserve volume (ERV), inspiratory reserve volume (IRV)). Results: A comparison of the chest expansion between the pre and post tests revealed similar rest, deep inspiration, deep expiration, and deep expiration-inspiration lengths in the CB and control groups (p>0.05). A comparison of the pulmonary function between pre and post tests, revealed significant improvements in the FVC, FEV, PEF, VC, IRV, and ERV in the CB group (p<0.05). There was a significant difference in the FVC, FEV1, PEF, VC and IRV between the 2 groups (p<0.05). Conclusion: These findings suggest that breathing exercise should help improve the pulmonary function, such as the volume and capacity. This suggests that the pulmonary functions of stroke patients might be improved further by a continued respiratory exercise program.

• 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.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.21 no.1
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• pp.13-20
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• 2015

Background: To evaluate the effect of thoracic mobility exercise and deep breathing exercise applied to stroke patients on pulmonary function. Methods: The subjects were divided into two group. Twenty-five patients with stroke were randomly assigned to DB (deep breathing exercise) group (n=13) and TM (combination of deep breathing exercise and thoracic mobility exercise) group (n=12). During four weeks, DB group were carried out deep breathing exercises for 5~10 minutes twice a day and TM Group were carried out deep breathing exercises for 5~10 minutes and thoracic mobility exercise for 20~30 minutes twice a day. All tests were completed before and after experiment. The pulmonary functions were measured by PowerBreathe K5 (Hab International Ltd, England) and tape measure respectively. For each case, the experimental data were obtained in 4 items; average of inspiratory load, inspiratory flow speed, inspiratory flow volume and chest expansion. Results: The results of this study were as follows: 1. In DB group, the statistically significants were shown on average of inspiratory flow speed, inspiratory flow volume and chest expansion (p<.05). 2. In TM group, the statistically significants were shown on all items (p<.05). 3. There was a statistically significant difference on all items between DB group and TM group (p<.05). Conclusions: The above results revealed that DB and TM group can be used to improve pulmonary function in stroke patients. In comparison of DB and TM group, TM group was more improved. In conclude, thoracic mobility exercise helped improving function of vital capacity and chest expansion in stroke patients.

• The Journal of Korean Physical Therapy
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• v.31 no.4
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• pp.193-198
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• 2019

Purpose: This study examined the effects of plank exercise combined with breathing and arm exercises on the external oblique, internal oblique, and transverse abdominal muscle thickness. Methods: Thirty healthy adults consisting of 12 males and 18 females from K area were divided into a plank exercise combined with breathing and arm exercises group (n = 15) and a plank exercise only group (n=15). The changes in muscle thickness before the exercise and four and eight weeks after the exercise were analyzed using a two-way repeated analysis of variance (ANOVA). The significance level was set to ${\alpha}=0.05$. Post-hoc t-tests were conducted to detect the interactions between the time and groups, and the significance level was set to ${\alpha}=0.01$. Results: According to the experimental results, the external oblique abdominal muscle showed significant differences over time (p<0.05). The internal oblique abdominal muscle also showed significant differences over time and in the interactions between the time and groups (p<0.05). The transverse abdominal muscle showed significant differences over time, in the interactions between time and groups, and in the changes between the groups (p<0.05). Conclusion: The results indicated that plank exercise combined with breathing and arm movement exercises led to increases in the abdominal muscle thickness. These types of exercises may be useful in lumbar stabilization rehabilitation treatment.

• Physical Therapy Korea
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• v.25 no.2
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• pp.44-52
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• 2018

Background: The deep cervical flexor (DCF) muscles have a crucial role in the management of neck pain. For preventing neck pain by activation of the DCF, craniocervical flexion (CCF) is an effective exercise. However, sternocleidomastoid (SCM) muscle is considered to affect negatively the activation of the DCF. SCM muscle which is an accessory muscle for respiration is activated differently depending on types of breathing patterns. It's not certain that breathing patterns affect the SCM and DCF muscles thickness during CCF exercise. Objects: The purpose of this study was to investigate the influence of breathing patterns on the SCM and DCF muscles thickness during CCF exercise. Methods: Forty-five subjects participated in this study, and they were classified according to their breathing pattern, as follows: costodiaphragmatic breathing (CDB) and upper costal breathing (UCB) groups. Ultrasonographic imaging of the SCM and DCF muscles was performed during five incremental levels of CCF during tidal breathing and expiration. Results: There was a significant interaction between the breathing pattern and the phase of CCF for percentage of SCM muscle thickness changes (p<.05). In phase 1 CCF, a percentage of SCM muscle thickness changes was increased in the UCB group than in the CDB group (p<.05). There was an increase in DCF muscles thickness with each additional CCF phase (p<.05). Conclusion: Recruitment of SCM muscle was increased in the UCB group while performing CCF with a low intensity. There were no significant differences on DCF recruitment between the breathing pattern groups. Higher CCF exercise intensities elicited a higher DCF recruitment.