The effect of 4-7-8 breathing exercise training on sleep quality of undergraduate nursing students: A randomized controlled study

Evidence indicates that healthy individuals who follow a training program comprised hyperventilatory breathing exercises and cold exposure can voluntarily activate their sympathetic nervous system and attenuate their systemic inflammatory response during experimental endotoxemia (intravenous administration of bacterial endotoxin). Furthermore, trained participants reported less endotoxemia-induced flu-like symptoms. However, it remained to be determined whether the effects on symptoms are due to the mitigated inflammatory response or involve direct analgesic effects of (elements of) the training program. In the present study, we used Nijmegen-Aalborg Screening Quantitative sensory testing (NASQ) to objectively map pain sensitivity using non-invasive stimuli to address this question. First, NASQ parameters were evaluated in 20 healthy volunteers before, during, and after the conduct of the hyperventilatory breathing exercise. Second, NASQ measurements were performed before and after 48 healthy volunteers followed different modalities of the training program: breathing exercise training, cold exposure training, the combination of both, or no training. Lastly, NASQ measurements were performed in these 48 subjects during experimental endotoxemia. Electrical pain detection thresholds increased during the breathing exercise (p = 0.001) as well as four hours afterwards (p = 0.03). Furthermore, cold exposure training resulted in lower VAS scores during hand immersion in ice water (p < 0.001). Systemic inflammation induced by administration of endotoxin nullified the decreased pain perception during the ice water test in subjects trained in cold exposure. A hyperventilatory breathing exercise decreases pain perception induced by an electrical stimulus. Furthermore, cold exposure training may decrease pain perception induced by hand immersion in ice water.

Purpose : This study attempts to examine the effect of the balance exercise on the unstable surfaces for the vital capacity in healthy adults. Methods : A total of 13 subjects was randomly divided into a breathing exercise training group (n=7) and a breathing and balance exercise training group (n=6). Changes in vital capacity and respiratory muscle activity were measured before and after the intervention. The intervention was performed three times a week for four weeks. Forced vital capacity (FVC), forced expiratory volume at one second (FEV1) and maximal voluntary ventilation (MVV) were used as measurement tools for the vital capacity test. Electromyography (EMG) was also used to examine respiratory muscle activity. Result : The breathing exercise training group showed significant improvement in terms of FVC, FEV1 and external oblique (EO), and transverse abdominis/internal oblique (TrA/IO) of MVV. The breathing and balance exercise training group showed significant improvement in terms of FVC, MVV and EO, TrA/IO of FVC and rectus abdominis (RA), EO, and TrA/IO of MVV. However, in comparing changes in vital capacity and respiratory muscle activity before and after the training, the breathing exercise training group and the breathing and balance exercise training group showed a significant difference in terms of MVV. Conclusion : This study is as a preliminary study to find out the relation between a balance exercise and a vital capacity, it is considered to require a further study with several revisions of subjects, duration and time for an intervention.

BackgroundPreoperative education and breathing exercise training by a physiotherapist minimises pulmonary complications after abdominal surgery. Effects on specific clinical outcomes such as antibiotic prescriptions, chest imaging, sputum cultures, oxygen requirements, and diagnostic coding are unknown.MethodsThis post hoc analysis of prospectively collected data within a double-blinded, multicentre, randomised controlled trial involving 432 participants having major abdominal surgery explored effects of preoperative education and breathing exercise training with a physiotherapist on postoperative antibiotic prescriptions, hypoxemia, sputum cultures, chest imaging, auscultation, leukocytosis, pyrexia, oxygen therapy, and diagnostic coding, compared to a control group who received a booklet alone. All participants received standardised postoperative early ambulation. Outcomes were assessed daily for 14 postoperative days. Analyses were intention-to-treat using adjusted generalised multivariate linear regression.ResultsPreoperative physiotherapy was associated with fewer antibiotic prescriptions specific for a respiratory infection (RR 0.52; 95% CI 0.31 to 0.85, p = 0.01), less purulent sputum on the third and fourth postoperative days (RR 0.50; 95% CI 0.34 to 0.73, p = 0.01), fewer positive sputum cultures from the third to fifth postoperative day (RR 0.17; 95% CI 0.04 to 0.77, p = 0.01), and less oxygen therapy requirements (RR 0.49; 95% CI 0.31 to 0.78, p = 0.002). Treatment effects were specific to respiratory clinical coding domains.ConclusionsPreoperative physiotherapy prevents postoperative pulmonary complications and is associated with the minimisation of signs and symptoms of pulmonary collapse/consolidation and airway infection and specifically results in reduced oxygen therapy requirements and antibiotic prescriptions.Trial registrationANZCTR 12613000664741; 19/06/2013.

Background: Lumbago is derived from the word “lumbar region.” This pain in the lower back/lumbar region is addressed low back pain (LBP). It is considered a major health issue causing disability, and associated with increased fatigue level, decreased abdominal strength, and poor cardiovascular fitness in the affected population. Objectives of the Study: Isolate and configure combined effect of breathing exercise and core strengthening training on fatigue, abdominal strength, and cardiovascular fitness in mechanical nonspecific lumbago subjects using tele-physiotherapy. Methods: A two-group online randomized control trial was conducted involving 60 participants. The duration of the study stretched for 4 weeks. Subjects recruited in accordance with the inclusion and exclusion criteria were split into two groups, i.e., experimental and control groups. The experimental group performed core strength training and breathing exercises, whereas the control group performed only core strength training. Before exercise and at the end of each week fatigue, abdominal strength, and VO2max of the subjects were measured and evaluated. Results: Results from the present study concluded significant improvement within each group fatigue, abdominal strength (P &lt; 0.05). However, no between groups difference was observed for VO2max (P &gt; 0.05). Pain intensity perceived by the patients was improved in the group subjected to combined intervention involving core strengthening and breathing exercises as compared to the control group. Conclusion: The study proposed a significant effect of breathing exercise along with core strength training on parameters of fatigue, abdominal strength, and cardiovascular fitness in subjects with lumbago.

Effectiveness of breathing exercises during the second stage of labor on labor pain and duration: a randomized controlled trial

Asthma is a common chronic respiratory disease in children. In addition to medications, physical therapy is considered as a treatment strategy for asthma. We conducted this study to investigate the effects of physical therapy on lung function in children with asthma. Three databases were searched. We conducted the meta-analysis for the forced expiratory volume in the first second in percent predicted values [FEV1(%pred)], the forced vital capacity in percent predicted values [FVC(%pred)], and the peak expiratory flow in percent predicted values [PEF(%pred)] by using a random effect model. Of the 6474 identified studies, 18 studies (16 in physical training, 2 in breathing exercise or inspiratory muscle training) were included in the systematic review and 11 studies (all in physical training) were included in the meta-analysis. The meta-analysis showed a significantly improved FVC(%pred) in the experimental group. Physical training improved FVC(%pred) significantly in children with asthma. Further study is needed, especially on the effects of breathing exercise and inspiratory muscle training in children with asthma. Our study reviewed the physical therapies for children with asthma and clarified whether and how these therapies affect them. Our study found that physical training improved the forced vital capacity in percent predicted values [FVC(%pred)] significantly in asthmatic children. Our study provided evidence that physical training could improve lung function in children with asthma, which is not identical to the Global Initiative for Asthma (GINA) guidelines.

This study was conducted to determine the effect of deep breathing exercises applied before chest tube removal on pain and anxiety levels before and 15 minutes after the tube was removed in patients with chest tubes in the Thoracic Surgery ward. This study used a quasi-experimental pre/post test single group design. The sample size in our study was 87. Patients admitted to the service were first given breathing exercise training. Data were collected using the Beck Anxiety Inventory and Visual Pain Scale. As a result of the statistical analysis, the difference between the mean pain and anxiety scale scores of the patients who underwent breathing exercises before and 15 minutes after the tube was removed was significantly significant. Pain management is considered a primary nursing role. Breathing exercises are a potential technique that nurses can use to manage pain and anxiety experienced by patients during chest tube removal. It is recommended that breathing exercises be actively used during the chest tube removal process and that clinical guidelines be created and added to clinical observation forms to manage chest tube-related pain and anxiety.

Postoperative pneumonia and delayed physical recovery are significant problems after emergency laparotomy. No randomized controlled trial has assessed the feasibility, safety, or effectiveness of intensive postoperative physical therapy in this high-risk acute population. The internal pilot phase of the Incidence of Complications after Emergency Abdominal Surgery: Get Exercising (ICEAGE) trial was a prospective, randomized controlled trial that evaluated the feasibility, safety, and clinical trial processes of providing intensive physical therapy immediately following emergency laparotomy. Fifty consecutive patients were recruited at the principal participating hospital and randomly assigned to standard-care or intensive physical therapy of twice daily coached breathing exercises for 2 days and 30 minutes of daily supervised rehabilitation over the first 5 postoperative days. Interventions were provided exactly as per protocol in 35% (78 of 221 patients) of planned treatment sessions. Main barriers to protocol delivery were physical therapist unavailability on weekends (59 of 221 patients [27%]), awaiting patient consent (18 of 99 patients [18%]), and patient fatigue (26 of 221 patients [12%]). Despite inhibitors to treatment delivery, the intervention group still received twice as many breathing exercise sessions and four times the amount of physical therapy over the first 5 postoperative days (23 minutes [interquartile range, 12-29 minutes] vs. 86 minutes [interquartile range, 53-121 minutes]; p < 0.001). One adverse event was reported from 78 rehabilitation sessions (1.3%), which resolved fully on cessation of activity without escalation of medical care. Intensive postoperative physical therapy can be delivered safely and successfully to patients in the first week after emergency laparotomy. The ICEAGE trial protocol resulted in intervention group participants receiving more coached breathing exercises and spending significantly more time physically active over the first 5 days after surgery compared with standard care. It was therefore recommended to progress into the multicenter phase of ICEAGE to definitively test the effect of intensive physical therapy to prevent pneumonia and improve physical recovery after emergency laparotomy. Therapeutic/Care Management; Level II.

Background This study aimed to determine the effect of moderate to high-intensity aerobic and breathing exercise on cardiorespiratory fitness and health-related Quality of Life (QoL) in post-discharge COVID-19 patients. The study included two groups of participants. Methods A prospective interventional study was conducted at the Bin-Inam Rehabilitation centre at the outpatient department, with 20 recruited patients having below standard 6-min walk test and QoL score at baseline. All the participants underwent five weeks (3 sessions/week) of aerobic training (20–60 min/session) and breathing exercise training (10 min/session). SF-36 health-related QoL modified Borg dyspnoea scale, and 6-min walk test measurements were collected at baseline and final intervention. Paired sample t-test was applied to determine the improvement after 5 weeks of intervention. Sub-group analysis according to inpatient ventilatory support used in active course of disease was also performed. A two-factor repeated measure ANOVA was applied to determine the time difference between sub-groups. All the data were analysed by using SPSS 24.0. Results Cardiorespiratory fitness, dyspnoea and quality of life has been significantly improved after 5-weeks of training. Sub-group analysis revealed that both groups significantly improved over time in measures of endurance, dyspnoea and quality of life (Time effect p < 0.05). An increase in exercise tolerance was observed in sub-group 1 (who did not used inpatient ventilatory support) manifested by a longer 6-min walk distance 667.8 (35.32) m compared to sub-group 2 (who used inpatient ventilatory support) 602.9 (46.1) m. There were trends towards greater improvement in General health and Body pain domains of health-related quality of life and dyspnoea in sub-Group 1 compared to sub-Group 2. Conclusions This study provides evidence that rehabilitation training in COVID-19 recovered patients may benefit the recovery after COVID-19. Clinical trial registration number NCT04445376

Background:Chronic rhinosinusitis (CRS) is the most common cause of smell loss and has a strong association with asthma. Breathing exercise training has been known to be an effective treatment for decreasing asthma symptoms. However, its effect on the olfactory disorder in asthmatic patients with CRS is unknown. This research aimed to investigate the effects of regular aerobic with nasal breathing exercise trainingon olfactory rehabilitation in asthmatic patients with CRS. Methods: In this quasi-experimental study, thirty-five inactive asthmatic women with CRS and olfaction disorder (mean age = 34.7±7.5 years) were selected and grouped into experimental (n=18) and control (n=17) groups. The experimental group participated in an aerobic and breathing exercise program (60 min/day, three days a week), and the control group refrained from participating in regular exercise for 12 weeks. Self-rated olfactory acuity and function questionnaires were used to assess changes in exercise-induced olfactory acuity and function. Results: After 12 weeks, the exercise group improved smell function (p =0.002) and exhibited significantly increased acuity in smelling the odor of gas (p =0.019) compared with the control group. BMI decreased (p =0.019) and forced expiratory volume in 1 second (FEV1( increased (p =0.002) significantly in the exercise group. There was a negative relationship between mean change in BMI and mean change in acuity in smelling the odor of gas (r=-0.381, p =0.024). Conclusion: According to the self-report olfactory acuity and function questionnaires, the improvement in the smell function of asthmatic patients with chronic sinusitis after 12 weeks of regular aerobic with nasal breathing exercise was promising and should be studied further.

This study was conducted to determine the effect of breathing and relaxation exercises training on psychological well-being and sleep quality in individuals diagnosed with schizophrenia. This study was conducted at a community mental health center between October 2022 and April 2023 as a randomized controlled study with a pretest-posttest control group. The study's participants were 64 individuals diagnosed with schizophrenia (31 in the experimental group and 33 in the control group). The Descriptive Characteristics Form, the Psychological Well-being Scale, and the Pittsburg Sleep Quality Index were used to collect data. The individuals in the experimental group underwent 6 sessions of breathing and relaxation exercises training in the form of group training, and no training was applied to the individuals in the control group. It was determined that the individuals in the experimental group had an increase in the total mean score of psychological well-being and a decrease in the total mean score of sleep quality after breathing and relaxation exercise training. In addition, a statistically significant difference was found between the posttest psychological well-being and sleep quality total mean scores of the experimental and control groups ( P <.05). It can be said that breathing and relaxation exercises training can be used as an effective intervention to increase the psychological well-being and sleep quality of individuals diagnosed with schizophrenia and can be used in addition to pharmacological treatment.

Radical cystectomy at times involves respiratory physical therapy aiming to reverse pulmonary dysfunction, thus avoiding postoperative pulmonary complications that increase hospital morbidity. The aim of this study was to investigate the effects of resisted breathing exercise versus incentive spirometer (IS) training on vital capacity (VC) outcomes in postoperative radical cystectomy cases. Forty male and female patients between 40 and 80 years of age who had undergone radical cystectomy participated in this study. Patients were randomly assigned into two equal groups of 20 each; both groups received traditional physical approaches. In addition, group A (19 men and 1 woman) received IS training for 15 min daily for 6 weeks, and group B (16 men and 4 women) received resisted breathing exercise for 15 min daily, for 6 weeks. The primary outcome was VC, which was measured using an electronic spirometer. This study showed a significant increase (P<0.05) in VC in both groups on comparing pretreatment and post-treatment values within each group. After 6 weeks of treatment, between-group statistical analysis showed equal improvements in VC (P=0.52). Nevertheless, the percentage of improvement in VC was 43.5% (2.46±0.64), higher than that in the resisted breathing exercise group at 23.9% (2.34±0.53). IS produced better objective improvement in VC compared with the usage of resistive breathing exercise. However, both are considered as a gold therapeutic tool in the management of pulmonary complication after radical cystectomy.

Individuals with Chronic Obstructive Pulmonary Disease (COPD) should engage in regular exercise, emphasizing the importance of home-based practices. This study aimed to investigate the effects of home follow-up, counselling and exercise training through telecounselling on hospital readmissions and the quality of life of individuals with COPD. This was a single-blind, randomized controlled clinical trial. Individuals in the intervention group were given breathing exercise training and following the training, the patients received weekly exercise programmes. It was added as a control tally on the back page of the training booklet, and a phone call was made to the patients once a week for 12 weeks. No intervention was applied to the control group patients during the 12 weeks. The research report was structured according to CONSORT. There was a statistically significant difference between the pretest and posttest difference averages of the SF 36 Quality of Life Scale and the number of hospital readmissions of individuals with COPD in the intervention and control groups (p < 0.05). It was determined that exercise training and 12-week teleconsultancy and home-based monitoring service applied to the intervention group patients increased the quality of life of individuals with COPD and reduced hospital readmissions.

Many studies have shown that slow breathing training is beneficial for human health. However, several factors might discourage beginners from continuing their training. For example, a long training period is generally required for benefit realization, and there is no real-time feedback to trainees to adjust their breathing control strategy. To raise the user’s interest in breathing exercise training, a virtual reality system with multimodal biofeedback is proposed in this work. In our system, a realistic human model of the trainee is provided in virtual reality (VR). At the same time, abdominal movements are sensed, and the breathing rate can be visualized. Being aware of the breathing rate, the trainee can regulate his or her breathing to achieve a slower breathing rate. An additional source of tactile feedback is combined with visual feedback to provide a more immersive experience for the trainees. Finally, the user’s satisfaction with the proposed system is reported through questionnaires. Most of the users find it enjoyable to use such a system for mediation training.

BackgroundIn this study, we aimed to examine the effectiveness of pulmonary rehabilitation applied after resection in patients with lung cancer.MethodsBetween October 2017 and December 2019, a total of 66 patients (53 males, 13 females; median age: 65 years; range, 58 to 70 years) who underwent lung resection for non-small cell lung cancer and who were not administered any chemotherapy or radiotherapy regimen were included in the study. An eight-week comprehensive outpatient pulmonary rehabilitation program was applied to half of the patients, while the other half received respiratory exercise training. After the intervention, the results of both groups were compared.ResultsIn the pulmonary rehabilitation group, forced vital capacity value (p=0.011), six-minute walking distance (p<0.001), and Short Form-36 physical function, mental health, vitality scores increased significantly, while all scores of St. George's Respiratory Questionnaire, dyspnea (p<0.001) and anxiety score (p=0.041) significantly decreased. In the group given breathing exercise training, only dyspnea (p=0.046) and St. George's Respiratory Questionnaire symptom scores (p=0.038) were decreased. When the changes in the groups after pulmonary rehabilitation were compared, the decrease in dyspnea perception was significantly higher in the pulmonary rehabilitation group (p<0.001).ConclusionPulmonary rehabilitation program applied after lung resection in patients with non-small cell lung cancer reduces dyspnea and psychological symptoms, increases exercise capacity, and improves quality of life. It should be ensured that patients with lung cancer who have undergone lung resection are directed to the pulmonary rehabilitation program and benefit from this program.