Breathing Exercises Research Articles

Effect of slow breathing exercise on heart rate variability: A non linear analysis in female major depressive disorder patients

Background: Major depressive disorder (MDD) is a mental health problem, associated with cardiac autonomic dysfunction. Cardiac autonomic function (CANF) can be assessed by non linear analysis of heart rate variability (HRV), a simple non-invasive software based analytical method. Yoga based slow breathing exercise (SBE) has role to improve autonomic dysfunction in some disease condition. Objective: To observe the effect of SBE on non linear measures of HRV in newly diagnosed female MDD patients. Methods: The quasi-experimental study was conducted in 2023 on sixty (60) newly diagnosed female MDD patients of 20-40 years aged, collected from the Department of Psychiatry, Bangabandhu Sheikh Mujib Medical University (BSMMU). Among them 30 were assigned with SBE and remaining 30 patients without SBE were followed up after 90 days. Both patient groups received conventional treatment during this period. Thirty apparently healthy female subjects with similar age & BMI were included as control for comparison and they did not perform breathing exercise. Data were taken at baseline and after 90 days in all the subjects. CANF was assessed by analysing non linear (poincare plot) of HRV by using ECG based data acquisition device, Power lab 8/35. Data were expressed as mean±SD. For statistical analysis, ANOVA followed by post hoc Bonferroni test and paired sample “t” test were used. Results: At baseline pulse rate and BP were significantly lower in both group of MDD patients compared to control. The pre-intervention values of standard deviation of short term RR interval variability (SD1), standard deviation of long term RR interval variability (SD2) and ratio of short term and long term RR interval variability (SD1/SD2) were found significantly (p< 0.001) lower in MDD patients compared to healthy control. Following 90 days of SBE, significant (p< 0.001, p< 0.05) rise of these poincare plot parameters was noted in MDD patients whereas no significant changes of these parameters were observed in patients without SBE after 90 days of follow-up. Moreover, the pulse BP almost reached control level though the non linear parameters were still below control level after 3 months of SBE.. Conclusion: Autonomic dysfunction occured in MDD patients SBE can improve cardiac autonomic dysfunction and sympathovagal balance in female MDD patients. J Bangladesh Soc Physiol 2023;18(2): 45-52

Impact of preoperative diaphragmatic breathing exercise on postoperative oxygenation and hospital length of stay in patients with elective coronary artery bypass graft: A narrative review

Impact of preoperative diaphragmatic breathing exercise on postoperative oxygenation and hospital length of stay in patients with elective coronary artery bypass graft: A narrative review

The Role of Preoperative Breathing Exercises in Reducing Postoperative Respiratory Complications in Coronary Artery Bypass Grafting: A Comparative Review of On-Pump and Off-Pump Techniques

Objectives: This review aims to evaluate the efficacy of preoperative breathing exercises in reducing postoperative respiratory complications, particularly respiratory failure, in patients undergoing CABG surgery. The review also compares the outcomes of these interventions in patients undergoing on-pump (ONCAB) versus off-pump (OPCAB) procedures. Methodology: A comprehensive literature search was conducted across multiple databases, including PubMed, Scopus, and Cochrane Library, to identify studies that examined the impact of preoperative breathing exercises on respiratory outcomes in CABG patients. The review focused on randomized controlled trials (RCTs) that compared the effectiveness of these exercises in ONCAB and OPCAB settings. Results: The review identified several studies supporting the role of preoperative breathing exercises in reducing postoperative respiratory complications. These exercises, including diaphragmatic breathing, incentive spirometry, and deep breathing, were associated with improved pulmonary outcomes, such as reduced incidence of respiratory failure, shorter durations of mechanical ventilation, and decreased hospital length of stay. While the overall results were positive for both ONCAB and OPCAB patients, variations were observed based on the surgical technique and patient-specific factors. Conclusion: Preoperative breathing exercises are an effective intervention for reducing the risk of postoperative respiratory complications in CABG patients. The benefits were observed in both ONCAB and OPCAB procedures, with particular advantages noted in the ONCAB group due to the higher baseline risk. Further research is needed to optimize these interventions, considering the individualized nature of patient responses and the specific characteristics of each surgical technique.

Slow breathing exercise improves cardiac autonomic tone in hypothyroid patients: a frequency domain analysis of HRV

Background: Hypothyroidism is associated with autonomic dysfunction and oxidative stress. Slow breathing exercise (SBE), a yoga-based relaxation technique, improves cardiac autonomic nerve function by changing sympathetic or parasympathetic activity. Objective: To assess the effect of SBEon cardiac autonomic tone and in hypothyroid patients. Methods: This non randomized controlled trial was conducted on 50 newly diagnosed drug naive female hypothyroid patients (18-45 years of age)recruited from the outpatient department of the Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University,(BSMMU), Shahbag, Dhaka. Twenty five apparently healthy female subjects formed control group. . Among the 50 hypothyroid patients, 25 were consecutively assigned with SBE for 90 days (Group SBE) and the remaining 25 patients were without SBE and followed up after 90 days (Group NSBE). Both groups of patients received treatment with thyroid hormone replacement during their follow up period. Control group did not perform SBE or any other exercise. Data were recorded at baseline(Day 0) and after 90 days in all the subjects. Based on data recording period SBE group was designated as SBE0(at day 0 or pre intervention)and SBE90(at day 90 or post intervention). Similarly, NSBE0(day 0) and NSBE90 (day 90) and control group was also designated as control0 (day 0) and control90 (day 90).Resting cardic autonomic tonic activity was assessed by frequency domain analysis of Heart Rate Variability(HRV). HRV data were recorded by a digital data acquisition device Power Lab, AD Instrument Australia. Data were expressed as mean±SD. For statistical analysis, ANOVA followed by post hoc Bonferroni test and paired sample “t” test were done. Results: At baseline i.e. at day 0 before follow up, diastolic blood pressure (DBP) (p<0.05), low frequency in normalized unit (LF norm) (p<0.001), low frequency/high frequency ratio (LF/HF) (p<0.001) were significantly higher and total power (TP) (p<0.001), low frequency power (LF power) (p<0.01), high frequency power (HF power) (p<0.001), high frequency power in normalized unit (HF norm) (p<0.001) were significantly lower in hypothyroid patients (group SBE0and NSBE0 ) compared to healthy control (group control0). After 90 days of intervention with SBE, SBP, DBP, LF norm, LF/HF ratio decreased significantly and TP, HF power, HF norm increased significantly in group SBE90 compared to SBE0. Whereas, in group NSBE90, after 90 days of follow up, LF norm, LF/HF ratio decreased significantly and HF power, HF norm increased significantly compared to NSBE0. Again, after 90 days of follow up/SBEHF norm were significantly higher and LF norm, LF/HF ratio were significantly lower in SBE90 compared to NSBE90. In addition, significant difference was present in all these parameters between NSBE90 and control90. Also, after 90 days of SBELF norm, HF norm and LF/HF ratio was not significantly different from control. Conclusions: Based on these results, it can be concluded that autonomic dysfunction characterized by reduced vagal tone and sympathetic hyperactivity occurred in drug naïve hypothyroid patients. In addition, thyroid hormone replacement therapy improved autonomic dysfunction by increasing parasympathetic and decreasing sympathetic tonic activity. Moreover, SBE caused further improvement of autonomic dysfunction and could restore sympathovagal balance to its normal state in these patients. J Bangladesh Soc Physiol 2023;18(1): 9-18

Breathing exercises for patients with early-stage lung cancer: a meta-analysis

BackgroundPostoperative pneumonia is a common but serious complication in patients with lung cancer. This meta-analysis aims to evaluate the effect of respiratory exercise on reducing postoperative pneumonia in patients with lung cancer and to provide a reliable basis for clinical treatment and nursing of patients with lung cancer.MethodsTwo reviewers searched PubMed, Embase, Web of Science, Cochrane Library, China Knowledge Network, Wanfang, and Weipu databases. We searched for the randomized controlled trials (RCTs) published in Chinese or English on the breathing exercises in patients with lung cancer up to January 30, 2024. The quality of the literature was evaluated with the Cochrane Risk of Bias Tool 2 (ROB 2). RevMan 5.3 software was used for meta-analysis.ResultsEleven RCTs with 1429 patients with lung cancer were included, and 710 patients received breathing exercises. The meta-analysis results showed that breathing exercises could significantly reduce the incidence of postoperative pneumonia [RR = 0.35, 95%CI (0.25, 0.51)], improve the FEV1 [MD = − 0.49, 95%CI (− 0.73, − 0.24)], FVC [MD = − 0.59, 95%CI (− 0.83, − 0.35)] in patients with lung cancer (all P < 0.05). There were significant differences in the incidence of pneumonia for patients undergoing breathing exercises with single exercise time ≥ 15 min (RR = 0.37, 95%CI 0.24 ~ 0.62), breathing exercises for 1 week (RR = 0.29, 95%CI 0.16 ~ 0.55) or for 2 weeks (RR = 0.48, 95%CI 0.28 ~ 0.85) and breathing exercises > 4 times (RR = 0.36, 95%CI 0.23 ~ 0.57) per day (all P < 0.05).ConclusionBreathing exercises have shown the capacity to augment pulmonary function in patients with lung cancer, concurrently mitigating the risk of postoperative pneumonia.

The Effects of Diaphragmatic Breathing Exercise on Hot Flashes in Menopausal Women during the COVID-19 Pandemic Period:

Vasomotor symptoms are the most common problem during the menopausal period. This study investigated the effects of diaphragmatic breathing exercises on hot flashes in menopausal Turkish women during the COVID-19 pandemic period. The study was carried out as a randomized controlled trial with the participation of menopausal women aged 45-60 years in eastern Turkey. A total of 68 women formed two groups, 34 in each group. A Descriptive Characteristics Form and the Hot Flash-Related Daily Interference Scale were used to collect study data.The results of the study showed that the menopause period in most women was between one and five years. The participants stated that the COVID-19 pandemic period increased the frequency of their menopausal hot flashes to a statistically significant extent. While there was a statistically significant difference (p0.05).The diaphragmatic breathing exercises in this study were found to reduce hot flashes complaints during the menopausal period.

Lactation-focused audio relaxation versus standard care for mothers of very preterm infants (the EXPRESS randomised clinical trial).

Mothers of very premature newborns often have low milk supply. Systematic review has shown increased milk quantity with relaxation interventions. We hypothesised that a self-directed audio relaxation and lactation-specific visualisation would increase milk quantity after a very premature birth. Unmasked, randomised, controlled trial, recruiting 132 participants in four United Kingdom neonatal units. Eligible women had given birth to one or two infants between 23+0 and 31+6 weeks of gestation. The intervention was a 12-min voice recording including breathing exercises, muscle relaxation and lactation-specific visualisation. Primary outcome was the highest 24-h breastmilk weight expressed on any of day 4, day 14 or day 21 after birth. Mean birth gestation was 27.8 weeks (SD 2.4), with 26% of participants giving birth under 26 weeks (34/132). Adjusted mean difference in primary outcome was 73.9 g (95% CI -61.7 to 209.5, p = 0.28). Spielberger State-Trait Anxiety Index adjusted mean difference was -1.9 (-8.2 to 4.3, p = 0.54). The majority of relaxation group participants felt the intervention was relaxing (32/42, 76%). There was no beneficial effect of this relaxation intervention on milk quantity. Mothers of very premature infants may value relaxation interventions but they are unlikely to have a large effect on milk quantity. This randomised trial did not show a beneficial effect of a self-directed audio relaxation and visualisation on mothers' own milk quantity expressed after very preterm birth. Mothers of very and extremely preterm infants may value relaxation interventions, but they are unlikely to have a large effect on milk quantity. Prior systematic review of mixed populations has shown an increase in mothers' own milk quantity with relaxation interventions. Combining this study with existing meta-analysis could result in a new hypothesis that the lower the gestation at birth, the smaller the impact of relaxation on milk quantity.

Effects of breathing exercises on young swimmers’ respiratory system parameters and performance

Breathing exercises are widely used to enhance respiratory function and athletic performance. This study aimed to assess the efficacy of a modified exercise regimen on respiratory parameters and its effect on the performance of young swimmers in competition. Thirty-one swimmers aged 16–17 from various clubs in Latvia were selected, comprising an experimental group (n = 15, height: 174.36 ± 7.85 cm, weight: 65.80 ± 9.35 kg, body mass index: 21.60 ± 1.54) and a control group (n = 16, height: 180.78 ± 7.05 cm, weight: 69.90 ± 6.49 kg, body mass index: 21.40 ± 1.56). With an average of eight years of experience, participants trained for approximately 43–45 weeks annually (pool and gym sessions), with an average training duration of 20 ± 2 hours per week. Measurements were conducted on days one and 30, involving spirometry and swimming performance assessment based on the best results in the freestyle 100-meter distance. The experiment consisted of a modified breathing exercise performed thrice weekly for four weeks. Significant improvements were observed in the experimental group compared to the control group in forced vital capacity (p = 0.02), peak inspiratory flow (p = 0.001), and performance (p = 0.001), with p-values &lt; 0.05. However, no significant changes were noted in peak expiratory flow (p = 0.46 &gt; 0.05). The findings indicate that modified breathing exercises effectively enhance respiratory parameters and performance in competitive swimmers.

The effect of pulmonary rehabilitation on quality of life and functional capacity after chemotherapy in patients with small cell lung cancer.

This study aimed to investigate the effect of pulmonary rehabilitation on quality of life during the survival period in individuals with small cell lung cancer. Thirty-six patients with a diagnosis of small cell lung cancer (SCLC), who completed chemotherapy treatment and were in the survival period, were included in the study. A pulmonary rehabilitation program was applied to individuals at 40-70% of submaximal heart rate, 3days a week for 8weeks. The pulmonary rehabilitation program will consist of warm up, breathing exercises, gait training, aerobic exercises, and cool down exercises. Demographic information, walking distance, and presence of dyspnea were questioned. Inspiration/expiration difference was evaluated. Vital signs were evaluated before each session. Quality of life was assessed with the Cancer-Specific Developed Quality of Life Scale (EORTC-QLQ-C30). Of the patients, 80% (36 people) completed the entire 8-week program. The mean age of the individuals was 51.78 ± 10.23. In the evaluation made at the end of the rehabilitation program, it was observed that the walking distance of the individuals increased significantly. Inspiration of individuals' expiratory difference increased by an average of 2.01 ± 0.40cm. Improvement was found in the sub-parameters of quality of life (p < 0.05). The participants with small cell lung cancer had decreased quality of life due to long-term immobilization, surgery, hospitalization times, side effects of chemotherapy treatment, and other problems. Regular exercise programs can provide an increase in the individual's pulmonary functions. Individual-specific pulmonary rehabilitation programs have important contributions to the quality of life in SCLC on the survival period, and it has shown that this study can guide physiotherapists and physicians working in oncological rehabilitation and pulmonary rehabilitation.

Multidisciplinary behavioral therapy reduces rumination.

Behavioral therapy has proved effective as rumination therapy. Our objective was to treat rumination patients using multidisciplinary behavioral therapy aimed at reducing ≥2 of the rumination score. All patients fulfilled Rome IV criteria for rumination and were referred to speech therapy for psychoeducation, diaphragmatic breathing exercises and guided eating, physiotherapy for exercises to relax the thoracic and abdominal muscles, and consultation with the psychologist and the dietitian. Symptoms, depression, anxiety, health-related quality of life (HRQoL), and functional capacity were evaluated by questionnaires (Rome IV, Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), 15D, and World Health Organization Disability Assessment Schedule (WHODAS) 2.0) at baseline and at 6-month control. Esophageal manometry was performed at 6-month control. The study enrolled 11 patients (19-64 years, 10 female). Rumination score: 6.5 (5-8) at baseline, 4.0 (3-5) at the 6-month control, p = 0.005. BDI/8 (6-13), BAI/15 (8-29) at baseline; BDI/7 (4-8), BAI/15 (7-27) at the 6-month control, NS. 15D score: 0.800 at baseline, 0.845 at the 6-month control, NS. WHODAS 2.0 score: 15 (7-33) at baseline, 11 (7-26) at the 6-month control, NS. Rumination could be evoked in manometry in six of nine (67%) patients at 6-month control. Behavioral multidisciplinary therapy significantly reduces the self-assessed frequency of rumination. These patients have more depression, anxiety and a lower HRQoL compared to the normal population.

Effects of Short-Term Physiotherapy in Hospitalized COVID-19 Patients Infected with Mutant and Non-Mutant Virus: A Prospective Study

Aim: The aim of study, to assess the short term effects of physiotherapy on patients infected with mutant and non-mutant SARS-CoV-2 virus. Material and Methods: The patients included in the study were analyzed in two different groups. Patients infected with non-mutant SARS-CoV-2 were in Group 1 (n=16; age=53.81±9.48). Patients infected with mutant SARS-CoV-2 were included in Group 2 (n=16; age=55.25±10.12). Physiotherapy which included mobilization, normal range of motion, and a breathing exercise program, was performed on both groups (Group 1: Median=7.00; Min-Max=5-20 days; Group 2: Median: 7.00; Min-Max=4-15 days). All patients underwent a once-daily physiotherapy program. The patients' muscle strength, mobility, activities of daily living, exercise capacity, and perception of fatigue were evaluated. The mixed repeated measures ANOVA model was used to compare groups. Results: It was found that physiotherapy improved muscle strength, mobility, ability to perform activities of daily living, exercise capacity, and perception of fatigue in both groups (p0.05). Conclusion: The current study showed that a short term physiotherapy program was as successful in patients infected with mutant SARS-CoV-2 as it was in patients infected with non-mutant SARS-CoV-2. Physiotherapy is beneficial for COVID-19 disease, as it decreases functional limitation and symptoms of COVID-19 disease by contributing positively to muscle strength, mobility, activities of daily living, exercise capacity, and the perception of fatigue.

Efficacy of combined exercise training during different menstrual phases in young students with primary dysmenorrhoea

AbstractObjectivesThe objective of the study was to compare the effectiveness of combined exercise training during different menstrual phases on pain, quality of life and menstrual symptoms.MethodsA total of 72 participants for the study were randomly assigned into three groups: Group 1 (N = 24), Group 2 (N = 24) and Group 3 (N = 24) which had undergone combined exercise training during the follicular, luteal and bleeding phases of their menstrual cycle, respectively. The treatment programme included combined exercise training involving deep breathing exercises, Kegel exercises, core strengthening exercises and stretching exercises. Exercises were repeated 5 times with hold duration of 15 s with total of 30–40 min session with 5–10 min of warm‐up and cooldown sessions. Demographic data and outcome measures (Visual Analogue Scale [VAS], Menstrual Symptom Questionnaire [MSQ], and Working ability, Location, Intensity, Days, Duration [WaLIDD]) were assessed at baseline and assessed again during the first menstrual cycle after the completion of the treatment programme. One‐way ANOVA was used for between‐group comparisons of the normally distributed data.ResultsWithin‐group comparison of the outcome variables except VAS in group 3 showed a statistically significant difference in all groups. Comparison of post‐intervention results of the outcome measures of all the groups revealed a statistically significant difference for the VAS, while there was no statistically significant difference for in between the comparison of the WaLIDD and MSQ scoring.ConclusionCombined exercise training is effective in reducing pain only when performed during follicular and luteal phases and significantly improve quality of life and menstrual symptoms in all phases of the menstrual cycle.

Inspiratory Muscle Trainer Versus Diaphragmatic Breathing Exercise on 6-Minute Walk Test in Adolescent Girls with End-Stage Renal Disease

Objective: Inspiratory muscle weakness (IMW) is very common among adolescents with end-stage renal disease (ESRD). Untreated IMW in ESRD adolescents induces acute and chronic pulmonary complications, low physical performance, and impairment in quality of life (QoL). This was a 12-week breathing-retraining trial that compared the effects of threshold inspiratory muscle trainer (TIMT) versus the diaphragmatic breathing exercise procedure (DBEP), on ESRD adolescent girls’ maximal inspiratory pressure (MIP) and QoL, which was assessed by the Child Health Questionnaire (50-item parent form) (CHQ/PF50), pulmonary functions, and six-minute walk test (6MWT).Material and Methods: This breathing-retraining trial enrolled forty adolescent girls with ESRD. The girls were randomly divided into two groups: one group contained twenty girls that were trained by TIMT, while the other group contained 20 girls whom were trained by DBEP. The 20-minute rehabilitation of IMW by TIMT or DBEP was applied 3 times weekly. Adolescent girls’ forced vital capacity (FVC), CHQ/PF50-related score of physical summary, MIP, 6MWT, CHQ/PF50-related score of psychosocial summary, forced expiratory volume in the first second of girls’ expiration (FEV1), and 6MWT-associated physiological data (blood pressure, heart rate, and rate of perceived exertion) were assessed.Results: All outcomes of adolescent girls with ESRD in the first group that were trained by TIMT showed significant improvements, whereas the other group’s girls did not show the same reported significant improvements. Conclusion: Compared to DBEP, the 12-week training by TIMT significantly improved ESRD adolescent girls’ FVC, CHQ/PF50-related score of physical summary, MIP, 6MWT, CHQ/PF50-related score of psychosocial summary, FEV1, and 6MWT-associated physiological data.

The Effect on Exercise Addiction and Anxiety Levels in Breathing Exercises in Bodybuilding Athletes

Abstract Exercise is considered a promising and emerging treatment for individuals recovering from addiction. The purpose of this research is to examine the effect of breathing exercises on exercise addiction and anxiety levels in bodybuilding athletes. The population of the research consisted of 20 test subjects and 20 control volunteers, male and female participants, who exercised in the fitness center of the Asis sports complex located at Van Yüzüncü Yıl University in Van province. Breathing exercises were performed on the subject group for 40 minutes, 2 days a week for 10 weeks. The survey was measured twice in total for the subject and control groups, before the exercise program and at the end of the exercise program. Personal information form, Exercise Addiction Scale (EAS) and Beck Anxiety Scale (BAS) were used as data collection tools in the study. To find the relationship between breathing exercises and exercise addiction and anxiety levels, Shapiro-Wilk analysis was tested and T-test was used to compare two independent groups since normal distribution was detected. When we look at the control group, there was only a difference in the comparison of exercise addiction results, while in the experimental group, a significant difference was found between the performance of breathing exercises and the comparison of exercise addiction and anxiety results. It can be said that breathing exercises reduce exercise addiction and anxiety levels in individuals doing bodybuilding sports. It is very important to maintain balance and have a healthy approach when exercising. In order to benefit from the benefits of exercise to the maximum extent, personalized programs should be prepared and implemented under expert guidance. It may be recommended that Breathing Exercise studies be applied to other sports branches as well. Keywords: Bodybuilding Athletes, Breathing Exercises, Exercise Addiction, Anxiety

A 10-week multicomponent outdoor exercise program improves hemodynamic parameters and physical fitness in cardiovascular disease adult and elderly patients

AbstractThis study aimed to assess the effects of a 10-week multicomponent outdoor exercise program on hemodynamic, physical fitness and psychological variables in subjects with CVDs. Twenty participants (12 M and 8 F; age 68.5 ± 8.6 years; BMI 28.49 ± 4.98 kg/m2) suffering from CVDs participated in this randomized controlled study and were allocated into two groups: an experimental group (EG; 6 M, 5 F) who underwent a multicomponent training (i.e., cardiorespiratory, resistance, mobility and breathing exercises; 60’, 2d·wk-1), or a wait-list control group (CG; 6 M, 3 F) who did not engage in any PA. Hemodynamic parameters were assessed through resting heart rate (RHR) and peripheral blood pressure (P-SBP/P-DBP). Physical fitness was assessed via a 30″ chair stand test (30CST), timed up and go (TUG) test, handgrip strength (HGS) test, and 2’ step test (TMST). The health status and quality of life (QoL) were evaluated with short form-12 (SF-12) and World Health Organization QoL (WHOQoL-bref), respectively. After the intervention, EG showed significant reduction in hemodynamic parameters (RHR p &lt; 0.001, ES = 0.98; P-SBP p &lt; 0.001, ES = 0.53; P-DBP: p &lt; 0.001, ES = 0.78), physical fitness (30CST p &lt; 0.001, ES = 0.92; TUG p = 0.001, ES = 0.67; TMST p &lt; 0.05, ES = 0.79) and physical component of SF-12 (PSC-12 p &lt; 0.05, ES = 0.42) compared to CG; no significant changes were observed in HGS, QoL and mental health component of the SF-12 (p &gt; 0.05). The findings showed significant improvements in hemodynamic parameters and physical fitness suggesting the effectiveness of the multicomponent outdoor exercise program in adults and elderly with stabilized CVDs.

The effect of music therapy and breathing exercise on anxiety and pain in patients undergoing coronary angiography: A randomized controlled study.

For over 50 years, music therapy and breathing exercises have been widely utilized as interventions to help individuals cope with fatigue, stress and pain globally. To analyse the effects of music and breathing exercises on anxiety and pain in patients undergoing coronary angiography. This is a single-blind, randomized controlled trial. The sample comprised 165 patients: 55 in the control group, 55 in the breathing exercise group and 55 in the music therapy group. Patients in the music group listened to music during angiography, those in the breathing exercise group practised exercises 30 min before the procedure and the control group received standard treatment. Anxiety levels were assessed before and after the procedure, and pain levels were measured post-procedure. The Consolidated Standards of Reporting Trials (CONSORT) checklist for reporting randomized trials was used to guide reporting. Anxiety scores rose significantly in the control group from 33.9 ± 4.2 pre-angiography to 37.7 ± 4.9 post-angiography. Conversely, the breathing group's anxiety scores decreased from 34.3 ± 3.5 before angiography to 31.7 ± 1.5 after angiography, and the music group exhibited a reduction from 32.3 ± 3.6 to 30.8 ± 1.6. Post-angiography, the control group reported a mean pain score of 64 ± 0.8 mm, while the breathing and music groups had significantly lower scores of 35 ± 0.6 and 29 ± 0.8 mm, respectively. Statistical analysis showed a highly significant difference in pain scores between the intervention and control groups. This study provides support for the beneficial effects of employing breathing exercises and music in alleviating pain and anxiety during coronary angiography procedures. Integrating these findings into clinical practice could be significant for improving patients' pain experiences and anxiety, enhancing the tolerance of invasive medical procedures.

AYURVEDIC LIFESTYLE RECOMMENDATIONS FOR LIVING IN HIGH POLLU-TION AREAS - A REVIEW

Air pollution refers to the presence of harmful or excessive quantities of substances in the air that can be detrimental to human health, the environment, and the climate. These substances, often called pollutants, can originate from natural and human-made sources. Air pollution is a significant risk to public health, particularly in municipal and industrialised regions. This article explores Ayurvedic lifestyle recommendations to diminish the adverse effects of air pollution on health. Ayurved is an ancient system of natural healing. It can offer a holistic approach to strengthening the body's defence system and promoting overall well-being in polluted environments. Key recommendations include dietary modifications, herbal Rasayanas, breathing exercises, and daily routines that enhance the body's natural detoxification processes. By integrating Ayurvedic practices with modern preventive measures, individuals can better protect themselves from the harmful impacts of air pollution and improve their quality of life.

Implementing a Pulmonary Telerehabilitation Program for Young Adults with Post-COVID-19 Conditions: A Pilot Study.

Several studies have shown that pulmonary telerehabilitation (PTR) improves respiratory capacity. However, there is little evidence of its effectiveness in youth with post-COVID-19 conditions (PCC). This study analyzed the effects of a PTR program on young adults with PCC. Sixteen youths were randomly assigned to a control group (CG) or an experimental group (EG), with eight participants each. The EG participated in a PTR program that included twelve remote, asynchronous four-week sessions with diaphragmatic breathing and aerobic exercises. Vital signs (SpO2, HR, RR, BP), physical capacity (sit-to-stand test), cardiorespiratory capacity (6-Minute Walk Test), and perceived exertion (Borg scale) were assessed in both groups. Statistical analyses showed a significant decrease in RR and HR (p < 0.012) and an increase in SpO2 (p < 0.042), physical (p < 0.012), and respiratory (p < 0.028) capacity. Perceived effort decreased significantly in both groups (CG: p < 0.006; EG: p < 0.001) only for physical but not for cardiorespiratory capacity (p < 0.106). There were no statistical changes registered in BP (p > 0.05). The PTR program, which includes respiratory and aerobic exercises, is feasible and effective in improving physical and cardiorespiratory capacity in young people with PCC, as well as reducing HR, RR, and dyspnea.

Low-intensity aerobic cycle ergometer effects on lung function of myasthenia gravis patients: A randomized controlled trial

Patients with generalized myasthenia gravis (MG) often show restrictive spirometry results. Although regular exercise and physical fitness are linked to better respiratory function, there is limited research assessing the effects of aerobic exercise on lung function in MG patients. The aim of this study was to analyze the effect of low-intensity aerobic exercise using a cycle ergometer on lung function parameters in MG patients. A randomized controlled trial with pre- and post-test was conducted at the Medical Rehabilitation Outpatient Clinic of Dr. Soetomo General Academic Hospital in Surabaya, Indonesia, in 2023. MG patients classified as I−IIb based on the Myasthenia Gravis Foundation of America (MGFA) classification were recruited and randomly divided into treatment and control groups. The treatment group was given low-intensity aerobic exercise using a cycle ergometer, education on lifestyle changes, and breathing exercises (deep and pursed lip breathing). Lung function parameters, including forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and forced expiratory volume ratio (FEVR), were then measured. Measurements were conducted before and after eight weeks of low-intensity aerobic cycle ergometer exercise and compared with those of a control group. A total of 17 MG patients were included in this study. The results showed a significant increase in FVC in the treatment group (p=0.003), whereas no significant change in the control group (p=0.068). A significant increase in FEV1 was observed both in the treatment (p=0.029) and the control group (p=0.016). There was no improvement in FEVR in either group. After the intervention, significant differences were observed in FVC (p=0.009) and FEV1 (p=0.029) between the treatment and control groups. There was no significant difference in FEVR values after the intervention between both groups (p=0.491). In conclusion, eight weeks of low-intensity aerobic cycle ergometer exercise led to significant improvements in FVC and FEV1 among MG patients.

Is intensive training with atime interval between instruction and planning CT necessary for deep inspiration breath-hold radiotherapy in breast cancer?

Breathing instruction and exercises and atime gap between training and planning CT scans (pCT) is recommended as part of deep inspiration breath-hold (DIBH) assisted radiotherapy (RT). However, this is associated with additional time expenditure. In two of the authors' treatment centers (TC), patient training took place before the planning CT of DIBH-assisted therapy. In TC1, afurther appointment was made with aminimum interval of 2days to perform the planning CT. At TC2, the planning CT was performed immediately after the first patient instruction. Aretrospective evaluation of the clinical parameters of the therapy was carried out to investigate the relevance of the time gap between DIBH exercises and pCT. Atotal of 72patients were included, 35 of whom were treated in TC1 and37 in TC2. In TC1, an average interval of ~4 days was observed between patient training and planning CT, while in TC2, training and CT were performed immediately after each other. No significant differences in radiation dose exposure of the lung on the treated side, the whole lung, or the heart were found between the two centers. Furthermore, there was no significant difference in the application of the daily RT fraction. The requirement for daily positioning checks was also the same at both treatment centers. This study does not show any advantages for atime gap between instruction/training and pCT. Skipping the time break does not deteriorate any clinically relevant endpoints.