Diaphragmatic Breathing Training Research Articles

Effects of Respiratory Training on Pulmonary Function, Cough, and Functional Independence in Patients with Amyotrophic Lateral Sclerosis

Background: Respiratory complications in patients with amyotrophic lateral sclerosis (ALS), due to the involvement of respiratory muscles, are the leading cause of death, and respiratory physiotherapy (RP) focuses on addressing these complications. Objectives: The objective was to evaluate the effectiveness of an RP intervention that combines the four specific techniques (inspiratory muscle training, lung volume recruitment, manually assisted coughing, and diaphragmatic breathing training) in patients with ALS. Methods: A quasi-experimental study was carried out, and a specific RP programme was implemented in 15 patients with ALS (12 sessions, 30 min/session, one session/week, duration of three months), based on directed ventilation techniques, lung volume recruitment, manually assisted coughing, and the use of incentive spirometry and a cough assist device, along with a daily home exercise programme. Respiratory functions were assessed (pre- and post-intervention, with follow-up at three months) using Forced Vital Capacity (FVC) and Peak Expiratory Cough Flow (PECF); functionality was assessed using the Revised ALS Functional Rating Scale (ALSFRS-R) and the Modified Barthel Index by Granger. Results: FVC experienced an increase after three months of the intervention initiation (p = 0.30), which was not sustained at the three-month follow-up after the intervention ended. All other variables remained practically constant after treatment, with their values decreasing at follow-up. Conclusion: A specific RP intervention could have beneficial effects on respiratory functions, potentially preventing pulmonary infections and hospitalisations in patients with ALS. It may improve FVC and help stabilize the patient's functional decline. Considering the progressive and degenerative nature of the disease, this finding could support the usefulness of these techniques in maintaining respiratory function.

Effects of Diaphragm Breathing Training Through Visual Feedback on Diaphragm Movement and Lung Function in Normal Women

Purpose: This study aimed to investigate the effects of diaphragmatic breathing training with visual feedback on diaphragm movement and lung function in healthy women. Methods: A randomized controlled trial was conducted with the participation of 20 healthy college-aged women without any underlying physical conditions. The participants were randomly assigned into two groups: the intervention group that received diaphragmatic breathing training with visual feedback and the control group that underwent sham training without visual feedback. Diaphragmatics movement were assessed through respiratory motion analysis, and lung function was measured using spirometry before and after the training period. Data analysis included a paired t-test to compare within-group differences and an independent t-test to compare the effects between the two groups. Results: In both groups, diaphragmatic movement significantly increased after the intervention (p<.05). In addition, the intervention group that received visual feedback exhibited significant improvements in forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and diaphragm movement (p<.05). However, the control group without visual feedback demonstrated only a significant increase in diaphragm movement (p<.05). Furthermore, the intervention group showed a significantly greater increase in FVC than the control group. Conclusion: This study reveals that incorporating visual feedback into diaphragmatic breathing training can effectively enhance diaphragmatic movement and improve lung function in healthy women. These findings suggest the potential benefits of visual feedback in optimizing the benefits of diaphragmatic breathing exercises. These results have implications for respiratory rehabilitation, stress reduction, and overall well-being in the general population. More studies are recommended to explore the long-term effects of diaphragmatic breathing training with visual feedback and its application in clinical populations with respiratory disorders.

Effect of diaphragmatic breathing training with visual biofeedback on respiratory function in patients with multiple rib fractures: A randomized-controlled study.

The aim of this study was to investigate the effect of diaphragmatic breathing training with visual biofeedback on respiratory function in patients with multiple rib fractures. Between June 2021 and October 2021, a total of 16 patients (15 males, 1 female; mean age: 49.50±11.85 years; range, 25 to 66 years) who were diagnosed with multiple rib fractures were randomly assigned into two groups as the control group (CG, n=8) and the visual biofeedback group (VBG, n=8). The effect of each diaphragmatic breathing training on respiratory function was evaluated before and after eight interventions. For respiratory function, pulmonary function test was used to measure pulmonary function and respiratory muscle strength, and the Pain, Inspiratory capacity, Cough (PIC) score was used to evaluated pain, inspiratory capacity, and cough ability. In both groups, the pulmonary function representing the ratio of measurements to predicted values of both forced vital capacity (CG mean difference=25.37±4.58, p=0.002, VBG mean difference=24.25±3.96, p=0.007) and forced expiratory volume in 1 sec (CG mean difference=32.38±5.7, p=0.002, VBG mean difference=26.15±5.73, p <0.001) increased significantly. The maximal inspiratory (CG mean difference=14.00±0.35, p=0.002, VBG mean difference=20.5±6.26, p=0.009) and expiratory pressure (CG mean difference=43.72±29.44, p=0.034, VBG mean difference=25.76±6.78, p=0.015), the indicators of respiratory muscle strength, increased significantly in both groups. The PIC score, which evaluated pain, inspiratory capacity, and cough ability, also increased significantly in both groups (CG mean difference=1.63±0.26, p≤0.001, VBG mean difference=3.13±0.19, p <0.001). The change of PIC score after intervention did not significantly differ between the groups (F=1.439, p=0.250); however, there was a significant difference over time (F=38.476, p <0.001). The change of PIC scores differed over time between the groups (F=2.806 p=0.011). Diaphragmatic breathing training and diaphragmatic breathing training with visual biofeedback can improve pulmonary function, respiratory muscle strength, pain, inspiratory capacity, and cough ability in patients with multiple rib fractures.

Justification of the need for the system of medical support for high school students with enhanced mental abilities

INTRODUCTION: To fully realize the intellectual potential of high school students with enhanced abilities, it is crucial to create conditions that promote and preserve their physical and mental health.&#x0D; METHODS: To scientifically support the system of assisting students with enhanced mental abilities in the face of risk factors within the educational environment, a one-stage study was conducted at a multidisciplinary lyceum for gifted adolescents. The study focused on identifying risk factors associated with the organization and intensity of the educational process and daily routine of students in grades 911. To further support the use of biofeedback in the school medical system, students were taught the diaphragmatic breathing technique. The effectiveness of this technique was evaluated through a comparative analysis of the functional state of the central nervous- and cardiovascular systems, as well as the psycho-emotional status of students before and after two weeks of functional biofeedback training.&#x0D; RESULTS: We found that students were at risk for health problems due to poorly organized educational activities, high intensity of studies and neglect of health-promoting habits such as adequate sleep and walking. However, it has also been found that academic demands can enhance mental performance, albeit at the cost of increased stress on the body's regulatory systems. Therefore, it is crucial to establish a support system for students that addresses these concerns. One promising intervention is diaphragmatic breathing training, which has been shown to reduce anxiety and improve mental performance and adaptability in students.&#x0D; CONCLUSION: Our findings have enabled the scientific substantiation and development of a comprehensive system to support students with enhanced abilities throughout their educational path. This system involves assessment of the psychophysiological state of students, identifying those at risk and those in good health, and organizing a range of corrective, health-promoting, and health-protecting measures. These measures are designed to enhance compensatory capabilities and psychophysiological reserves, as well as to strengthen students' health during the learning process.

Retracted: A Retrospective Study of Diaphragmatic Breathing Training Combined with Discharge Care Bundles in Patients with Chronic Obstructive Pulmonary Disease.

[This retracts the article DOI: 10.1155/2022/9649986.].

A Retrospective Study of Diaphragmatic Breathing Training Combined with Discharge Care Bundles in Patients with Chronic Obstructive Pulmonary Disease.

Objective Both physical exercise and discharge care bundles can improve patient outcomes and reduce hospitalization rates among subjects with chronic obstructive pulmonary disease (COPD). The retrospective analysis aims to determine the advantages of care bundles combined with diaphragmatic breathing training (DBT) in COPD patients after discharge. Methods Of the 110 COPD patients, 55 patients received DBT alone (DBT group) and 55 participants received the combined intervention (care bundle + DBT group). Three months after discharge, we assessed the outcomes of patients using Bristol COPD Knowledge Questionnaire (BCKQ), Hospital Anxiety and Depression Scale (HADS), COPD Assessment Test (CAT), and St. George's Respiratory Questionnaire (SGRQ). Meanwhile, COPD-related hospital readmissions were also recorded. Results The BCKQ score for assessing the disease knowledge level was increased in patients at 3 months after the combined interventions as compared to the baseline values, which was higher in the care bundle + DBT group than the DBT group at 3 months. Moreover, improvements in negative emotion and clinical symptoms from baseline to 3-month follow-up were seen in both the two groups. Besides, the care bundle + DBT group showed the mitigation of depression and anxiety and the alleviation of clinical symptoms in comparison with the DBT group at 3 months. Participants who received combined interventions had lower SGRQ scores than those who received DBT alone. The time to first COPD-related readmission was shorter for patients in the care bundle + DBT group compared with the DBT group. Conclusions DBT combined with discharge care bundles for COPD patients resulted in improvements in disease-specific knowledge, negative emotions, and clinical symptoms with better HRQOL and lower readmission rate.

The effects of diaphragmatic breathing training on the quality of life and clinical symptoms of patients with gastroesophageal reflux disease: A randomized controlled trial

Background and purposeGastroesophageal reflux disease (GERD) has an adverse impact on the quality of life of affected individuals. Diaphragmatic breathing training (DBT) my be effective in GERD, but research on the benefits of this complementary therapy for affected patients is scarce. This study was therefore intended to examine the effects of DBT on the quality of life and clinical symptoms of patients with GERD. Materials and methodsThis is a randomized controlled trial with two-parallel groups. The experimental group (n = 47) received four weeks of DBT sessions plus treatment-as-usual, while the control group (n = 49) maintained treatment-as-usual only. The outcome variables were measured using the Reflux Disease Questionnaire and GERD-Quality of Life questionnaire. The questionnaires were completed before and after the intervention. ResultsThe mean scores of symptom frequency (p < 0.001), symptom severity (p < 0.001) and quality of life (p = 0.001) decreased significantly after the intervention in the two groups. The results also showed that the difference between before and after intervention for mean scores of symptom frequency (p = 0.006), symptom severity (p = 0.001) and quality of life (p = 0.004) was significant in the experimental group compared to the control group. Furthermore, no statistically significant difference in patients' satisfaction with their condition was found between the two groups before (p = 0.698) and after (p = 0.124) the intervention. ConclusionDiaphragmatic breathing training can alleviate symptoms and improve quality of life in patients with GERD.

COVID-19: A New Challenge for Pulmonary Rehabilitation?

Coronavirus disease 2019 (COVID-19), currently one of the immense burdens for global healthcare, is often characterized by rapid progression and the occurrence of symptoms particularly affecting the respiratory system. Continuous refinement of treatment protocols improves prognosis; however, COVID-19 survivors are often left with the symptomatic burden of dyspnea and fatigue. Therefore, it is necessary to continue comprehensive treatment including pulmonary rehabilitation. This study aimed to review the available literature on pulmonary rehabilitation in patients diagnosed with COVID-19. The pulmonary rehabilitation programs implemented various forms, i.e., aerobic exercise, breathing exercises, effective cough exercises, diaphragmatic breathing, and respiratory muscle training. Based on the literature review, it was found that pulmonary rehabilitation programs result in an improvement of respiratory function, reduction of fatigue and dyspnea, and improvement in exercise endurance and quality of life after completing both short-term and long-term programs, but depression and anxiety problems did not improve. Pulmonary rehabilitation combined with psychological therapy is crucial for COVID-19 survivors and plays a substantial role in patients’ recovery.

Pulmonary Rehabilitation in COVID-19 patients: A scoping review of current practice and its application during the pandemic.

The novel coronavirus-2019 (COVID-19) pandemic primarily affects the respiratory system. Elderly individuals with comorbidity are severely affected. Survivors weaned from mechanical ventilation are at a higher risk of developing post-intensive care syndrome (PICS). This scoping review, based on 40 recent publications, highlights pulmonary rehabilitation (PR) in COVID-19. There is a paucity of high-quality research on this topic. However, rehabilitation societies including the Turkish Society of Physical Medicine and Rehabilitation have issued PR recommendations in COVID-19 pneumonia with productive cough can benefit from diaphragmatic breathing, pursed-lip breathing, and resistance-breathing training. Besides, those in mechanical ventilation and post-PICS COVID-19 cases, oxygen therapy, early mobilization, airway clearance, aerobic exercise, gradual-graded limb muscle resistance exercise, nutritional and psychological interventions should be consideration. During PR, careful evaluation of vital signs and exercise-induced symptoms is also required. When in-person PR is not possible, telerehabilitation should be explored. However, the long-term effects of PR in COVID-19 need further evaluation.

The effect of a stress and anxiety coping program on objective structured clinical examination performance among nursing students in shiraz, Iran

BackgroundEvaluation of the competence and practical skills of nursing students, using the objective structured clinical examination (OSCE), is an integral part of the nursing education program. However, their performance could be negatively influenced by a significant level of stress and anxiety prior to the test. The present study aimed to evaluate the effect of an anxiety coping program on the OSCE performance level of first-year nursing students in Shiraz, Iran.MethodsThe present quasi-experimental study was conducted among 76 nursing students; control group (n = 35) and intervention group (n = 41). To attain the study purpose, the intervention group received a pre-exam anxiety coping program that included relaxation and soothing techniques, diaphragmatic breathing training, and progressive muscle relaxation training accompanied by light instrumental music, while the control group received no intervention before the exam. Data collection instruments included a demographic characteristics form and State-Trait Anxiety Inventory (STAI) questionnaire. Demographic characteristics of the participants indicated an overall homogeneity within the study population. The STAI questionnaire was filled in before and after the OSCE and the results were compared with those of the control group. The data were analysed using SPSS software (version 22.0). P < 0.05 was considered statistically significant.ResultsAs a result of the anxiety coping program, a substantial reduction in the anxiety score (by 11.61 units) in the intervention group was observed. There was a significant difference in the pre- and post-exam anxiety scores between the control and intervention groups (P < 0.001). The anxiety coping program improved the examination results of nursing students in the final exam compared to the midterm results (an increase of 0.9487 units, P < 0.001).ConclusionThe anxiety coping program reduced the anxiety level among nursing students and improved their OSCE results. Our findings can be utilized to better evaluate clinical activities in different medical and paramedical groups. Moreover, educators can implement such coping programs prior to evaluations in order to effectively assess the knowledge, attitude, and performance of the students.

Brief Relaxation Training for the Prevention of Stress-Related Difficulties: A Pilot Study.

The present study piloted a brief, single-session behavioral intervention to prevent stress-related illnesses in college students. Participants were recruited at a large public university ( N = 213). A total of 132 participants completed in-person research sessions and were randomly assigned to one of three conditions (two control and one intervention), and another 81 participants completed measures online (online control) without any face-to-face contact. The intervention consisted of brief, one-on-one diaphragmatic breathing training, delivered by trained research assistants. Data were collected at baseline and 2-week follow-up. Participants receiving the intervention provided positive ratings of intervention acceptability and reported utilizing diaphragmatic breathing during the 2-week period. They also reported significant improvements in perceived stress, anxiety, and depressive symptoms. When compared with the control conditions, however, the Intervention condition produced superior improvement in depressive symptoms only. Results suggest that diaphragmatic breathing training can be offered by trained peers to college students to help reduce stress-related symptoms.

Rumination syndrome after esophagectomy

Gastric conduit dysfunction after esophagectomy is a disabling condition that may require revisional surgery. Rumination syndrome is an uncommon and poorly recognized functional foregut disorder of unknown etiology characterized by effortless oral regurgitation of recently ingested food. Rumination is associated with increased intragastric pressure generated by an unconscious mechanism eliciting contraction of the abdominal wall and relaxation of the diaphragm. Rumination syndrome after esophagectomy has not been previously reported in the literature. Two female patients were referred for inability to eat and weight loss due to severe food regurgitation following esophagectomy and gastric conduit replacement. Their previous medical and psychiatric history was apparently unremarkable. Symptoms occurred within the first postoperative year and progressively worsened. High-dose proton pump inhibitors, erythromycin, metoclopramide, antidepressant medications, pneumatic pyloric dilatation, and laparoscopic pyloromyotomy failed to relieve symptoms, and both patients eventually required permanent tube jejunostomy for nutritional support. Subsequently, thoracoscopic implant of a neurostimulator and a laparoscopic Roux-en-Y gastrojejunostomy were performed and failed in both patients. All medical and surgical attempts to relieve symptoms were clinically unsuccessful in these patients in whom radiological and endoscopic investigations did not demonstrate trans-diaphragmatic hernia or mechanical obstruction of the gastric conduit. Eventually, the diagnosis of rumination syndrome was made based on the Rome IV criteria. In the absence of anatomical or other functional abnormalities of the gastric conduit, revisional surgery is contraindicated; rather, the diagnosis of rumination syndrome should be considered. The role of behavioral therapy integrated with diaphragmatic breathing training and biofeedback should be investigated in these patients.

Use of real-time ultrasound imaging for biofeedback of diaphragm motion during normal breathing in healthy subjects

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.

Pilot Study of a Single Session Heart Rate Variability Biofeedback Intervention on Veterans' Posttraumatic Stress Symptoms.

Veterans with posttraumatic stress symptoms exhibit reduced heart rate variability characteristic of autonomic nervous system dysregulation. Studies show heart rate variability biofeedback (HRVB) is effective in reducing posttraumatic stress symptoms by improving autonomic functioning. Participants in this pilot study were veterans of different war eras with military-related posttraumatic stress symptoms. The study aims were to examine the impact of a single session HRVB intervention on posttraumatic stress symptoms and heart rate variability, test persistence of effects, and determine if veterans would find the intervention acceptable. One group (n = 6) received training in diaphragmatic breathing and heart rate variability biofeedback, augmented by twice-daily practice using a smart phone and breath pacing app. A second group (n = 6) received only a single session of diaphragmatic breathing training. After 4weeks, participants in the second group (n = 5) received the full intervention. HRVB significantly reduced global posttraumatic stress symptoms, whereas diaphragmatic breathing alone did not. Further, veterans found the approach acceptable, as demonstrated by a high degree of adherence with prescribed practice, low study attrition, and continued use over time. Results of this pilot study warrant further refinement of a protocol utilizing mHealth to treat posttraumatic stress symptoms in military populations.

A comparative study of Effectiveness between Diaphragmatic Breathing and Resistive Inspiratory Muscle Training on Pulmonary Functions (ERV) during Pregnancy

A comparative study of Effectiveness between Diaphragmatic Breathing and Resistive Inspiratory Muscle Training on Pulmonary Functions (ERV) during Pregnancy

Improving Children's cancer pain management in the home setting: Development and formative evaluation of a web-based program for parents

Background and methodsDespite advances in health care, the majority of children undergoing cancer treatment experience pain, particularly in the home setting. Mobile health tools provide a promising avenue to deliver pain management education and information to parents of children receiving cancer treatment. The current study describes the development and formative evaluation of a novel intervention, Cancer-Tailored Intervention for Pain and Symptoms (C-TIPS), which provides empirically-based pharmacological and non-pharmacological pain management information and coping skills training to parents of pediatric cancer patients. C-TIPS is a web-based application including a tailoring algorithm, customization tools, guided diaphragmatic breathing training, relaxation practice, and educational material (COPE modules). Thirty parents of children undergoing chemotherapy treatment for cancer participated in this initial mixed methods pilot study. Participants completed quantitative measures assessing their stress and relaxation ratings and satisfaction with C-TIPS. Formative evaluation and qualitative data were collected using individual and group interviews. ResultsParents reported high satisfaction with both the educational and skills training modules of C-TIPS (ps < 0.001). Parent self-reported stress significantly reduced (p = 0.004) and relaxation increased (p = 0.05) following participation with the skills training module. ConclusionsC-TIPS is a feasible and well-received web-based intervention that promises to improve pain management in children undergoing cancer treatment, improve stress management in parents, and increase parents' knowledge and understanding of their child's cancer treatment. Results from the current study will help make improvements to C-TIPS in preparation for a randomized-controlled trial of this innovative program.

Effects of Diaphragmatic Breathing Training Using Real-time Ultrasonography on Chest Function in Young Females With Limited Chest Mobility

Effects of Diaphragmatic Breathing Training Using Real-time Ultrasonography on Chest Function in Young Females With Limited Chest Mobility

The Effect of Diaphragmatic Breathing versus Pursed-Lips Breathing on Pulmonary Functions among Patients with Chronic Obstructive Pulmonary Disease

Pulmonary rehabilitation plays a key role in the management of chronic obstructive pulmonary disease COPD. It offers supervised exercise and education for those with breathing problems. The nurse plays a key role in identifying potential candidates for pulmonary rehabilitation, and in facilitating and reinforcing the material learned in rehabilitation program. Objectives: 1-Assess the effect of diaphragmatic breathing on pulmonary functions of COPD patients. 2-Assess the effect of pursed-lips breathing on pulmonary functions of COPD patients. 3-Compare between the effect of diaphragmatic breathing and pursed-lips breathing on pulmonary functions of COPD patients. Setting: The study was carried out at Inpatient Medical Chest Disease Unit at Alexandria Main University Hospital. Subjects: a convenient sample of 60 adult patients of both sexes diagnosed with chronic obstructive pulmonary disease, free from co-morbid diseases that affect the result. The sample was divided randomly into two equal groups, 30 patients each. Group (I) received diaphragmatic breathing training, Group (II) received pursed-lips breathing. Tools: Two tools were used in this study. Tool I an interview questionnaire to illicit socio- demographic data, tool II the Chronic Obstructive Pulmonary Disease patient pulmonary functions tests assessment tool. Validity and reliability of the tool were estimated. Results: The study findings revealed that pulmonary function parameters showed only significant changes in tidal volume and expiratory reserve volume after exercise training in both groups. There were significant differences in PaO2, PCO2, SPO2 results among both studied subjects. Conclusion: Diaphragmatic breathing and Pursed lips breathing have almost equal effect on improving pulmonary functions of COPD patients. Recommendation: Patient education regarding pulmonary rehabilitation should be part of the in-service nursing health education programs.

Use of controlled diaphragmatic breathing for the management of motion sickness in a virtual reality environment.

Evidence indicates that activation of the parasympathetic nervous system (PNS) suppresses physiological responses associated with motion sickness. Research also shows paced breathing increases PNS activation; the current study examines the use of paced diaphragmatic breathing (DB) training to quell motion sickness symptoms. Healthy participants (N=60) were pre-screened for motion sickness susceptibility. Participants were then randomly assigned to either a control condition, focusing on environmental awareness, or to an experimental condition implementing paced DB. Following this, participants were exposed to a virtual reality (VR) motion sickness experience, while heart rate variability, breathing rate (RPM), and motion sickness ratings were collected. Results demonstrated participants in the DB condition had higher PNS activation and reported fewer motion sickness symptoms during the VR experience than the participants in the control condition. Results suggest that the DB protocol can be used to significantly increase PNS tone and decrease the development of motion sickness symptoms.

Using Virtual Reality to Explore Self-Regulation in High-Risk Settings

Virtual reality (VR) models allow investigators to explore high-risk situations carefully in the laboratory using physiological assessment strategies and controlled conditions not available in field settings. This article introduces the use of a virtual experience to examine the influence of self-regulatory skills training on female participants’ reactions to a high-risk encounter with an aggressive male. Sixty-three female participants were recruited for the study. Demographic data indicated that 54% of the participants were not currently in a relationship, 36.5% were in a committed relationship, and 9.5% were occasionally dating. After obtaining informed consent, participants were assigned randomly to either a diaphragmatic breathing training condition or an attention control condition. Results indicated that both groups rated the virtual environment as equally realistic; the aggressive advances of the male were also perceived as equally real across the two experimental groups. Physiological data indicated that there were no differences between the groups on respiration or cardiovascular measures during baseline or during the VR task. After the VR experience, however, the participants in the breathing training condition had lower respiration rates and higher heart rate variability measures than those in the control condition. The results suggest that VR platforms provide a realistic and challenging environment to examine how self-regulation procedures may influence behavioral outcomes. Real-time dynamic engagement in a virtual setting affords investigators with an opportunity to evaluate the utility of self-regulatory skills training for improving safety in situations where there are uncertain and risky outcomes.