• Journal of International Academy of Physical Therapy Research
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• v.3 no.2
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• pp.458-463
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• 2012

This study is to examine the effects of a feedback breathing device exercise and diaphragm breathing exercise on pulmonary functions of chronic strokes patients. The selection of 20 subjects was divided equally and placed into a experiment group and a control group and the intervention was applied four times per a week for five weeks. In each session, both groups received rehabilitative exercise treatment for 30 minutes, and a feedback breathing device exercise for 15 minutes. In addition, experimental group conducted a combination of diaphragm breathing exercise for 15 minutes. Prior to and after the experiment, patients' pulmonary functions were measured using a spirometer. The pulmonary function tests included FVC, FEV1, FEV1/FVC, PEF, VC, TV, IC, ERV, IRV. With respect to changes in the pulmonary functions of both groups, the experimental group significantly differed in FVC, FEV1, TV, ERV but did not in PEF, FEV1/FVC, VC, IRV. The control group did not significantly differ in any of the tests. There were significant differences in FEV1, FEV1/FVC, TV, ERV between the two groups, but no significant differences in FVC, PEF, FEV1/FVC, VC, IRV between them after the experiment. The experimental group, which conducted a combination of a feedback breathing device exercise and diaphragm breathing exercise, saw their respiratory ability increase more significantly than the control group. The breathing exercise was found to improve pulmonary function in chronic stroke patients.

• Journal of International Academy of Physical Therapy Research
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• v.4 no.2
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• pp.552-556
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• 2013

The purpose of this study is to examine the effects of feedback breathing exercise on respiratory muscle activity. Thirty stroke patients were randomly and equally assigned to an experimental group and a control group. The experimental group received rehabilitation exercise treatment for 30 minutes and feedback respiratory exercise for 30 minutes and the control group received rehabilitation exercise treatment for 30 minutes and conducted motomed exercise for 30 minutes. All of them conducted exercises five times per week for four weeks. Respiratory muscles including the upper trapezius(UT), longissimus dorsi(LD), rectus abdominis(RA), external abdominal oblique(EAO) and, internal abdominal oblique(IAO) were measured using MP 150WSW prior to and after the experiment. Regarding pulmonary functions prior to and after the experiment, the experimental group showed significant differences in all sections but the control group did not show significant differences in any sections. As for in-between group differences after the experiment, there were significant differences in the UT, LD, RA, and IAO but no significant differences in the EAO. In conclusion, respiratory muscle activity was more effective for the experimental group than the control group. It is considered that feedback respiratory exercise may induce improvement in respiratory muscles in stroke patients through feedback breathing exercise.

• Journal of Korean Critical Care Nursing
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• v.5 no.2
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• pp.28-36
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• 2012

Purpose: The purpose of this study was to examine the effects of the systematic breathing exercise program on recovery of patients with pneumothorax. Methods: An nonequivalent interrupted time-series control group posttest design was used. Participants were 40 inpatients (Experimental Group; 20, Control Group; 20) at the one University Hospital in U city. The systematic breathing exercise program including education on deep breathing exercise using incentive spirometry, Range of motion (ROM) exercise in shoulder joint, walking exercise and feedback were provided to the experimental group, while the control group carried out deep breathing exercise using incentive spirometry. The duration of chest tube insertion, duration of hospitalization, and frequency of analgesics use were measured. The data were analysed by a SPSS/WIN program. Results: The duration of chest tube insertion and duration of hospitalization in the experimental group were significantly shorter than the control group. However, there is no difference of the frequency of analgesics use between the experimental group and control group. Conclusion: The result showed that the systematic breathing exercise program was effective to improve recovery of patients with pneumothorax. This program can be applied in hospitals for patients with pneumothorax as one of the nursing intervention modalities.

• The Journal of Korean Physical Therapy
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• v.28 no.2
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• pp.149-154
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• 2016

Purpose: The aim of this study is to suggest an intervention method for clinical use in the future by analyzing the effect of breathing exercise on activity of sternocleidomastoid muscle and scalenus anterior muscle, which are respiratory synergist muscles, and pulmonary functions in patients with forward head posture. Methods: Prior to the experiment, 12 patients (experimental group) performed feedback exhalation exercise along with conventional deep neck exercise, and 11 subjects (control group) performed feedback deep neck exercise along with conventional deep neck exercise. The intervention programs were performed for 40 minutes once a day (three times a week for four weeks). Results: Before intervention, %RMS was measured for surface electromyography (sEMG), and FVC, FEV1, and FEV1/FVC were measured using a spirometer. After four weeks, these items were re-measured under the same condition and analyzed. In within-group comparison of the experimental group, activity of sternocleidomastoid muscle and scalenus anterior muscle showed a significant decrease (p<0.05)(p<0.001), and forced vital capacity (FVC) showed a significant increase (p<0.05). In within-group comparison of the control group, activity of sternocleidomastoid muscle and scalenus anterior muscle showed a significant decrease (p<0.05), and in between-group comparison, there were significant differences in activity of sternocleidomastoid muscle and FVC (p<0.05). Conclusion: Long-term forward head posture restrains exercise performance of the neck and leads to exercise avoidance of the neck during daily activities, thus restraint factors might be created even while breathing. To cut off this link, a constant effort is required and diversified research on the correlation between neck functions and breathing should be conducted.

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

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

• Journal of International Academy of Physical Therapy Research
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• v.8 no.2
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• pp.1146-1151
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• 2017

The purpose of this study was to compare the effects of respiratory exercise on cardiopulmonary function and muscle activity of rectus abdominis in smokers and non-smokers with elderly people. All the participants were older than 65 years, and twenty non-smokers, and twenty smokers participated. Non-smokers and smokers were randomly divined into 10 feedback breathing exercises (FBE) and a balloon-blowing exercise (BBE) group. The FBE and the BBE were performed three times a week for four weeks. Forced vital capacity (FVC), forced expiratory volume at one second (FEV1), forced expiratory volume at one second/forced vital capacity (FEV1/FVC), peak expiratory flow (PEF), and vital capacity (VC) were measured as pulmonary function. EMG was used to measure the activity of the rectus abdominis. In the FBE and BBE groups, $FEV_1$ was significantly lower in non-smokers compared to smokers at two and four weeks (p<.05), $FEV_1/FVC$, PEF and VC were significantly lower in non-smokers compared to smokers to pre-test, two weeks, four weeks and six weeks (p<.05). Muscle activity of rectus abdominis was significantly difference in the BBE group at pre-test, two weeks, four weeks, and six weeks (p<.05). These results suggest that respiratory exercise was effective in improving pulmonary function and rectus muscle activity.

• The Journal of Korean Physical Therapy
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• v.27 no.5
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• pp.287-291
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• 2015

Purpose: This study was conducted to determine the influence of inspiratory muscle exercise using visual biofeedback and inspiratory muscle exercise with diaphragm breathing retraining in stroke patients in regard to inspiratory muscle activity and respiratory function and to provide fundamental information on intervention for improvement of pulmonary function in stroke patients. Methods: The current study measured and analyzed inspiratory muscle activity and pulmonary function of 15 randomly selected subjects in a Biofeedback inspiratory muscle exercise (BIE) group that uses visual feedback and 15 subjects in the Diaphragm breathing exercise (DBE) group that uses breathing retraining before and after intervention. Intervention was performed for 30 minutes, 5 times a week, for 8 weeks. Subjects were measured for muscle activity of upper trapezius muscle and lattisimus dorsi muscle using a surface electromyography system and maximum inspiratory pressure was measured using a respiratory measurement device. For homogeneity test of subjects, independent t-test was performed and ANCOVA was performed for comparison of inspiratory muscle activity and pulmonary function between groups. Results: In the study results, the BIE group showed more significant muscle activity than the DBE group in upper trapezius muscle and lattisimus dorsi muscle (p<0.001). In addition, the BIE group showed more pressure than the DBE group in maximum inspiratory pressure (p<0.001). Conclusion: Based on the current study, performing biofeedback respiration exercise simultaneously with breathing retraining in stroke patients can provide more efficient respiratory physical therapy. In addition, it is considered that consistent study on the effectiveness is necessary to further improve clinical availability.

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

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

• The Journal of Korean Physical Therapy
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• v.28 no.1
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• pp.46-51
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• 2016

Purpose: This study intended to classify voluntary respiratory exercise and exercise using breathing training equipment to suggest proper respiratory exercise to relieve symptoms of patients with severe chronic obstructive pulmonary disease. Methods: Sixteen subjects were randomly selected for experimental group I, which performed feedback breathing exercise and 15 subjects were randomly selected for experimental group II, which performed a complex breathing exercise. The mediation program was performed 30 minutes a session, once a day, three times a week, for five weeks. This study analyzed before and after results within groups and between groups through measurement of respiratory muscle activity and health-related quality of life. Results: Activity of sternocleidomastoid muscle and scalene muscle increased meaningfully within experimental group I and activity of diaphragm increased significantly within experimental group II (p<0.05) and there was a meaningful difference in health-related quality of life within experimental group II (p<0.05). Significant differences in change of activity of respiratory muscle and health-related quality of life were observed between groups (p<0.05). Conclusion: This study showed conflicting results between activity of agonist and synergist in patients with severe chronic obstructive pulmonary disease according to types of respiratory exercise and that complex respiratory exercise is more effective in health-related quality of life. Therefore, it found that the more severity increase, the more self-respiratory technique is an effective program. Diversified approach methods will be needed to improve respiratory function and quality of life for patients, and continuous clinical studies will be needed in the future.

• Journal of the Korean Applied Science and Technology
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• v.35 no.2
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• pp.445-453
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• 2018

The purpose of this study was to analyze the effect of acute respiratory training feedback upon a change on HRV-Autonomic nervous system in middle-aged women. The research subjects were totally 24 middle-aged women(40-60 years old), were randomly allocated 12 people to the respiratory training group and 12 people to the control group, and then were carried out the acute respiratory training. The feedback exercise in the respiratory training group was conducted for totally 15 minutes. Following the 10-minute breath awareness training according to the expert's guidance, the 5-minute autonomous breathing exercise was implemented. The data analysis was carried out Repeated Measures ANOVA with SPSS WIN 20.0. The conclusions that were obtained through this are as follows. The middle-aged women got significantly higher in SDNN, RMSSD, LF, HF after the acute respiratory training. Compared to the control group. the respiratory training group was indicated to have gotten higher significantly in SDNN, RMSSD, LF, HF. Mean HR and LF/HF were not shown a significant difference in both the main effect of group & period and the interaction effect of group & period. Above of a result the acute respiratory training feedback is effective for SDNN, RMSSD, sympathetic activity, parasympathetic activity in the middle-aged women. Thereby, the respiratory training program improves autonomic nervous system, being considered to be possibly expected the effective value of exercise intervention available for relieving stress and recovering autonomic dysfunction in the middle-aged women.