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  1. Kow FP, Adlina B, Sivasangari S, Punithavathi N, Ng KK, Ang AH, et al.
    Med J Malaysia, 2018 08;73(4):233-238.
    PMID: 30121686 MyJurnal
    INTRODUCTION: As pharmacological treatment of hypertension has become a burden worldwide, the study looked into nonpharmacological ways of reducing blood pressure. The objective was to determine if music guided, slow and deep breathing will reduce the blood pressure among patients with hypertension in eight weeks.

    METHODS: A participant blinded, multi-centre, randomised controlled trial was conducted in which the participants in the intervention group (IG) practiced deep breathing exercise guided by sound cues and those in the control group (CG) listened to the music. The primary end point was reduction in blood pressure at eight weeks.

    RESULTS: 87 patients, 46 males and 41 females with mean age of 61.1 years were recruited and 93.1% of them successfully completed the study. There was significant reduction in systolic and diastolic Blood Pressure from baseline by 8 weeks in both groups. The reduction in Mean systolic blood pressure (SBP) in the control arm was 10.5mmHg compared to 8.3mmHg (p<0.001) in intervention group. Diastolic blood pressure (DBP) reduction in control and intervention groups were 5.2 mmHg (p<0.001) and 5.6 mmHg (p<0.001) respectively. The absolute difference in SBP reduction from baseline in IG & CG was -2.2 (95%CI: -7.8 to 3.5) and DBP was -0.4 (95%CI: -2.9 to 3.6). However, blood pressure reduction between the two groups was not significant.

    CONCLUSIONS: Both listening to music and deep breathing exercise were associated with a clinically significant reduction in SBP and DBP. However, deep breathing exercise did not augment the benefit of music in reducing BP.

    Matched MeSH terms: Breathing Exercises/methods*
  2. Jahan I, Begum M, Akhter S, Islam Z, Haque M, Jahan N
    J Popul Ther Clin Pharmacol, 2020 06 11;27(2):e68-e77.
    PMID: 32543162 DOI: 10.15586/jptcp.v27i2.675
    Alternate nostril breathing (ANB) is one of the best and easiest breathing exercises. ANB exercise has beneficial effects on cardiac function in healthy and diseased people. The objectives of this study were to assess the effects of ANB exercise on cardiac physiology among healthy medical students. This was a prospective interventional study that was conducted in the Department of Physiology, Chittagong Medical College (CMC), Chattogram, Bangladesh, from July 2017 to June 2018. A total of 100 research participants (RPs) aged 18-20 years, Year-I medical students of CMC, were selected. A simple random sampling method was adopted. The selection was done after the inclusion and exclusion criteria were applied. The age and body mass index (BMI) of the RPs were analogous in both the control and experimental groups. Cardiac parameters, like pulse and blood pressure (BP), were measured. The initial baseline data were recorded for both groups and after 4 weeks. The research respondents of the experimental group performed ANB exercise for 4 weeks. The mean value pulse and BP were significantly (p < 0.001) changed after breathing exercise, compared to the values before the breathing exercise. The results of this study suggest that cardiac function significantly improves after the breathing exercise. Therefore, ANB can be recommended for increasing cardiac efficiency.
    Matched MeSH terms: Breathing Exercises/methods*
  3. Jahan I, Begum M, Akhter S, Islam MZ, Jahan N, Haque M
    J Popul Ther Clin Pharmacol, 2020 03 19;27(1):e104-e114.
    PMID: 32320171 DOI: 10.15586/jptcp.v27i1.668
    Alternate nostril breathing (ANB) is one of the best and easiest breathing exercises (pranayama) of yoga that are good for health and physical fitness. ANB exercise has beneficial and therapeutic effects on respiratory function in both normal as well as diseased humans. This study was conducted with the objective of assessing the physiological effects of short-term ANB exercise on respiratory function in healthy adult individuals leading a stressful life. This prospective interventional study was conducted in the Department of Physiology, Chittagong Medical College (CMC), Chattogram, Bangladesh from July 2017 to June 2018. A total of 100 participants aged 18-20 years, studying in the first year in CMC, were included by using a simple random sampling method. Among them, 50 participants were enrolled in the experimental group. Age- and BMI-matched 50 participants constituted the control group. Height, weight were measured, and BMI was calculated. The participants of the experimental group performed ANB exercise over 4 weeks for 10 min/day. The control participants were neither trained nor allowed to practice nostril breathing during the whole study period. Respiratory parameters like forced vital capacity (FVC), forced expiratory volume in 1st second (FEV1), and peak expiratory flow rate (PEFR) were measured by using a digital spirometer (Chest graph HI-101, Japan). Readings were taken in a healthy upright sitting posture in the control and experimental group initially and after 4 weeks. Student's t-test was conducted by using SPSS for windows version-23. The mean value of FVC, FEV1, PEFR were significantly (P < 0.001) changed after the ANB exercise when compared to the values before breathing exercise. The results of this study suggest that respiratory function is significantly improved after the ANB exercise. Therefore, ANB can be recommended for increasing respiratory efficiency.
    Matched MeSH terms: Breathing Exercises/methods*
  4. Jahan I, Begum M, Akhter S, Islam MZ, Jahan N, Samad N, et al.
    Ann Afr Med, 2021 7 3;20(2):69-77.
    PMID: 34213471 DOI: 10.4103/aam.aam_114_20
    Introduction: Alternate nostril breathing (ANB) is an effective breathing exercise with therapeutic benefits on cardiorespiratory functions for healthy and diseased individuals. This study was conducted to assess the effects of ANB exercise on cardiorespiratory tasks in healthy adults.

    Materials and Methods: This randomized experimental study was conducted in the Department of Physiology, Chittagong Medical College, Chattogram, from July 2017 to June 2018. A total of 100 1st-year students, aged between 18 and 20 years, were included by a random sampling method. Fifty participants (25 males and 25 females) were enrolled in the experimental group, while age- and body mass index-matched another 50 participants (25 males and 25 females) served as the control group. Experimental group participants performed ANB exercise for 4 weeks. Cardiorespiratory parameters (pulse rate, blood pressure, forced vital capacity, forced expiratory volume in 1st s [FEV1], and peak expiratory flow rate [PEFR] were measured. Data were taken at the start and after 4 weeks in both groups.

    Results: Independent t-test showed no significant differences in the cardiorespiratory functions between the experimental and control groups among the male and female participants, except for the females' PEFR which showed small differences. On the other hand, repeated measure ANOVA shows significant improvement in the experimental groups among males (P < 0.001-0.028) and females (P < 0.001-0.001) in all the cardiorespiratory functions measured, except for the FEV1 and PEFR among males.

    Conclusion: The results of this study suggest that cardiorespiratory functions were improved after breathing exercise, and therefore, ANB can be recommended for increasing cardiorespiratory efficiency.

    Matched MeSH terms: Breathing Exercises/methods*
  5. Andrea Ban YL, Siti Istiana AS, Nik Nuratiqah NA, Ng BH, Rose Azzlinda O, Hasni J, et al.
    Med J Malaysia, 2024 Sep;79(5):561-568.
    PMID: 39352158
    INTRODUCTION: Inspiratory muscle dysfunction is prevalent in chronic obstructive pulmonary disease (COPD). This study aimed to compare the benefits of adding volume incentive spirometry (VIS) to active-cycle-breathing technique (ACBT) and ground-based walking (GBW) training in patients hospitalised for COPD exacerbations. The objectives were to evaluate the impact of early initiation of VIS on respiratory muscle strength, measured by maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP) and the 6-minute walk test (6-MWT), as well as on symptoms, as assessed by the COPD assessment test (CAT) score.

    MATERIALS AND METHODS: This randomised, prospective study was conducted among COPD subjects admitted with exacerbation between June 2021 and August 2022. Subjects were randomly assigned to either the VIS (interventional group) or the control group. Baseline assessments, including spirometry, MIP, CAT score, and the 6-minute walk test (6MWT), were performed. Both groups commenced active cycle of breathing techniques (ACBT) and groundbased walking (GBW) training within 72 hours of admission, with daily sessions involving three repetitions of each phase to complete one cycle, repeated three times daily. The intervention group received VIS. Upon discharge, subjects were provided with a diary and instructed to continue a home-based pulmonary exercise regimen, performed for at least 15 minutes per day, 3 days a week, with compliance monitored through weekly phone calls. At the 4-week followup, repeat assessments of spirometry, MIP, maximal expiratory pressure (MEP), CAT score and 6MWT were conducted to evaluate the outcomes.

    RESULTS: A total of 34 subjects with a median age of 68 years (interquartile range [IQR] 65-74.3 years). The cohort predominantly males (32 subjects, 94%). The distribution of disease severity was as follows: GOLD 2 in 15 subjects (44%) and GOLD 3 in 14 subjects (41%). Additionally, 17 subjects (50%) had experienced three or more exacerbations in the preceding year. The majority of patients (29 out of 34, 85%) had a length of stay of less than 7 days. In the interventional group, the median MIP improved from 50 cm H2O (IQR 40.5-70.5) to 59 cm H2O (IQR 39-76.5), though this was not statistically significant (p = 0.407). The control group saw an improvement from 58 cm H2O (IQR 36.5-85) to 60 cm H2O (IQR 33-88), also not statistically significant (p = 0.112). The 6MWT distance improved in the interventional group from 220 meters (IQR 118-275) to 260 meters (IQR 195-327) (p = 0.002) and in the control group from 250 meters (IQR 144-294) to 280 meters (IQR 213-359.5) (p = 0.001). The median CAT score decreased significantly in the interventional group from 22 (IQR 16-28) to 11 (IQR 7.5-13) (p < 0.001) and in the control group from 21 (IQR 14-24.5) to 10 (IQR 8-12.5) (p < 0.001).

    CONCLUSION: Early initiation of pulmonary rehabilitation in patients with acute exacerbations, characterised by poor muscle strength and a history of exacerbations, resulted in significant improvements in patient-reported symptoms and 6MWT outcomes. Although there was only a numerical improvement in MIP and MEP, the intervention did not extend the length of hospital stay, highlighting its safety and efficacy in the acute care setting.

    Matched MeSH terms: Breathing Exercises/methods
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