The purpose of this study was to investigate the effects of diver-style breathing training on symptoms, pulmonary function, and respiratory muscle, in patients with allergic rhinitis.
This study aims to investigate the effects of diver-style breathing training in patients with allergic rhinitis. A total of 30 patients aged 18-35 years were recruited from students and staff of Chulalongkorn University, as well as patients attending the Chulalongkorn University Health Service Center and King Chulalongkorn Memorial Hospital. Participants were randomly assigned into two groups: an experimental group (n = 15) that received diver-style breathing training and a control group (n = 15) that continued their usual daily activities without any exercise intervention. The independent variable was diver-style breathing training. The dependent variables included rhinitis symptom outcomes (symptom scores, Peak Nasal Inspiratory Flow, nasal blood flow, and Fractional Exhaled Nitric Oxide), pulmonary function parameters (FVC, FEV1, FEV1/FVC, FEF25-75%, MVV, and breath-holding time), and respiratory muscle strength (MIP and MEP).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
SINGLE
Enrollment
30
The diver-style breathing training program lasts 40 minutes per session. Participants sit upright with proper posture and begin with 5 minutes of normal breathing. They then perform a progressive deep inhalation technique: inhaling through the nose to expand the abdomen, continuing to expand the chest, and finally inhaling further until a sensation of throat tightness is felt. The breath is then held for at least 20 seconds or as long as possible before exhaling through the mouth. Each cycle counts as one round, and participants aim to gradually increase their breath-holding duration over 30 minutes. The session ends with 5 minutes of normal breathing.
Faculty of Sports Science, Chulalongkorn University
Bangkok, Bangkok, Thailand
Rhinitis symptom scores
Nasal symptoms were assessed using Total Nasal Symptom Score (TNSS) questionnaire. The subjects were asked to score symptoms of persistent allergic rhinitis before and after yoga training protocol. The total nasal symptom scores were computed as the sum of four individual nasal symptom scores; nasal congestion, itching, sneezing, and rhinorrhea. The scores ranged from 0 to 3 scale (0=none, 1=mild, 2=moderate, 3= severe)
Time frame: Change from Baseline Rhinitis symptom scores at 8 weeks.
Peak nasal inspiratory flow; PNIF
Participants were instructed to inhale through the device as quickly and forcefully as possible using a Peak Nasal Inspiratory Flow (PNIF) meter.
Time frame: Change from Baseline respiratory muscle strength at 8 weeks.
Nasal blood flow
Laser Doppler flowmetry (DRT4, Moor Instruments, UK) was used to measure the NBF. Before the test, each subject rested for 1 hour in a separate room. During the test, the participants were instructed to breathe normally and not to speak, cough, or move. A lateral endoscopic probe with a flexible 1.34-mm-diameter flexible nylon sheath was placed on the front of the nose.
Time frame: Change from Baseline Rhinitis symptom scores at 8 weeks.
Fractional Exhaled Nitric Oxide Testing; FeNO
FeNO Monitor (BedFont, UK) was used to measure the FeNO. The participants inhaled deeply for 2 to 3 seconds before exhaling slowly, which normally took 10 seconds.
Time frame: Change from Baseline Rhinitis symptom scores at 8 weeks.
Forced Vital Capacity; FVC
Participants were seated in a chair and wore a nasal clip during the assessment. They first performed three cycles of slow, normal breathing, followed by a demonstration of forced inspiration and expiration, and then returned to normal breathing.
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Time frame: Change from Baseline respiratory muscle strength at 8 weeks.
Forced Expiratory Volume in one second; FEV1
Participants were seated in a chair and wore a nasal clip during the assessment. They first performed three cycles of slow, normal breathing, followed by a demonstration of forced inspiration and expiration, and then returned to normal breathing.
Time frame: Change from Baseline respiratory muscle strength at 8 weeks.
Forced Expiratory Flow at 25-75% of FVC; FEF25 - 75 %
Participants were seated in a chair and wore a nasal clip during the assessment. They first performed three cycles of slow, normal breathing, followed by a demonstration of forced inspiration and expiration, and then returned to normal breathing.
Time frame: Change from Baseline respiratory muscle strength at 8 weeks.
Maximum Voluntary Ventilation; MVV
Participants were instructed to breathe in and out as quickly and forcefully as possible for 15 seconds.
Time frame: Change from Baseline respiratory muscle strength at 8 weeks.
Breath Holding Time Test
Participants were instructed to inhale as deeply as possible, hold their breath for as long as possible, and then exhale through the mouth.
Time frame: Change from Baseline respiratory muscle strength at 8 weeks.
Maximal Inspiratory Pressure; MIP
Participants were instructed to exhale fully to functional residual capacity (FRC), then place the mouthpiece securely and perform a maximal inspiratory effort sustained for 1-2 seconds.
Time frame: Change from Baseline respiratory muscle strength at 8 weeks.
Maximal expiratory pressure; MEP
Participants inhaled fully to total lung capacity (TLC), maintained a tight seal on the mouthpiece, and then performed a maximal expiratory effort for 1-2 seconds.
Time frame: Change from Baseline respiratory muscle strength at 8 weeks.