COMBINED EFFECT OF DIAPHRAGMATIC BREATHING AND CONTROLLED COUGHING ON LUNG FUNCTION IN COPD PATIENTS
Main Article Content
Keywords
COPD, diaphragmatic breathing, controlled coughing, lung function, spirometry, pulmonary function
Abstract
Chronic Obstructive pulmonary disease COPD means progressive obstructions form within the pulmonary system.COPD reduces the efficiency of the gas exchange process and causes the impairmentof parts of the lungs,mucus blocking the airways, and inflammation of the airway lining.COPD is the 3rd leading cause of death worldwide, having caused 3.23 million deaths in 2019. Spirometry is the diagnostic test used to monitor pulmonary functions, particularly in COPD patients. Breathing exercises like diaphragmatic breathing and controlled coughing are important contributor in patients having COPD.Diaphragmatic breathing deals with chronic pain management and enhances pulmonary functions in COPD patients. The force of an effective or controlled cough which originates from deep within the lung is just enough to loosen and move mucus through the airways without narrowing and collapsing them. Certain studies report the beneficial effect of Diaphragmatic breathing and Controlled coughing. The objectiveof the study was to evaluate the combined effectiveness of diaphragmatic breathing and controlled coughing on lung functions by improving pain and pulmonary functions (FEV1, FVC, FEV1\FVC) in COPD patients. Controlled coughing control conserves oxygen and energy.Material and Methodology:Asample of 30 males and femalesaged 35 to 60 years with diagnosed COPD was evaluated for the effectiveness of the given treatment by using spirometry for lung function and a numeric rating scale for pain. It was a quasi-experimental study including diaphragmatic breathing and controlled coughing exercises comprises 2 sets of 5-10 repetitions per day, for a total interval of 6 weeks. Spirometry readings were taken once before the interventions applied. Follow up was taken after three weeks. And the final spirometry readings were taken at the end of 6th weekData Analysis: the data was analyzed by using SPSS version 20 and Descriptive statistics.
References
1. Andrianopoulos, V., Gloeckl, R., Vogiatzis, I., &Kenn, K. (2021). Cognitive impairment in COPD: should cognitive evaluation be part of respiratory assessment?. Breathe, 13(1), e1-e9.
2. Basso-Vanelli, R. P., Di Lorenzo, V. A. P., Labadessa, I. G., Regueiro, E. M., Jamami, M., Gomes, E. L., & Costa, D. (2016). Effects of inspiratory muscle training and calisthenics-and-breathing exercises in COPD with and without respiratory muscle weakness. Respiratory care, 61(1), 50-60.
3. Brocki, B. C., Andreasen, J. J., Langer, D., Souza, D. S. R., & Westerdahl, E. (2015). Postoperative inspiratory muscle training in addition to breathing exercises and early mobilization improves oxygenation in high-risk patients after lung cancer surgery: a randomized controlled trial. European Journal of Cardio-Thoracic Surgery, 49(5), 1483-1491.
4. Cahalin, L. P., Braga, M., Matsuo, Y., & Hernandez, E. D. (2002). Efficacy of diaphragmatic breathing in persons with chronic obstructive pulmonary disease: a review of the literature. Journal of Cardiopulmonary Rehabilitation and Prevention, 22(1), 7-21.
5. Cancelliero-Gaiad, K. M., Ike, D., Pantoni, C. B., Borghi-Silva, A., & Costa, D. (2014). Respiratory pattern of diaphragmatic breathing and pilates breathing in COPD subjects. Brazilian journal of physical therapy, 18, 291-299.
6. Cao W, Chen HD, Yu YW, Li N, Chen WQ. Changing profiles of cancer burden worldwide and in China: a secondary analysis of the global cancer statistics 2020. Chin Med J (Engl) (2021);134:783–791.
7. Cavaggioni, L., Ongaro, L., Zannin, E., Iaia, F. M., & Alberti, G. (2015). Effects of different core exercises on respiratory parameters and abdominal strength. Journal of physical therapy science, 27(10), 3249-3253.
8. Chatreewatanakul, B., Othaganont, P., & Hickman, R. L. (2022). Early symptom recognition and symptom management among exacerbation COPD patients: A qualitative study. Applied Nursing Research, 63, 151522.
9. Chatwin, M., Toussaint, M., Gonçalves, M. R., Sheers, N., Mellies, U., Gonzales-Bermejo, J., ... & Morrow, B. M. (2018). Airway clearance techniques in neuromuscular disorders: a state of the art review. Respiratory medicine, 136, 98-110.
10. CliftonSmith, T., & Rowley, J. (2011). Breathing pattern disorders and physiotherapy: inspiration for our profession. Physical therapy reviews, 16(1), 75-86.
11. De Troyer, A., and M. G. Sampson. 2007. Activation of the parasternal intercostals during breathing efforts in human subjects. J. AppL Physiol. 52:524-529.
12. Efficace F, Cartoni C, Niscola P, Tendas A, Meloni E, Scaramucci L, Soldati S, Brunetti GA, Marini MG, Mandelli F. Predicting survival in advanced hematologic malignancies: do patient-reported symptoms matter? Eur J Haematol. (2012);89:410–416.
13. Fernandes, M., Cukier, A., & Feltrim, M. I. Z. (2011). Efficacy of diaphragmatic breathing in patients with chronic obstructive pulmonary disease. Chronic respiratory disease, 8(4), 237-244.
14. Fukuda S, Nakajima K, Miyazaki Y, Takahashi T, Kurokawa Y, Yamasaki M, Miyata H, Takiguchi S, Mori M, Doki Y. Use of double-lumen peripherally inserted central catheters for safer perioperative management of esophageal cancer patients. J Vasc Access. 2015;16:338–343.
15. Garcia-Aymerich, J., Serra, I., Gomez, F. P., Farrero, E., Balcells, E., Rodriguez, D. A., ... & Anto, J. M. (2009). Physical activity and clinical and functional status in COPD. Chest, 136(1), 62-70.
16. GBD 2019 Diseases and Injuries Collaborators. Global Burden of 369 Diseases and Injuries in 204 Countries and Territories, 1990–2019: A Systematic Analysis for the Global Burden of Disease Study 2019. Lancet 2020, 396, 1204–1222.
17. Gosselink, R. (2006). Physical therapy in adults with respiratory disorders: where are we?. Brazilian Journal of Physical Therapy, 10, 361-372.
18. Hamasaki, H. (2020). Effects of diaphragmatic breathing on health: a narrative review. Medicines, 7(10), 65.
19. Hayhurst, C. (2021). The Lungs: Learning how We Breathe. The Rosen Publishing Group, Inc.
20. Hegland, K. W., Davenport, P. W., Brandimore, A. E., Singletary, F. F., & Troche, M. S. (2016). Rehabilitation of swallowing and cough functions following stroke: an expiratory muscle strength training trial. Archives of physical medicine and rehabilitation, 97(8), 1345-1351.
21. Hoy H, Lynch T, Beck M. Surgical Treatment of Lung Cancer. Crit Care Nurs Clin North Am. (2019);31:303–313.
22. Ides, K., Vissers, D., De Backer, L., Leemans, G., & De Backer, W. (2011). Airway clearance in COPD: need for a breath of fresh air? A systematic review. COPD: Journal of Chronic Obstructive Pulmonary Disease, 8(3), 196-205.
23. Jacob, A. M. (2021). Pulmonary epithelial plasma membrane rupture and barrier function disruption during airway reopening (Doctoral dissertation, Tulane University School of Science and Engineering).
24. Jafari, A., Esmaeilzadeh, F., Mowla, D., Sadatshojaei, E., Heidari, S., & Wood, D. A. (2021). New insights to direct conversion of wet microalgae impregnated with ethanol to biodiesel exploiting extraction with supercritical carbon dioxide. Fuel, 285, 119199.
25. Kang, J. I., Jeong, D. K., & Choi, H. (2020). The effects of breathing exercise types on respiratory muscle activity and body function in patients with mild chronic obstructive pulmonary disease. Journal of physical therapy science, 28(2), 500-505.
26. Ko FW, Tam W, Siu EHS, Chan KP, Ngai JC, Ng SS, Chan TO, Hui DS. Effect of short-course exercise training on the frequency of exacerbations and physical activity in patients with COPD: A randomized controlled trial. Respirology. 2021; 26:72–79.
27. Le J, Grigorian A, Chen S, Kuo IJ, Fujitani RM, Kabutey NK. Novel endovascular technique for removal of adherent PICC. J Vasc Access. 2016;17:e153–e155.
28. Li L, Xu F, Ye J. Effect of Family Participatory Nursing Model Based on WeChat Platform on Psychological Elasticity and Quality of Life of Patients with Lung Cancer. Biomed Res Int. 2022; 2022:4704107.
29. Ma, X., Yue, Z. Q., Gong, Z. Q., Zhang, H., Duan, N. Y., Shi, Y. T., ... & Li, Y. F. (2017). The effect of diaphragmatic breathing on attention, negative affect and stress in healthy adults. Frontiers in psychology, 8, 234806.
30. Mahler, D. A., Decramer, M., D'Urzo, A., Worth, H., White, T., Alagappan, V. K., ... & Banerji, D. (2014). Dual bronchodilation with QVA149 reduces patient-reported dyspnoea in COPD: the BLAZE study. European Respiratory Journal, 43(6), 1599-1609.
31. Maltais, F., Bourbeau, J., Shapiro, S., Lacasse, Y., Perrault, H., Baltzan, M., ... & Bernard, S. (2008). Effects of home-based pulmonary rehabilitation in patients with chronic obstructive pulmonary disease: a randomized trial. Annals of internal medicine, 149(12), 869-878.
32. Martarelli, D., Cocchioni, M., Scuri, S., & Pompei, P. (2011). Diaphragmatic breathing reduces exercise-induced oxidative stress. Evidence-Based Complementary and Alternative Medicine, 2011.
33. McCullagh, A., Rosenthal, M., Wanner, A., Hurtado, A., Padley, S., & Bush, A. (2020). The bronchial circulation—worth a closer look: a review of the relationship between the bronchial vasculature and airway inflammation. Pediatric pulmonology, 45(1), 1-13.
34. McDonald, V. M., Hiles, S. A., Jones, K. A., Clark, V. L., &Yorke, J. (2021). Health‐related quality of life burden in severe asthma. Medical Journal of Australia, 209(S2), S28-S33.
35. Mendes, L. P., Moraes, K. S., Hoffman, M., Vieira, D. S., Ribeiro-Samora, G. A., Lage, S. M., ... & Parreira, V. F. (2019). Effects of diaphragmatic breathing with and without pursed-lips breathing in subjects with COPD. Respiratory care, 64(2), 136-144.
36. Peters, M., Köhler, B., Kuckshinrichs, W., Leitner, W., Markewitz, P., & Müller, T. E. (2021). Chemical technologies for exploiting and recycling carbon dioxide into the value chain. ChemSusChem, 4(9), 1216-1240.
37. Prasad, B. (2020). Chronic obstructive pulmonary disease (COPD). International Journal of Pharmacy Research & Technology (IJPRT), 10(1), 67-71.
38. Reyes, A., Castillo, A., & Castillo, J. (2020). Effects of expiratory muscle training and air stacking on peak cough flow in individuals with Parkinson’s disease. Lung, 198, 207-211.
39. Saey D, Debigare R, Leblanc P, Mador MJ, Cote CH, Jobin J, Maltais F. Contractile leg fatigue after cycle exercise: a factor limiting exercise in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2003; (168): 425-30.
40. Saltnes, S. S., Storhaug, K., Borge, C. R., Enmarker, I., & Willumsen, T. (2015). Oral health-related quality-of-life and mental health in individuals with chronic obstructive pulmonary disease (COPD). Acta Odontologica Scandinavica, 73(1), 14-20.
41. Senior, R. M., &Anthonisen, N. R. (2020). Chronic obstructive pulmonary disease (COPD). American journal of respiratory and critical care medicine, 157(4), S139-S147.
42. Siafakas, N. M., Vermeire, P., Pride, N. A., Paoletti, P., Gibson, J., Howard, P., ... &Postma, D. S. (2021). Optimal assessment and management of chronic obstructive pulmonary disease (COPD). The European Respiratory Society Task Force. European Respiratory Journal, 8(8), 1398-1420.
43. Wang, Z., Wang, Z., Fang, Q., Li, H., Zhang, L., & Liu, X. (2019). Effect of expiratory muscle strength training on swallowing and cough functions in patients with neurological diseases: a meta-analysis. American Journal of Physical Medicine & Rehabilitation, 98(12), 1060-1066.
44. Westerdahl, E., Wittrin, A., Kånåhols, M., Gunnarsson, M., & Nilsagård, Y. (2016). Deep breathing exercises with positive expiratory pressure in patients with multiple sclerosis–a randomized controlled trial. The clinical respiratory journal, 10(6), 698-706.
45. Wolf, J. S., Papadimitriou, J. C., Morales, R. E., Califano III, J. A., Kline, N. L., Bhatnagar, K., ... & Taylor, R. J. (2022, March). The association of active and passive tobacco smoke exposure with chronic rhinosinusitis symptom severity: A cross‐sectional study. In International Forum of Allergy & Rhinology (Vol. 12, No. 3, pp. 278-285).
46. Zhao L, Shi P, Xiong X, Zeng J. Nonpharmacological interventions for cancer-related fatigue in lung cancer patients: A protocol for an evidence map of overview of a network meta-analysis of existing trials. Medicine (Baltimore) 2021;100:e26864.
47. Zhou T, Sun C. Effect of physical manipulation pulmonary rehabilitation on lung cancer patients after thoracoscopic lobectomy. Thorac Cancer. 2022;13:308–315.
48. https://www.healthline.com/health/copd
49. https://medlineplus.gov/ency/article/000091.htm
50. https://www.healthline.com/human-body-maps/lung
51. https://courses.lumenlearning.com/suny-ap2/chapter/the-lungs/
52. https://www.nhs.uk/conditions/spirometry/
53. https://my.clevelandclinic.org/health/diagnostics/17833-spirometry
54. https://my.clevelandclinic.org/health/articles/9445-diaphragmatic-breathing
55. Medically reviewed by Cheryl Crumpler, PhD — By Jon Johnson — Updated on February 9, 2023
56. https://www.medicalnewstoday.com/articles/diaphragmatic-breathing
57. https://my.clevelandclinic.org/health/articles/8697-coughing-controlled-coughing
58. https://www.verywellhealth.com/coughing-as-an-airway-clearance-technique-914980
2. Basso-Vanelli, R. P., Di Lorenzo, V. A. P., Labadessa, I. G., Regueiro, E. M., Jamami, M., Gomes, E. L., & Costa, D. (2016). Effects of inspiratory muscle training and calisthenics-and-breathing exercises in COPD with and without respiratory muscle weakness. Respiratory care, 61(1), 50-60.
3. Brocki, B. C., Andreasen, J. J., Langer, D., Souza, D. S. R., & Westerdahl, E. (2015). Postoperative inspiratory muscle training in addition to breathing exercises and early mobilization improves oxygenation in high-risk patients after lung cancer surgery: a randomized controlled trial. European Journal of Cardio-Thoracic Surgery, 49(5), 1483-1491.
4. Cahalin, L. P., Braga, M., Matsuo, Y., & Hernandez, E. D. (2002). Efficacy of diaphragmatic breathing in persons with chronic obstructive pulmonary disease: a review of the literature. Journal of Cardiopulmonary Rehabilitation and Prevention, 22(1), 7-21.
5. Cancelliero-Gaiad, K. M., Ike, D., Pantoni, C. B., Borghi-Silva, A., & Costa, D. (2014). Respiratory pattern of diaphragmatic breathing and pilates breathing in COPD subjects. Brazilian journal of physical therapy, 18, 291-299.
6. Cao W, Chen HD, Yu YW, Li N, Chen WQ. Changing profiles of cancer burden worldwide and in China: a secondary analysis of the global cancer statistics 2020. Chin Med J (Engl) (2021);134:783–791.
7. Cavaggioni, L., Ongaro, L., Zannin, E., Iaia, F. M., & Alberti, G. (2015). Effects of different core exercises on respiratory parameters and abdominal strength. Journal of physical therapy science, 27(10), 3249-3253.
8. Chatreewatanakul, B., Othaganont, P., & Hickman, R. L. (2022). Early symptom recognition and symptom management among exacerbation COPD patients: A qualitative study. Applied Nursing Research, 63, 151522.
9. Chatwin, M., Toussaint, M., Gonçalves, M. R., Sheers, N., Mellies, U., Gonzales-Bermejo, J., ... & Morrow, B. M. (2018). Airway clearance techniques in neuromuscular disorders: a state of the art review. Respiratory medicine, 136, 98-110.
10. CliftonSmith, T., & Rowley, J. (2011). Breathing pattern disorders and physiotherapy: inspiration for our profession. Physical therapy reviews, 16(1), 75-86.
11. De Troyer, A., and M. G. Sampson. 2007. Activation of the parasternal intercostals during breathing efforts in human subjects. J. AppL Physiol. 52:524-529.
12. Efficace F, Cartoni C, Niscola P, Tendas A, Meloni E, Scaramucci L, Soldati S, Brunetti GA, Marini MG, Mandelli F. Predicting survival in advanced hematologic malignancies: do patient-reported symptoms matter? Eur J Haematol. (2012);89:410–416.
13. Fernandes, M., Cukier, A., & Feltrim, M. I. Z. (2011). Efficacy of diaphragmatic breathing in patients with chronic obstructive pulmonary disease. Chronic respiratory disease, 8(4), 237-244.
14. Fukuda S, Nakajima K, Miyazaki Y, Takahashi T, Kurokawa Y, Yamasaki M, Miyata H, Takiguchi S, Mori M, Doki Y. Use of double-lumen peripherally inserted central catheters for safer perioperative management of esophageal cancer patients. J Vasc Access. 2015;16:338–343.
15. Garcia-Aymerich, J., Serra, I., Gomez, F. P., Farrero, E., Balcells, E., Rodriguez, D. A., ... & Anto, J. M. (2009). Physical activity and clinical and functional status in COPD. Chest, 136(1), 62-70.
16. GBD 2019 Diseases and Injuries Collaborators. Global Burden of 369 Diseases and Injuries in 204 Countries and Territories, 1990–2019: A Systematic Analysis for the Global Burden of Disease Study 2019. Lancet 2020, 396, 1204–1222.
17. Gosselink, R. (2006). Physical therapy in adults with respiratory disorders: where are we?. Brazilian Journal of Physical Therapy, 10, 361-372.
18. Hamasaki, H. (2020). Effects of diaphragmatic breathing on health: a narrative review. Medicines, 7(10), 65.
19. Hayhurst, C. (2021). The Lungs: Learning how We Breathe. The Rosen Publishing Group, Inc.
20. Hegland, K. W., Davenport, P. W., Brandimore, A. E., Singletary, F. F., & Troche, M. S. (2016). Rehabilitation of swallowing and cough functions following stroke: an expiratory muscle strength training trial. Archives of physical medicine and rehabilitation, 97(8), 1345-1351.
21. Hoy H, Lynch T, Beck M. Surgical Treatment of Lung Cancer. Crit Care Nurs Clin North Am. (2019);31:303–313.
22. Ides, K., Vissers, D., De Backer, L., Leemans, G., & De Backer, W. (2011). Airway clearance in COPD: need for a breath of fresh air? A systematic review. COPD: Journal of Chronic Obstructive Pulmonary Disease, 8(3), 196-205.
23. Jacob, A. M. (2021). Pulmonary epithelial plasma membrane rupture and barrier function disruption during airway reopening (Doctoral dissertation, Tulane University School of Science and Engineering).
24. Jafari, A., Esmaeilzadeh, F., Mowla, D., Sadatshojaei, E., Heidari, S., & Wood, D. A. (2021). New insights to direct conversion of wet microalgae impregnated with ethanol to biodiesel exploiting extraction with supercritical carbon dioxide. Fuel, 285, 119199.
25. Kang, J. I., Jeong, D. K., & Choi, H. (2020). The effects of breathing exercise types on respiratory muscle activity and body function in patients with mild chronic obstructive pulmonary disease. Journal of physical therapy science, 28(2), 500-505.
26. Ko FW, Tam W, Siu EHS, Chan KP, Ngai JC, Ng SS, Chan TO, Hui DS. Effect of short-course exercise training on the frequency of exacerbations and physical activity in patients with COPD: A randomized controlled trial. Respirology. 2021; 26:72–79.
27. Le J, Grigorian A, Chen S, Kuo IJ, Fujitani RM, Kabutey NK. Novel endovascular technique for removal of adherent PICC. J Vasc Access. 2016;17:e153–e155.
28. Li L, Xu F, Ye J. Effect of Family Participatory Nursing Model Based on WeChat Platform on Psychological Elasticity and Quality of Life of Patients with Lung Cancer. Biomed Res Int. 2022; 2022:4704107.
29. Ma, X., Yue, Z. Q., Gong, Z. Q., Zhang, H., Duan, N. Y., Shi, Y. T., ... & Li, Y. F. (2017). The effect of diaphragmatic breathing on attention, negative affect and stress in healthy adults. Frontiers in psychology, 8, 234806.
30. Mahler, D. A., Decramer, M., D'Urzo, A., Worth, H., White, T., Alagappan, V. K., ... & Banerji, D. (2014). Dual bronchodilation with QVA149 reduces patient-reported dyspnoea in COPD: the BLAZE study. European Respiratory Journal, 43(6), 1599-1609.
31. Maltais, F., Bourbeau, J., Shapiro, S., Lacasse, Y., Perrault, H., Baltzan, M., ... & Bernard, S. (2008). Effects of home-based pulmonary rehabilitation in patients with chronic obstructive pulmonary disease: a randomized trial. Annals of internal medicine, 149(12), 869-878.
32. Martarelli, D., Cocchioni, M., Scuri, S., & Pompei, P. (2011). Diaphragmatic breathing reduces exercise-induced oxidative stress. Evidence-Based Complementary and Alternative Medicine, 2011.
33. McCullagh, A., Rosenthal, M., Wanner, A., Hurtado, A., Padley, S., & Bush, A. (2020). The bronchial circulation—worth a closer look: a review of the relationship between the bronchial vasculature and airway inflammation. Pediatric pulmonology, 45(1), 1-13.
34. McDonald, V. M., Hiles, S. A., Jones, K. A., Clark, V. L., &Yorke, J. (2021). Health‐related quality of life burden in severe asthma. Medical Journal of Australia, 209(S2), S28-S33.
35. Mendes, L. P., Moraes, K. S., Hoffman, M., Vieira, D. S., Ribeiro-Samora, G. A., Lage, S. M., ... & Parreira, V. F. (2019). Effects of diaphragmatic breathing with and without pursed-lips breathing in subjects with COPD. Respiratory care, 64(2), 136-144.
36. Peters, M., Köhler, B., Kuckshinrichs, W., Leitner, W., Markewitz, P., & Müller, T. E. (2021). Chemical technologies for exploiting and recycling carbon dioxide into the value chain. ChemSusChem, 4(9), 1216-1240.
37. Prasad, B. (2020). Chronic obstructive pulmonary disease (COPD). International Journal of Pharmacy Research & Technology (IJPRT), 10(1), 67-71.
38. Reyes, A., Castillo, A., & Castillo, J. (2020). Effects of expiratory muscle training and air stacking on peak cough flow in individuals with Parkinson’s disease. Lung, 198, 207-211.
39. Saey D, Debigare R, Leblanc P, Mador MJ, Cote CH, Jobin J, Maltais F. Contractile leg fatigue after cycle exercise: a factor limiting exercise in patients with chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2003; (168): 425-30.
40. Saltnes, S. S., Storhaug, K., Borge, C. R., Enmarker, I., & Willumsen, T. (2015). Oral health-related quality-of-life and mental health in individuals with chronic obstructive pulmonary disease (COPD). Acta Odontologica Scandinavica, 73(1), 14-20.
41. Senior, R. M., &Anthonisen, N. R. (2020). Chronic obstructive pulmonary disease (COPD). American journal of respiratory and critical care medicine, 157(4), S139-S147.
42. Siafakas, N. M., Vermeire, P., Pride, N. A., Paoletti, P., Gibson, J., Howard, P., ... &Postma, D. S. (2021). Optimal assessment and management of chronic obstructive pulmonary disease (COPD). The European Respiratory Society Task Force. European Respiratory Journal, 8(8), 1398-1420.
43. Wang, Z., Wang, Z., Fang, Q., Li, H., Zhang, L., & Liu, X. (2019). Effect of expiratory muscle strength training on swallowing and cough functions in patients with neurological diseases: a meta-analysis. American Journal of Physical Medicine & Rehabilitation, 98(12), 1060-1066.
44. Westerdahl, E., Wittrin, A., Kånåhols, M., Gunnarsson, M., & Nilsagård, Y. (2016). Deep breathing exercises with positive expiratory pressure in patients with multiple sclerosis–a randomized controlled trial. The clinical respiratory journal, 10(6), 698-706.
45. Wolf, J. S., Papadimitriou, J. C., Morales, R. E., Califano III, J. A., Kline, N. L., Bhatnagar, K., ... & Taylor, R. J. (2022, March). The association of active and passive tobacco smoke exposure with chronic rhinosinusitis symptom severity: A cross‐sectional study. In International Forum of Allergy & Rhinology (Vol. 12, No. 3, pp. 278-285).
46. Zhao L, Shi P, Xiong X, Zeng J. Nonpharmacological interventions for cancer-related fatigue in lung cancer patients: A protocol for an evidence map of overview of a network meta-analysis of existing trials. Medicine (Baltimore) 2021;100:e26864.
47. Zhou T, Sun C. Effect of physical manipulation pulmonary rehabilitation on lung cancer patients after thoracoscopic lobectomy. Thorac Cancer. 2022;13:308–315.
48. https://www.healthline.com/health/copd
49. https://medlineplus.gov/ency/article/000091.htm
50. https://www.healthline.com/human-body-maps/lung
51. https://courses.lumenlearning.com/suny-ap2/chapter/the-lungs/
52. https://www.nhs.uk/conditions/spirometry/
53. https://my.clevelandclinic.org/health/diagnostics/17833-spirometry
54. https://my.clevelandclinic.org/health/articles/9445-diaphragmatic-breathing
55. Medically reviewed by Cheryl Crumpler, PhD — By Jon Johnson — Updated on February 9, 2023
56. https://www.medicalnewstoday.com/articles/diaphragmatic-breathing
57. https://my.clevelandclinic.org/health/articles/8697-coughing-controlled-coughing
58. https://www.verywellhealth.com/coughing-as-an-airway-clearance-technique-914980
Article Sidebar
Published
Dec 13, 2024
Article Details
How to Cite
Ramiza Khalid, Tooba saher, Uswa rana, Rimsha ashfaq, Sawaira nazir, Areeb Fatima, & Rabia Shahzad. (2024). COMBINED EFFECT OF DIAPHRAGMATIC BREATHING AND CONTROLLED COUGHING ON LUNG FUNCTION IN COPD PATIENTS. Journal of Population Therapeutics and Clinical Pharmacology, 31(9), 3509-3527. https://doi.org/10.53555/d1t7y361
Section
Articles
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Author Biographies
Ramiza Khalid
Lecturer, college of physical therapy, Government college university Faisalabad
Tooba saher
Physiotherapist, ghurki trust and teaching hospital Lahore
Uswa rana
Rehabilitation house officer, ghurki trust and teaching hospital Lahore
Rimsha ashfaq
Physiotherapist, ghurki trust and teaching hospital Lahore
Sawaira nazir
Physiotheapist, Al aziz health clinic Burewala
Areeb Fatima
College of physical therapy, Government college university Faisalabad
Rabia Shahzad
Visiting lecturer,Ripha international university Faisalabad
How to Cite
Ramiza Khalid, Tooba saher, Uswa rana, Rimsha ashfaq, Sawaira nazir, Areeb Fatima, & Rabia Shahzad. (2024). COMBINED EFFECT OF DIAPHRAGMATIC BREATHING AND CONTROLLED COUGHING ON LUNG FUNCTION IN COPD PATIENTS. Journal of Population Therapeutics and Clinical Pharmacology, 31(9), 3509-3527. https://doi.org/10.53555/d1t7y361