Diaphragmatic breathing Exercise in adult Asthmatic patients

Background: Short period exercise used for strengthening the diaphragm has been observed to improve exercise capacity and asthma symptoms and decreasing frequency of asthma exacerbation and hospital admission. Objective: To evaluate the impact of diaphragmatic breathing exercise on asthmatic patients. Methodology: An interventional study was conducted on 60 asthmatics patients. Measurements of ventilatory-function tests (VC%, FVC%, FEV1%, FEV1/FVC ratio, FEF25-57% and MVV%) and ultrasound assessment of diaphragmatic excursion and thickness were done before and after 12 weeks of diaphragmatic breathing exercise. Recording of diaphragm surface electromyography was done after maximum voluntary ventilation(MVV) maneuver. Result: In total asthma group, the ventilatory-function indices values were significantly increased after diaphragmatic breathing exercise compared to baseline values (p<0.05), the uncontrolled asthmatics showed the highest increase followed by partially controlled and lastly controlled asthmatics (p p<0.05). The ultrasound diaphragmatic excursion during (normal, deep and sniffing) breathing and the diaphragmatic thickness at end inspiration and end expiration values were significantly increased after diaphragmatic breathing exercise in total asthma group compared to baseline values (p<0.05), the uncontrolled asthmatics showed the highest significant increase of diaphragmatic excursion during either normal or deep breathing and the diaphragmatic thickness at end expiration followed by partially controlled and lastly controlled asthmatics (p<0.05). After MVV maneuver, there was a significant decrease of diaphragm surface electromyography value in total asthma group compared to baseline values (p<0.05), the uncontrolled asthmatics showed the greatest significant decrease followed by partially controlled subgroup and lastly controlled subgroup (p-p<0.05). The delta changes of FEV1%, FEV1/FVC ratio, FEF 25-57%, and MVV% were positively correlated with delta changes of diaphragmatic excursion during either normal or deep breathing and diaphragmatic thickness at end expiration (p<0.05). Conclusion: Diaphragm breathing exercise has favorable impacts in asthmatic patients at any asthma control level, improving ventilatory-function indices and diaphragmatic functions.