Asthma is a chronic respiratory disease that can cause breathing difficulties, reduced lung function, and poor sleep quality. Breathing exercises are increasingly used as non-pharmacological interventions to improve respiratory symptoms and overall well-being in individuals with asthma.
This study aims to compare the effects of two breathing techniques, Box Breathing and Rhythmic Breathing, on dyspnea (breathlessness), pulmonary function, and quality of sleep in patients with asthma. Participants with asthma will be randomly assigned to receive either Box Breathing or Rhythmic Breathing exercises in addition to standard care. Both interventions will be performed three times per week for eight weeks.
The primary outcomes of this study include changes in dyspnea severity, pulmonary function measured by spirometry, and sleep quality assessed using validated questionnaires. The findings of this study may help determine which breathing technique is more effective and provide evidence for incorporating structured breathing exercises into asthma management programs.
Male and female patients diagnosed with asthma.
Age between 18 and 40 years.
Patients with mild to moderate asthma who are clinically stable.
Patients able to understand and follow breathing exercise instructions.
Patients with severe or uncontrolled asthma.
Patients with acute asthma exacerbation during the study period.
Patients with other significant respiratory diseases (e.g., chronic obstructive pulmonary disease, pulmonary fibrosis).
Patients with severe cardiovascular, neurological, or musculoskeletal disorders that may interfere with participation.
Parallel
Box Breathing
BehavioralParticipants assigned to the Box Breathing intervention received a structured breathing exercise protocol following standardized baseline respiratory care. The Box Breathing technique consisted of inhalation for 4 seconds, breath holding for 4 seconds, exhalation for 4 seconds, and a second breath hold for 4 seconds (4-4-4-4 pattern). The intervention was administered for 20 minutes per session, three sessions per week, for eight weeks. Short rest periods were permitted after every 5-6 breathing cycles as needed. The intervention was performed in a quiet environment and aimed to improve respiratory control, reduce dyspnea, enhance ventilatory efficiency, and promote autonomic regulation.
Rhythmic Breathing
BehavioralParticipants assigned to the Rhythmic Breathing intervention received a structured breathing exercise protocol following standardized baseline respiratory care. The Rhythmic Breathing technique consisted of a controlled breathing pattern using a 4:6 ratio, with inhalation through the nose for 4 seconds and exhalation through the mouth for 6 seconds. The intervention was administered for 20 minutes per session, three sessions per week, for eight weeks. Short rest periods were provided every 6-7 minutes as needed. The intervention was designed to promote respiratory efficiency, improve autonomic balance, reduce dyspnea, and enhance pulmonary function and sleep quality.
Dyspnea Severity
Dyspnea severity will be assessed using the Modified Borg Scale, a numerical rating scale ranging from 0 to 10, where higher scores indicate greater perceived breathlessness.
Pulmonary Function (Forced Expiratory Volume in 1 Second [FEV₁])
Pulmonary function will be assessed using spirometry. Forced Expiratory Volume in 1 second (FEV₁) will be used to evaluate changes in lung function following the intervention.
Sleep Quality
Sleep quality will be assessed using the Pittsburgh Sleep Quality Index (PSQI), a validated questionnaire measuring subjective sleep quality over the previous month. Lower scores indicate better sleep quality.
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