Preliminary study: comparative effects of lung volume therapy between slow and fast deep-breathing techniques on pulmonary function, respiratory muscle strength, oxidative stress, cytokines, 6-minute walking distance, and quality of life in persons with COPD

Figures & data

Table 1 Characteristics of all the participants in the SDBT and FDBT groups

Variables	SDBT (n=15)	FDBT (n=15)	P-value
Age (years)	70.14±9.57 (51–91)	73.27±10.48 (46–84)	0.41
Sex, M:F	4:11	3:12	–
Weight (kg)	53.94±11.43 (36.2–69.2)	59.25±14.07 (36.4–81.2)	0.27
Height (m)	1.54±0.02 (1.40–1.65)	1.59±0.09 (1.40–1.70)	0.15
BMI (kg/m^2)	22.56±4.63 (16.22–30.73)	23.02±3.88 (17.63–29.27)	0.77
SBP (mmHg)	121.71±13.46 (110–132)	120.2±4.4 (100–132)	0.65
DBP (mmHg)	72.86±10.78 (56–89)	88.4±9.12 (65–98)	0.42
Bronchodilators
Seretide™ (MDI)	9	6
Berodual^® (MDI)	^Citation4	2

Notes: Data are presented as number or mean and SD (minimal and maximal value). P-value was analyzed by the independent pair t-test. The “–” indicates no statistical analysis.

Abbreviations: SDBT, slow deep-breathing technique; FDBT, fast deep-breathing technique; M, male; F, female; BMI, body mass index; SBP, systolic blood pressure; DBP, diastolic blood pressure; MDI, metered-dose inhaler.

Figure 1 Pulmonary function test: FVC (A), FEV₁ (B and C), FEV₁/FVC (D), and PI_max (E) between the SDBT (n=15) and FDBT (n=15) in the pre-experimental period (white bar) and post-experimental period (black bar).

Notes: P-value was analyzed statistically using the post hoc Bonferroni test. Each bar represents the mean and SD.

Abbreviations: PI_max, maximal inspiratory pressure; SDBT, slow deep-breathing technique; FDBT, fast deep-breathing technique.

Figure 2 Levels of TAC (A), MDA (B), NO (C), TNF-α (D), and IL-6 (E) for the SDBT (n=15) and FDBT (n=15) groups in the pre-experimental period (white bar) and post-experimental period (black bar).

Notes: P-value was analyzed statistically using the post hoc Bonferroni test. Each bar represents the mean and SD.

Abbreviations: TAC, total antioxidant capacity; MDA, malondialdehyde; NO, nitric oxide; TNF-α, tumor necrosis factor-alpha; SDBT, slow deep-breathing technique; FDBT, fast deep-breathing technique.

Figure 3 6MWD (A) and total QoL score (B) between the SDBT (n=15) and FDBT (n=15) groups in the pre-experimental period (white bar) and post-experimental period (black bar).

Notes: P-value was analyzed statistically using the post hoc Bonferroni test. Each bar represents the mean and SD.
Abbreviations: 6MWD, 6-minute walking distance; QoL, quality of life; SDBT, slow deep-breathing technique; FDBT, fast deep-breathing technique.

Table 2 Pulmonary function test and respiratory muscle strength in both groups before and after training

Parameters	SDBT (n=15)				FDBT (n=15)				P-value^#
	Before	After	P-value	d	Before	After	P-value	d
Pulmonary function
FVC (L)	2.05±0.65 (0.60–2.99)	2.17±0.78 (0.77–3.52)	0.90	0.47	2.29±0.69 (1.21–4.25)	2.50±0.70 (1.17–4.12)	0.001	1.0	0.237
FVC (%)	91.23±13.41 (71.43–113.16)	93.82±21.00 (62.25–125.25)	0.56	0.16	97.41±9.04 (82.01–115.22)	99.43±16.28 (52.00–120.12)	0.577	0.15	0.427
FEV1 (L)	1.30±0.59 (0.31–2.37)	1.41±0.56 (0.51–2.36)	0.18	0.74	1.56±0.59 (0.73–3.38)	1.81±0.64 (0.77–3.43)	0.000	1.15	0.090
FEV1 (%)	62.00±11.92 (50.00–79.21)	62.84±10.73 (51.16–79.23)	0.63	0.13	68.02±6.62 (56.34–79.50)	71.62±7.02 (61.23–84.00)	0.000	1.39	0.017
FEV1/FVC (%)	66.38±3.94 (59.56–70.00)	66.96±6.94 (56.49–78.45)	0.71	0.10	67.48±2.68 (62.00–70.00)	70.68±4.71 (62.00–83.25)	0.036	0.59	0.108
PImax (cmH2O)	63.35±24.21 (25–102)	69.78±21.23 (39–105)	0.01	0.76	64.13±20.59 (42–124)	91.86±42.15 (64–135)	0.001	1.15	0.019

Notes: The data are mean±SD (min–max). P-value and d effect size value from statistical analysis were compared to those in the pre-experimental period in each group. ^#P-value from statistical analysis between the groups in the post-experimental period.

Abbreviations: SDBT, slow deep-breathing technique; FDBT, fast deep-breathing technique; PI_max, maximal inspiratory pressure.

Notes: The data are mean±SD (min–max). P-value and d effect size value from statistical analysis were compared to those in the pre-experimental period in each group. ^#P-value from statistical analysis between the two groups in the post-experimental period.

Abbreviations: TAC, total antioxidant capacity; GSH, glutathione; MDA, malondialdehyde; NO, nitric oxide; TNF-α, tumor necrosis factor-alpha; SDBT, slow deep-breathing technique; FDBT, fast deep-breathing technique.

Table 3 Oxidative stress markers (TAC, GSH, MDA, and NO) and cytokine markers (TNF-α and IL-6) in both groups before and after the experimental period

Parameters	SDBT (n=15)				FDBT (n=15)				P-value#
	Before	After	P-value	d	Before	After	P-value	d
Oxidative stress marker
TAC (mmol Trolx/L)	1.10±0.04 (1.04–1.17)	1.16±0.07 (1.00–1.25)	0.002	0.99	1.10±0.06 (1.00–1.24)	1.18±0.06 (1.10–1.31)	0.000	1.91	0.237
GSH (mg/dL)	62.79±7.98 (50.66–82.21)	59.84±11.61 (48.30–80.50)	0.215	0.35	64.41±3.61 (58.37–68.92)	61.33±10.42 (40.61–73.37)	0.250	0.36	0.719
MDA (µmol/L)	7.24±3.49 (2.99–14.96)	5.92±2.92 (2.40–13.09)	0.206	0.36	7.47±2.11 (5.11–12.34)	5.46±1.52 (3.00–7.68)	0.005	0.85	0.602
NO (µmol/L)	5.94±5.00 (2.20–20.35)	4.16±1.85 (2.33–7.97)	0.084	0.50	5.90±2.95 (3.00–14.20)	4.02±2.12 (1.50–8.01)	0.005	2.60	0.845
Cytokine marker
TNF-α (pg/mL)	11.95±3.70 (6.4–17.6)	10.89±3.35 (6.8–16.51)	0.059	0.55	10.95±3.46 (7.5–17.5)	6.72±1.88 (4.5–10.5)	0.000	2.01	0.001
IL-6 (pg/mL)	8.71±3.98 (3.4–15.4)	7.68±3.24 (3.5–13.5)	0.024	0.68	9.62±3.63 (4.2–15.6)	5.09±2.17 (2.6–8.5)	0.000	2.08	0.017

Notes: The data are mean±SD (min–max). P-value and d effect size value from statistical analysis were compared to those in the pre-experimental period in each group.

# P-value from statistical analysis between the two groups in the post-experimental period.

Abbreviations: TAC, total antioxidant capacity; GSH, glutathione; MDA, malondialdehyde; NO, nitric oxide; TNF-α, tumor necrosis factor-alpha; SDBT, slow deep-breathing technique; FDBT, fast deep-breathing technique.

Table 4 6MWD and QoL in both groups before and after the experimental period

Parameter	SDBT (n=15)				FDBT (n=15)				P-value^#
	Before	After	P-value	d	Before	After	P-value	d
6MWD (m)	303.14±121.01 (110–495)	324.50±108.66 (121–523)	0.034	0.63	307.87±70.41 (132–441)	362.00±67.58 (213–491)	0.000	1.87	0.269
QoL
Total score	1.41±0.91 (0.20–2.80)	0.99±0.69 (0.00–2.20)	0.003	0.97	0.99±0.75 (0.00–2.75)	0.43±0.54 (0.00–1.50)	0.001	1.10	0.021
Symptom	2.27±1.34 (0.50–4.25)	1.74±1.13 (0.00–3.75)	0.028	0.66	1.72±1.15 (0.00–4.35)	0.75±0.94 (0.00–2.25)	0.001	1.07	0.017
Mental	0.43±0.55 (0.00–1.50)	0.46±0.66 (0.00–2.00)	0.836	0.06	0.40±0.60 (0.00–2.00)	0.07±0.26 (0.00–1.00)	0.045	1.13	0.052
Function	1.04±1.13 (0.00–3.50)	0.80±0.89 (0.00–2.50)	0.240	0.32	0.91±0.65 (0.00–2.75)	0.18±0.38 (0.00–1.00)	0.026	0.62	0.08

Notes: The data are mean±SD (min–max). P-value and d effect size value from statistical analysis were compared to those in the pre-experimental period in each group. ^#P-value from statistical analysis between the two groups in the post-experimental period.

Abbreviations: 6MWD, 6-minute walking distance; QoL, quality of life; SDBT, slow deep-breathing technique; FDBT, fast deep-breathing technique.

AhmadAShameemMHusainQAltered oxidant-antioxidant levels in the disease prognosis of chronic obstructive pulmonary diseaseInt J Tuberc Lung Dis20131781104110923827037

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