Effect of Dynamic Neuromuscular Stabilization Breathing Exercises on Respiratory Function of Sedentary Students with Poor Posture

Document Type : Original Research

Authors
1 Department of Sports Injuries & Corrective Exercises, Faculty of Sport Sciences, University of Isfahan, Isfahan, Iran
2 Department of Exercise Physiology, Faculty of Sports Sciences, Ferdowsi University of Mashhad, Mashhad, Iran
3 “Department of Physical Therapy, School of Paramedical Sciences” and “Orthopedic Research Center”, Mashhad University of Medical Sciences, Mashhad, Iran
Abstract
Aims: Dynamic neuromuscular stabilization approach, as functional mechanisms, evaluate and activate the local spinal stabilizers to optimize the performance of posture and respiratory for both prevention and rehabilitation. But the outcomes of this approach remain unclear. So the aim of this study was to evaluate the change in respiratory function in response to DNS breathing exercises in sedentary students with poor posture.

Materials & Methods: This experimental study was carried out on 26 poor posture sedentary male students that were selected by purposive sampling method. First, a pretest of the respiratory function including Maximum voluntary ventilation (MVV), Forced expiratory volume in first second (FEV1), Forced vital capacity (FVC), and FEV1/FVC ratio were done for each participant. DNS breathing exercise protocol was trained for 6 weeks (6 sessions per a week) and after completion of training, post-test was performed from all parameters. The statistical analysis was performed by SPSS 16 software and paired-sample T test.

Findings: After 6 weeks, significant improvements were observed compared to baseline in spirometry parameters including MVV, FEV1, FVC, and FEV1/FVC ratio (p<0.001).

Conclusion: DNS breathing exercise is an effective protocol to improve respiratory function.

Keywords

Subjects


  1. 1. Novotná B, Slováková M. The current problem of school children-lack of physical activity. Eur Res Ser A. 2016;(4):231–8.
    2. Latalski M, Bylina J, Fatyga M, Repko M, Filipovic M, Jarosz MJ, et al. Risk factors of postural defects in children at school age. Ann Agric Environ Med. 2013;20(3).
    3. Szczygieł E, Blaut J, Zielonka-Pycka K, Tomaszewski K, Golec J, Czechowska D, et al. The Impact of Deep Muscle Training on the Quality of Posture and Breathing. J Mot Behav. 2017;1–9.
    4. Pawlicka-Lisowska A, Motylewski S, Lisowski J, Michalak K, Poziomska-Piatkowska E. Faulty posture and selected respiratory indicators. Pol Merkur Lek Organ Pol Tow Lek. 2013;35(206):67–71.
    5. Dajah S Al, Muthusamy H. Effects of back and respiratory muscle exercises on posture and respiratory function in elderly patients with osteoporosis. Int J Ther Rehabil. 2015 May 2;22(5):233–7.
    6. Bradley H, Esformes JD. Breathing pattern disorders and functional movement. Int J Sports Phys Ther. 2014;9(1):28.
    7. Dimitriadis Z, Kapreli E, Strimpakos N, therapy JO-M, 2013 undefined. Respiratory weakness in patients with chronic neck pain. Elsevier.
    8. O’Sullivan PB, Dankaerts W, Burnett AF, Farrell GT, Jefford E, Naylor CS, et al. Effect of different upright sitting postures on spinal-pelvic curvature and trunk muscle activation in a pain-free population. Spine (Phila Pa 1976). 2006;31(19):E707–12.
    9. De Troyer A, Wilson TA. Mechanism of the increased rib cage expansion produced by the diaphragm with abdominal support. J Appl Physiol. 2015;118(8):989–95.
    10. Page P, Frank C, Lardner R. Assessment and treatment of muscle imbalance: the Janda approach. Human kinetics; 2010.
    11. Hodges PW, Heijnen I, Gandevia SC. Postural activity of the diaphragm is reduced in humans when respiratory demand increases. J Physiol. 2001;537(3):999–1008.
    12. Kolar P, Sulc J, Kyncl M, Sanda J, Neuwirth J, Bokarius A V, et al. Stabilizing function of the diaphragm: dynamic MRI and synchronized spirometric assessment. J Appl Physiol. 2010;109(4):1064–71.
    13. Oh D-S, Park S-E. The effect of lumbar stabilization exercise on the pulmonary function of stroke patients. J Phys Ther Sci. 2016;28(6):1896–900.
    14. Lewit K. Relation of faulty respiration to posture, with clinical implications. J Am Osteopath Assoc. 1980;79(8):525–9.
    15. Bendíková E, Görner K, Paugshová B. Exercise programme for schoolgirl with poor posture. J Educ Heal Sport. 2016;6(13):54–64.
    16. Canales JZ, Fiquer JT, Campos RN, Soeiro-de-Souza MG, Moreno RA. Investigation of associations between recurrence of major depressive disorder and spinal posture alignment: A quantitative cross-sectional study. Gait Posture. 2017;52:258–64.
    17. Kiesel K, Rhodes T, Mueller J, Waninger A, Butler R. Development of a screening protocol to identify individuals with dysfunctional breathing. Int J Sports Phys Ther. 2017;12(5):774.
    18. Negahban H, Mostafaee N, Sohani SM, Mazaheri M, Goharpey S, Salavati M, et al. Reliability and validity of the Tegner and Marx activity rating scales in Iranian patients with anterior cruciate ligament injury. Disabil Rehabil. 2011;33(22–23):2305–10.
    19. Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, et al. Standardisation of spirometry. Eur Respir J. 2005;26(2):319–38.
    20. Kolar P, Kobesova A. Postural–locomotion function in the diagnosis and treatment of movement disorders. Clin Chiropr. 2010;1(13):58–68.
    21. Lim YL, Lepsikova M, Singh DKA. Effects of Dynamic Neuromuscular Stabilization on Lumbar Flexion Kinematics and Posture Among Adults with Chronic Non-specific Low Back Pain: A Study Protocol. In: Regional Conference on Science, Technology and Social Sciences (RCSTSS 2016). Springer; 2018. p. 715–24.
    22. Frank C, Kobesova A, Kolar P. Dynamic neuromuscular stabilization & sports rehabilitation. Int J Sports Phys Ther. 2013;8(1):62.
    23. Kobesova A, Kolar P. Developmental kinesiology: three levels of motor control in the assessment and treatment of the motor system. J Bodyw Mov Ther. 2014;18(1):23–33.
    24. Kobesova A, Dzvonik J, Kolar P, Sardina A, Andel R. Effects of shoulder girdle dynamic stabilization exercise on hand muscle strength. Isokinet Exerc Sci. 2015;23(1):21–32.
    25. Gupta M, Jain S, Sharma VK-PR, 2016 undefined. Effect of Raja Yoga Meditation on Pulmonary Functions of Young Obese Medical Students. researchgate.net.
    26. Husted JA, Cook RJ, Farewell VT, Gladman DD. Methods for assessing responsiveness: a critical review and recommendations. J Clin Epidemiol. 2000;53(5):459–68.
    27. Shirley D, Hodges PW, Eriksson AEM, Gandevia SC. Spinal stiffness changes throughout the respiratory cycle. J Appl Physiol. 2003;95(4):1467–75.
    28. Bezzoli E, Andreotti D, Pianta L, Mascheroni M, Piccinno L, Puricelli L, et al. Motor control exercises of the lumbar-pelvic region improve respiratory function in obese men. A pilot study. Disabil Rehabil. 2016;1–7.
    29. Lakhera S, Mathew L, … SR-I journal of, 1984 undefined. Pulmonary function of Indian athletes and sportsmen: comparison with American athletes. europepmc.org.
    30. Cohen J. Statistical power analysis for the behavioural sciences. Hillsdale, NJ: erlbaum; 1988.
    31. Dinesh T, … MR-NJ of, 2018 undefined. Effect of 12 weeks of slow breathing exercise practice on anthropometric parameters in healthy volunteers. search.proquest.com.
    32. Attarzadeh Hosseini SR, Hojati Oshtovani Z, Soltani H HKS. Changes in Pulmonary Function and Peak Oxygen Consumption in Response to Interval Aerobic Training in Sedentary Girls. Q J Sabzevar Univ Med Sci. 2012;19(1):42–51.
    33. Sivakumar G, Prabhu K, Baliga R, … MP-IJP, 2011 undefined. Acute effects of deep breathing for a short duration (2-10 minutes) on pulmonary functions in healthy young volunteers. ijpp.com.
    34. Malatova R, Dřevikovská P. Testing procedures for abdominal muscles using the muscle dynamometer SD02. Proc Inst Mech Eng Part H J Eng Med. 2009;223(8):1041–8.
    35. Joshi L, Joshi V, (2) LG-IJPP 1992; 36, 1992 undefined. Effect of short term pranayam, practice of breathing rate, & ventilatory functions of lung. ijpp.com.
    36. Obayashi H, Urabe Y, Yamanaka Y, Okuma R. Effects of respiratory-muscle exercise on spinal curvature. J Sport Rehabil. 2012;21(1):63–8.
    37. De Troyer A, Boriek AM. Mechanics of the respiratory muscles. Compr Physiol. 2011;
    38. Kondam A, Chandrasekhar M, … PP-NJ of, 2015 undefined. Combined effects of pranayama and suryanamaskar on dynamic spirometric values in normal young subjects. search.proquest.com.
    39. Medical DK-IJ of R in, 2018 U. Role of regular yoga practice in improvement of various pulmonary parameters in first year medical students. pdfs.semanticscholar.org.
    40. Shumway-Cook A, Woollacott M. Motor control: translating research into clinical practice. 2007.
  2. Novotná B, Slováková M. The current problem of school children-lack of physical activity. Eur Res Ser A. 2016;105(4):231-8. [Link] [DOI:10.13187/er.2016.105.231]
  3. Latalski M, Bylina J, Fatyga M, Repko M, Filipovic M, Jarosz MJ, et al. Risk factors of postural defects in children at school age. Ann Agric Environ Med. 2013;20(3):583-7. [Link]
  4. Szczygieł E, Blaut J, Zielonka-Pycka K, Tomaszewski K, Golec J, Czechowska D, et al. The impact of deep muscle training on the quality of posture and breathing. J Mot Behav. 2018;50(2):219-27. [Link] [DOI:10.1080/00222895.2017.1327413]
  5. Pawlicka-Lisowska A, Motylewski S, Lisowski J, Michalak K, Poziomska-Piatkowska E. Faulty posture and selected respiratory indicators. Pol Merkur Lekarski. 2013;35(206):67-71. [Polish] [Link]
  6. Dajah S Al, Muthusamy H. Effects of back and respiratory muscle exercises on posture and respiratory function in elderly patients with osteoporosis. Int J Ther Rehabil. 2015;22(5):233-7. [Link] [DOI:10.12968/ijtr.2015.22.5.233]
  7. Bradley H, Esformes J. Breathing pattern disorders and functional movement. Int J Sports Phys Ther. 2014;9(1):28-39. [Link]
  8. Dimitriadis Z, Kapreli E, Strimpakos N, Oldham J. Respiratory weakness in patients with chronic neck pain. Man Ther. 2013;18(3):248-53. [Link] [DOI:10.1016/j.math.2012.10.014]
  9. O'Sullivan PB, Dankaerts W, Burnett AF, Farrell GT, Jefford E, Naylor CS, et al. Effect of different upright sitting postures on spinal-pelvic curvature and trunk muscle activation in a pain-free population. Spine (Phila Pa 1976). 2006;31(19):E707-12. [Link] [DOI:10.1097/01.brs.0000234735.98075.50]
  10. De Troyer A, Wilson TA. Mechanism of the increased rib cage expansion produced by the diaphragm with abdominal support. J Appl Physiol. 2015;118(8):989-95. [Link] [DOI:10.1152/japplphysiol.00016.2015]
  11. Page P, Frank C, Lardner R. Assessment and treatment of muscle imbalance: the Janda approach. Windsor, ON: Human Kinetics; 2010. [Link]
  12. Hodges PW, Heijnen I, Gandevia SC. Postural activity of the diaphragm is reduced in humans when respiratory demand increases. J Physiol. 2001;537(Pt 3):999-1008. [Link] [DOI:10.1113/jphysiol.2001.012648]
  13. Kolar P, Sulc J, Kyncl M, Sanda J, Neuwirth J, Bokarius AV, et al. Stabilizing function of the diaphragm: dynamic MRI and synchronized spirometric assessment. J Appl Physiol. 2010;109(4):1064-71. [Link] [DOI:10.1152/japplphysiol.01216.2009]
  14. Oh DS, Park SE. The effect of lumbar stabilization exercise on the pulmonary function of stroke patients. J Phys Ther Sci. 2016;28(6):1896-900. [Link] [DOI:10.1589/jpts.28.1896]
  15. Lewit K. Relation of faulty respiration to posture, with clinical implications. J Am Osteopath Assoc. 1980;79(8):525-9. [Link]
  16. Bendíková E, Görner K, Paugshová B. Exercise programme for schoolgirl with poor posture. J Educ Health Sport. 2016;6(13):54-64. [Link]
  17. Canales JZ, Fiquer JT, Campos RN, Soeiro-de-Souza MG, Moreno RA. Investigation of associations between recurrence of major depressive disorder and spinal posture alignment: a quantitative cross-sectional study. Gait Posture. 2017;52:258-64. [Link] [DOI:10.1016/j.gaitpost.2016.12.011]
  18. Kiesel K, Rhodes T, Mueller J, Waninger A, Butler R. Development of a screening protocol to identify individuals with dysfunctional breathing. Int J Sports Phys Ther. 2017;12(5):774-86. [Link] [DOI:10.26603/ijspt20170774]
  19. Negahban H, Mostafaee N, Sohani SM, Mazaheri M, Goharpey S, Salavati M, et al. Reliability and validity of the Tegner and Marx activity rating scales in Iranian patients with anterior cruciate ligament injury. Disabil Rehabil. 2011;33(23-24):2305-10. [Link] [DOI:10.3109/09638288.2011.570409]
  20. Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, et al. Standardisation of spirometry. Eur Respir J. 2005;26(2):319-38. [Link] [DOI:10.1183/09031936.05.00034805]
  21. Kolar P, Kobesova A. Postural-locomotion function in the diagnosis and treatment of movement disorders. Clin Chiropract. 2010;13(1):58-68. [Link] [DOI:10.1016/j.clch.2010.02.063]
  22. Lim YL, Lepsikova M, Singh DKA. Effects of dynamic neuromuscular stabilization on lumbar flexion kinematics and posture among adults with chronic non-specific low back pain: a study protocol. In: Mohamad Noor MY, Ahmad BE, Ismail MR, Hashim H, Abdullah Baharum MA, editors. Proceedings of the Regional Conference on Science, Technology and Social Sciences (RCSTSS 2016); 2018 May 26, University Technology MARA Pahang, Malaysia. Singapore: Springer; 2018. p. 715-24. [Link] [DOI:10.1007/978-981-13-0074-5_69]
  23. Frank C, Kobesova A, Kolar P. Dynamic neuromuscular stabilization & sports rehabilitation. Int J Sports Phys Ther. 2013;8(1):62-73. [Link]
  24. Kobesova A, Kolar P. Developmental kinesiology: three levels of motor control in the assessment and treatment of the motor system. J Bodyw Mov Ther. 2014;18(1):23-33. [Link] [DOI:10.1016/j.jbmt.2013.04.002]
  25. Kobesova A, Dzvonik J, Kolar P, Sardina A, Andel R. Effects of shoulder girdle dynamic stabilization exercise on hand muscle strength. Isokinet Exerc Sci. 2015;23(1):21-32. [Link] [DOI:10.3233/IES-140560]
  26. Gupta M, Jain S, Kumar V. Effect of Raja Yoga meditation on pulmonary functions of young obese medical students. Indian J Public Health Res Dev. 2016;7(2):1-4. [Link] [DOI:10.5958/0976-5506.2016.00054.1]
  27. Husted JA, Cook RJ, Farewell VT, Gladman DD. Methods for assessing responsiveness: a critical review and recommendations. J Clin Epidemiol. 2000;53(5):459-68. [Link] [DOI:10.1016/S0895-4356(99)00206-1]
  28. Shirley D, Hodges PW, Eriksson AE, Gandevia SC. Spinal stiffness changes throughout the respiratory cycle. J Appl Physiol. 2003;95(4):1467-75. [Link] [DOI:10.1152/japplphysiol.00939.2002]
  29. Bezzoli E, Andreotti D, Pianta L, Mascheroni M, Piccinno L, Puricelli L, et al. Motor control exercises of the lumbar-pelvic region improve respiratory function in obese men. A pilot study. Disabil Rehabil. 2018;40(2):152-8. [Link] [DOI:10.1080/09638288.2016.1244292]
  30. Lakhera SC, Mathew L, Rastogi SK, Sen Gupta J. Pulmonary function of Indian athletes and sportsmen: comparison with American athletes. Indian J Physiol Pharmacol. 1984;28(3):187-94. [Link]
  31. Cohen J. Statistical power analysis for the behavioral sciences. 2nd Edition. Hillsdale, N.J: Erlbaum Associates; 1988. [Link]
  32. Dinesh T, Rajajeyakumar M, Sakila S. Effect of 12 weeks of slow breathing exercise practice on anthropometric parameters in healthy volunteers. Natl J Physiol Pharm Pharmacol. 2018;8(12):1650-3. [Link] [DOI:10.5455/njppp.2018.8.0620502102018]
  33. Attarzadeh Hosseini SR, Hojjati Oshtovani Z, Soltani H, Hosseini Kakhak SAR. Changes in pulmonary function and peak oxygen consumption in response to interval aerobic training in sedentary girls. J Sabzevar Univ Med Sci. 2012;19(1):42-51. [Persian] [Link]
  34. Sivakumar G, Prabhu K, Baliga R, Pai MK, Manjunatha S. Acute effects of deep breathing for a short duration (2-10 minutes) on pulmonary functions in healthy young volunteers. Indian J Physiol Pharmacol. 2011;55(2):154-9. [Link]
  35. Malatova R, Dřevikovská P. Testing procedures for abdominal muscles using the muscle dynamometer SD02. Proc Inst Mech Eng H. 2009;223(8):1041-8. [Link] [DOI:10.1243/09544119JEIM575]
  36. Joshi LN, Joshi VD, Gokhale LV. Effect of short term 'Pranayam' practice on breathing rate and ventilatory functions of lung. Indian J Physiol Pharmacol. 1992;36(2):105-8. [Link]
  37. Obayashi H, Urabe Y, Yamanaka Y, Okuma R. Effects of respiratory-muscle exercise on spinal curvature. J Sport Rehabil. 2012;21(1):63-8. [Link] [DOI:10.1123/jsr.21.1.63]
  38. De Troyer A, Boriek AM. Mechanics of the respiratory muscles. Compr Physiol. 2011;1(3):1273-300. [Link] [DOI:10.1002/cphy.c100009]
  39. Kondam A, Chandrasekhar M, Punita P, Varadharaju B, Suresh M, Karthik S. Combined effects of pranayama and suryanamaskar on dynamic spirometric values in normal young subject. Natl J Physiol Pharm Pharmacol. 2015;5(2):79-84. [Link] [DOI:10.5455/njppp.2015.5.020920141]
  40. Kumar K, Kumar D, Pandey PT, Divya R. Role of regular yoga practice in improvement of various pulmonary parameters in first year medical students. Int J Res Med Sci. 2018;6(7):2523-7. [Link] [DOI:10.18203/2320-6012.ijrms20182848]
  41. Shumway-Cook A, Woollacott MH. Motor control: translating research into clinical practice. 3rd Edition. Philadelphia: Lippincott Williams & Wilkins; 2007. [Link]