Asthma Clinical Trial
Official title:
The Effects of Core Stabilization Training on Dynamic Balance and Pulmonary Parameters Among Patients With Asthma: A Randomized Controlled Trial
Objective: To investigate the effectiveness of core stabilization exercises combined with the
patient education program (AEP) and breathing exercises in patients with asthma.
Design: A randomized controlled study Setting: Chest diseases clinic of a university
hospital. Subjects: The study sample consists of 26-68 years old asthma patients who were
diagnosed at least 6 month prior to the study.
Interventions: All subjects were included in the asthma education program (AEP) and both
groups were trained for diaphragmatic and pursed lip breathing exercises (2times/wk. 6-week
duration at clinic). The core stabilization program was applied twice a week for a duration
of 6 weeks in TG.
Main Measures: Spirometry, maximum inspiratory pressure (MIP) and maximum expiratory pressure
(MEP), International Physical Activity Questionnaire Short Form (IPAQ), Hospital Anxiety and
Depression Scale(HADS), Asthma Quality of Life Questionnaire(AQOL), Six-minute walking
test(6MWT), Prokin PK200, Italy were used to evaluate feasibility of interventions.
All volunteers received an asthma education program (AEP) and trained for diaphragmatic and
pursed lip breathing exercises. Additionally, the TG participated in the core stabilization
exercises program combined with AEP and breathing exercises. Data were collected from all the
patients at baseline and post interventions (6 week) by the same physiotherapist who also
supervised the exercise sessions.
All subjects were included in the asthma education program (AEP). AEP was performed at least
once for approximately 20 minutes via face to face interviews. Education topics covered
description of asthma, physiological changes of lungs, risk factors, treatment methods,
relaxation positions to reduce dyspnea and usage of a specific inhaler. Breathing exercises
were comprised of instructing breathing control, diaphragmatic breathing and pursed lip
breathing exercises. Participants attended breathing exercises training for 2 days at the
clinic under the supervision of a physiotherapist and 3 days at home as a home-exercise
program. Total duration of breathing exercises lasted for 6 weeks. TG performed core
stabilization exercises combined with breathing control for 2 days/a week for the duration of
6 weeks under the supervision of a physiotherapist at the clinic. Basic knowledges on spine,
muscles of core stabilization and working principle of diaphragm and biofeedback unit (SPB)
(Chattanooga Stabilizer Pressure Biofeedback, USA) were explained before the training. The
SPB consists of an inflation pump and a cell like sphygmomanometer, which reflects body
spinal movement in terms of mmHg by changing pressure in air filled cells. The SPB was placed
under the lumbar 5th vertebra and patients attempted to maintain their core stability
performing neutral zones at the settled level of 40 mmHg pressure. Furthermore,
physiotherapist tried to improve thoracolumbar awareness by following changes from SPB and
volunteers assured a constant lumbar position during upper and lower extremity movements
combined with diaphragmatic movements. The 6 week exercise protocol emphasized core muscle
co-contraction in hook-lying position with a flat cushion between two knees to provide
integration between the pelvic floor muscles and diaphragm. Subsequently, exercises
progressed as diaphragmatic breathing, flexion of both shoulder with breathing control and
extending knees bilaterally with breathing control. Moreover, the hold time and the number of
repetitions were increased from 5 repeats x 1 set to 5 repeats x 4 sets and each session
lasted 20 minutes.
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