Authors: Associate Professor Dr. Vandana, Assistant Professor Dr. Sapna Shokeen
Abstract: Background: Interstitial Lung Disease (ILD) profoundly impacts respiratory function, leading to restrictive ventilatory impairment, diminished respiratory muscle efficiency, and reduced exercise capacity. Two rehabilitative approaches, Diaphragmatic Breathing (DB) and Respiratory Muscle Stretch Gymnastics (RMSG), are commonly employed to enhance respiratory mechanics in these patients. Objective: This study aimed to critically compare the distinct effects of DB and RMSG on crucial clinical parameters, including pulmonary function, severity of dyspnea, respiratory muscle strength, and overall quality of life in individuals diagnosed with ILD. Methods: A single-blind randomized controlled trial (RCT) was conducted involving 60 ILD patients. Participants were equally and randomly allocated to one of two intervention groups: Group A (n=30) received Diaphragmatic Breathing exercises, while Group B (n=30) underwent Respiratory Muscle Stretch Gymnastics. Both interventions were delivered consistently, three times per week for a duration of eight weeks. Key outcome measures included spirometry readings (Forced Vital Capacity [FVC], Forced Expiratory Volume in 1 second [FEV1]), Maximum Inspiratory Pressure (MIP), the modified Medical Research Council (mMRC) Dyspnea Scale, and the St. George’s Respiratory Questionnaire (SGRQ). Results: Post-intervention analysis revealed significant improvements in both groups across various parameters (p<0.05). Notably, RMSG led to more substantial gains in chest expansion, demonstrating a 17.5% increase compared to 9.8% in the DB group (p<0.01), and a greater reduction in dyspnea severity (mMRC score change of 1.4 vs. 0.9). Conversely, DB exhibited superior enhancements in Maximum Inspiratory Pressure, with an average increase of 12 cmH₂O compared to 7 cmH₂O in the RMSG group. Conclusion: The findings suggest that RMSG is particularly effective in improving thoracic mobility and alleviating symptoms of dyspnea, while DB plays a more prominent role in optimizing inspiratory muscle strength. The distinct benefits observed underscore the potential for a combined rehabilitative strategy to offer synergistic and comprehensive improvements for patients with ILD.
