Additional Effects of Box Breathing Technique With Short Term Pulmonary Rehabilitation on Dyspnea and Functional Capacity in Patients With Chronic Obstructive Pulmonary Disease

Chronic Obstructive Pulmonary Disease is progressive and irreversible respiratory condition characterized by persistent airflow limitation leading to dyspnea and reduced functional capacity.

Pulmonary rehabilitation along with different technqiues of breathing exercises reduces dyspnea and enhance functional capacity by improving ventilatory efficiency, respiratory muscle control and overall exercise tolerance in patients with COPD.

Study Overview

• Status: Recruiting
• Conditions: Pulmonary Disease, Chronic Obstructive (COPD)
• Intervention / Treatment: Other: Short term Pulmonary Rehabilitation; Other: Box breathing with short term pulmonary rehabilitation

Detailed Description

Chronic Obstructive pulmonary Disease is a progressive and irreversible respiratory condition characterized by persistent airflow limitation leading to dyspnea and reduced functional capacity.

Pulmonary Rehabilitation, a cornerstone in COPD management helps to reduce dyspnea and improve functional capacity. Although long-term PR programs yield sustained benefits, shorter-duration PR (e.g., 3-week interventions) may offer greater feasibility and higher patient adherence.

Total 40 participants will be allocated into two groups. Group A will be provided with short term Pulmonary rehabilitation along with pharmacological management and group B will be given additional Box breathing along with short term pulmonary rehabilitation The objective of this study is to determine the additional effects of Box breathing technique with short term pulmonary rehabilitation versus short term pulmonary rehabilitation alone on Dyspnea, Functional capacity and quality of life in patients with chronic obstructive pulmonary disease.

• Study Type: Interventional
• Enrollment (Estimated): 40
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Fanila Tamdeen, MSPT-CPT; Phone Number: +923185085604; Email: fanilatamdeen69@gmail.com
• Study Contact Backup: Name: Zara Khalid, PhD; Phone Number: +92333-5415822; Email: zara.khalid@fui.edu.pk

Study Locations

• Pakistan
  • Islamabad, Pakistan
    • Recruiting
    • Foundation University Islamabad
    • Contact: Zara Khalid, PhD; Phone Number: +92333-5415822; Email: zara.khalid@fui.edu.pk

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Age between 40-65 years
• Both genders (male and female)
• Grade 1-3 on mMRC scale of dyspnea
• COPD mild stage according to global initiative for chronic obstructive lung -disease (GOLD) classification; Mild = FEV1 greater than or equal to 80% predicted

Exclusion Criteria:

• Patients having acute exerbation of COPD
• Patients diagnosed with acute infection (pmeumonia, T.B)
• Any orthopedic or neuromuscular condition that hinders participation in exercise training program
• Patients unable to follow command and instructions

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Short term pulmonary rehabilitation; Patients in this group will receive Short term pulmonary rehabilitation along with pharmacological management. Two sessions per week, supervised by physiotherapist will be conducted for a total of 3 weeks.	Other: Short term Pulmonary Rehabilitation; Patients in this group will receive short term pulmonary rehabilitation along with pharmacological management. A total of 3 weeks protocol will be followed in which 2 seesions per week will be supervised by physiotherapist. Short term pulmonary rehabilitation includes: Warm-up(5-7min): light walking Aerobic training: mild-moderate intensity (40-60% of MHR) cycling or walk on treadmill/over ground Strength training: Exercises for major muscle groups (upper limb, lower limb and trunk) using body weight based on 1RM. Upper limb: upright row, shoulder press, bicep curls Lower limb: sit-to-stand, mini knee lifts, 3 steps calf raises Core: Seated abdominal contraction, back extension Perform 1-2 sets of 5-10 repetitions for each exercise, resting 1-2 mins between sets. Breathing exercise: pursed-lip breathing (1-3 sets of 5-10 reps) Cool down: (5-10min) Pharmacological management: Patient will receive medications as per prescribed by pulmonologist
Experimental: Box breathing with short term pulmonary rehabilitation; Patients in this group will receive Box breathing as well as short term pulmonary rehabilitation along with pharmacological management. Two sessions per weeek, supervised by physiotherapist will be conducted for a total of 3 weeks. In Group B, box breathing will be performed daily. A home diary will be provided in order to ensure and follow-up that the participants are performing breathing exercise at home.	Other: Box breathing with short term pulmonary rehabilitation; Patients in this group will receive box breathing with short term pulmonary rehabilitation along with pharmacological management. A total 3 weeks protocol will be followed in which 2 sessions per week will be supervised by physiotherapist and box breathing will be performed daily. Patient will receive short term pulmonary rehabilitation including: Warm -up (5-7 min): light walking Aerobic training: mild-moderate intensity (40-60%of MHR) cycling or walk on treadmill/over ground. Strength training: Exercises for major muscle groups (upper limb, lower limb and trunk) using body weight based on 1RM. Upper limb: upright row, shoulder press, bicep curls Lower limb: sit-to-stand, mini knee lifts, 3 steps calf raises Core: seated abdominal contractions, back extensions Perform 1-2 sets of 5-10 repetitions for each exercise resting 1-2 min between sets. Breathing exercise: pursed-lip breathing (1-3 sets of 5 -10 repetitions) Cool down: (5-10 min) Box breathing: The patient will be instructed

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Dyspnea	Evaluation will be performed using the Modified Medical Research Council (mMRC) Dyspnea Scale, a clinician-administered scale ranging from 0 to 4, where: 0 indicates breathlessness only with strenuous exercise 4 indicates severe breathlessness (too breathless to leave the house or breathless while dressing) Higher scores represent worse dyspnea severity and poorer functional status.	03 weeks

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Functional Capacity	Evaluation will be done by using 6 minute walk test	03 weeks

Collaborators and Investigators

• Sponsor: Foundation University Islamabad

Study record dates

Study Major Dates

• Study Start (Actual): February 28, 2026
• Primary Completion (Estimated): May 15, 2026
• Study Completion (Estimated): May 15, 2026

Study Registration Dates

• First Submitted: March 27, 2026
• First Submitted That Met QC Criteria: April 7, 2026
• First Posted (Actual): April 8, 2026

Study Record Updates

• Last Update Posted (Actual): April 8, 2026
• Last Update Submitted That Met QC Criteria: April 7, 2026
• Last Verified: February 1, 2026

More Information

Terms related to this study

• Keywords: COPD; functional capacity; dyspnea; Short term pulmonary rehabilitation; box breathing
• Additional Relevant MeSH Terms: Pathologic Processes; Chronic Disease; Disease Attributes; Respiratory Tract Diseases; Respiration Disorders; Lung Diseases, Obstructive; Signs and Symptoms, Respiratory; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Lung Diseases; Pulmonary Disease, Chronic Obstructive; Dyspnea
• Other Study ID Numbers: FUCP/CTR/2026/01

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No