Comparative Effect of Pursed Lip Breathing Alone and Combined With Alternate Nostril Breathing on Pulmonary Function Test and Quality of Life in Patients in Grade I COPD Patients.

Chronic Obstructive Pulmonary Disease (COPD) is a progressive respiratory disorder characterized by airflow limitation, breathlessness, and reduced quality of life. Breathing exercises are commonly used in pulmonary rehabilitation to improve respiratory efficiency and functional capacity. Among these techniques, pursed lip breathing (PLB) helps slow expiration, reduce air trapping, and improve ventilation, while alternate nostril breathing (ANB), a yogic breathing technique, may enhance respiratory control and relaxation.

The purpose of this study is to determine the effects of pursed lip breathing alone compared with the combined effect of pursed lip breathing and alternate nostril breathing on pulmonary function and quality of life in patients with Grade I COPD. This randomized controlled trial will include approximately 40 participants diagnosed with mild COPD. The participants will be divided into two groups: one group will perform pursed lip breathing exercises, while the other group will perform a combination of pursed lip breathing and alternate nostril breathing.

Pulmonary function tests and quality of life assessments will be used as outcome measures to evaluate the effectiveness of these interventions. The study aims to determine whether combining both breathing techniques provides greater improvement in respiratory function and patient well being than pursed lip breathing alone. The findings may contribute to developing more effective physiotherapy based pulmonary rehabilitation strategies for patients with COPD.

Study Overview

• Status: Recruiting
• Conditions: COPD Grade I
• Intervention / Treatment: Other: pursed lip breathing; Other: Alternate Nostril breathing:

Detailed Description

Chronic Obstructive Pulmonary Disease (COPD) is a progressive respiratory condition characterized by persistent airflow limitation, chronic inflammation of the airways, and reduced lung function. It is commonly associated with long term exposure to harmful particles or gases, especially cigarette smoke. Patients with COPD often experience symptoms such as breathlessness, chronic cough, sputum production, and reduced exercise tolerance, which significantly affect their daily activities and overall quality of life. Pulmonary rehabilitation, particularly breathing exercises, plays an important role in the physiotherapy management of COPD.

Among the commonly used breathing techniques, pursed lip breathing is widely recommended for patients with COPD. This technique helps slow down expiration, prevents airway collapse, reduces air trapping, and improves ventilation efficiency. As a result, it may decrease dyspnea and enhance oxygen exchange. Another breathing technique, alternate nostril breathing, is a yogic breathing exercise that promotes better control of respiration, improves relaxation, and may enhance respiratory muscle coordination.

The purpose of this study is to investigate the effect of pursed lip breathing alone and in combination with alternate nostril breathing on patients with Grade I COPD. The study aims to determine whether the combined use of these breathing techniques can provide additional benefits compared to pursed lip breathing alone. By improving breathing patterns and respiratory mechanics, these interventions may help patients manage symptoms more effectively and enhance their functional capacity.

This research will follow an interventional study design in which participants will be divided into two groups. One group will receive pursed lip breathing exercises, while the second group will perform both pursed lip breathing and alternate nostril breathing. The intervention will be conducted over a specified period under proper supervision and guidance.

The findings of this study may contribute to the development of more effective physiotherapy based breathing exercise programs for patients with mild COPD and may support the integration of combined breathing techniques in pulmonary rehabilitation programs.

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

Contacts and Locations

• Study Contact: Name: Haleema Sadia Sultan, MSPT-CPT; Phone Number: 03325881596; Email: sadiaawan798@gmail.com
• Study Contact Backup: Name: Syeda Sumaira Batool, MSPT-CPT; Phone Number: 03328868680; Email: sumira.batool@fui.edu.pk

Study Locations

• Pakistan
  • Islamabad, Pakistan
    • Recruiting
    • Foundation University Islamabad
    • Contact: Syeda Sumaira Batool, MSPT-CPT; Phone Number: 03328868680; Email: sumira.batool@fui.edu.pk

Participation Criteria

Eligibility Criteria

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

Description

Inclusion Criteria:

• Patients diagnosed with Grade I COPD (FEV₁ > 80% predicted)
• Age between 40 to 65 years.
• Both male and female patients.
• Patients able to follow verbal instructions and perform breathing exercises.
• Patients willing to provide written informed consent.

Exclusion Criteria:

• History of orthopedic conditions limiting sitting or breathing exercises.
• Recent respiratory infections or COPD exacerbations within the past 4 weeks.
• Neurological or cognitive impairments.
• Recent thoracic or abdominal surgeries.
• Regular practitioners of yoga or alternate nostril breathing.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: Pursed lip breathing exercises; Participants in Group A will perform pursed lip breathing exercises. In this technique, patients are instructed to inhale slowly through the nose and then exhale slowly through pursed lips, as if blowing out a candle. The expiration phase is prolonged to help reduce air trapping and improve ventilation. The exercise will be performed under supervision for the prescribed duration and frequency during the intervention period.	Other: pursed lip breathing; Alternate Nostril Breathing (ANB): Alternate nostril breathing is a controlled breathing technique commonly used in yogic practices to regulate breathing patterns. In this method, the individual inhales through one nostril while the other is closed, then exhales through the opposite nostril in an alternating pattern. This technique promotes relaxation, improves respiratory control, and may enhance lung function.
Experimental: Pursed lip breathing with alternate nostril breathing; Participants in Group B will perform a combination of pursed lip breathing and alternate nostril breathing. Along with PLB, patients will practice alternate nostril breathing, a controlled breathing technique in which inhalation and exhalation occur alternately through one nostril at a time while the other nostril is gently closed using the fingers. This technique helps regulate breathing patterns, improve respiratory control, and promote relaxation. The exercises will be performed under supervision according to the prescribed duration and frequency during the intervention period.	Other: Alternate Nostril breathing: Alternate nostril breathing is a simple technique where you inhale through one nostril and exhale through the other in a controlled pattern. It helps calm the mind and improves lung function. This breathing exercise can be beneficial in conditions like Chronic Obstructive Pulmonary Disease. Practicing it regularly enhances relaxation and balances the body.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Pulmonary Function Test	Pulmonary function will be assessed using a calibrated spirometer to evaluate lung function parameters, including forced vital capacity (FVC), forced expiratory volume in one second (FEV₁), and FEV₁/FVC ratio. The test will be performed according to standardized guidelines, with participants instructed to perform maximal inspiration followed by a forceful and sustained expiration into the spirometer.	04 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: April 6, 2026
• First Submitted That Met QC Criteria: April 12, 2026
• First Posted (Actual): April 15, 2026

Study Record Updates

• Last Update Posted (Actual): April 15, 2026
• Last Update Submitted That Met QC Criteria: April 12, 2026
• Last Verified: April 1, 2026

More Information

Terms related to this study

• Keywords: exercise; breathing; quality of life; COPD; pulmonary functions; pursed lip breathing; chest expansion; alternate nostril breathing
• Additional Relevant MeSH Terms: Pathologic Processes; Chronic Disease; Disease Attributes; Respiratory Tract Diseases; Lung Diseases; Respiration Disorders; Lung Diseases, Obstructive; Pathological Conditions, Signs and Symptoms; Behavior; Pulmonary Disease, Chronic Obstructive; Respiratory Aspiration; Motor Activity
• Other Study ID Numbers: FUCP/CTR/2026/05

Drug and device information, study documents

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