Effects of Breathing and Core Stabilization Exercises in Gastroesophageal Reflux Disease
The Effects of Diaphragmatic Breathing Exercises and Core Stabilization Exercises on Symptom Severity, Quality of Life, and Sleep Quality in Patients With Gastroesophageal Reflux Disease
This study is a randomized controlled trial designed to investigate the effects of diaphragmatic breathing exercises and core stabilization exercises on symptom severity, quality of life, and sleep quality in patients with gastroesophageal reflux disease (GERD).
Participants will be randomly allocated into three groups: a control group, a diaphragmatic breathing exercise group, and a combined diaphragmatic breathing and core stabilization exercise group. The intervention program will last for 8 weeks. Diaphragmatic breathing exercises will be performed 5 days per week, while core stabilization exercises will be performed 3 days per week.
Posture, body awareness, pain intensity, GERD-related symptoms, quality of life, and sleep quality will be assessed using validated measurement tools. The aim of the study is to compare the therapeutic effects of these exercise interventions on GERD-related outcomes and overall patient well-being.
Study Overview
Status
Conditions
Intervention / Treatment
Detailed Description
Participants will be randomly assigned to three groups using a computer-assisted simple randomization method: (1) control group, (2) diaphragmatic breathing exercise group, and (3) combined diaphragmatic breathing and core stabilization exercise group. No exercise intervention will be applied to the control group. The exercise programs will last 8 weeks. Core stabilization exercises will be performed 3 days per week, while diaphragmatic breathing exercises will be performed 5 days per week.
Diaphragmatic breathing exercises will be designed to facilitate conscious activation of the diaphragm and to support the function of the lower esophageal sphincter and crural diaphragm. Core stabilization exercises will target the transversus abdominis, multifidus, pelvic floor, and diaphragm muscles, aiming to optimize trunk posture, abdominal-diaphragmatic coordination, and intra-abdominal pressure regulation.
Postural assessment will be performed using the Posture Screen Lite application. Body awareness will be evaluated with the Body Awareness Questionnaire. The location of musculoskeletal pain will be assessed using a body diagram, and pain intensity will be measured with the Visual Analog Scale (VAS). Disease-related symptom severity will be assessed using the Gastroesophageal Reflux Disease Questionnaire and the PROMIS GERD Scale. Quality of life will be evaluated using the Gastroesophageal Reflux Disease Quality of Life Questionnaire (GERD-QOL). Sleep quality will be assessed with the Pittsburgh Sleep Quality Index (PSQI).
Study Type
Enrollment (Estimated)
Phase
- Not Applicable
Contacts and Locations
Study Contact
- Name: Nurcan Contarli, PhD
- Phone Number: +90 370 418 9171
- Email: nurcancontarli@karabuk.edu.tr
Participation Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Age between 18 and 65 years.
- Diagnosis of GERD by a gastroenterologist, and
- Physical ability to participate in an exercise program.
Exclusion Criteria:
- Presence of serious cardiopulmonary or neurological disorders,
- History of abdominal, thoracic, or spinal surgery within the previous 6 months,
- Presence of systemic conditions preventing participation in exercise, and
- Participation in a regular exercise program during the study period.
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Double
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
|---|---|
|
No Intervention: control group
No exercise intervention will be applied to the control group. |
|
|
Experimental: diaphragmatic breathing exercise group
Diaphragmatic breathing exercises will be performed 5 days per week. |
Diaphragmatic breathing exercises will be designed to facilitate conscious activation of the diaphragm and to support the function of the lower esophageal sphincter and crural diaphragm. |
|
Experimental: combined diaphragmatic breathing and core stabilization exercise group
The exercise programs will last 8 weeks. Core stabilization exercises will be performed 3 days per week, while diaphragmatic breathing exercises will be performed 5 days per week. |
Diaphragmatic breathing exercises will be designed to facilitate conscious activation of the diaphragm and to support the function of the lower esophageal sphincter and crural diaphragm. Core stabilization exercises will target the transversus abdominis, multifidus, pelvic floor, and diaphragm muscles, aiming to optimize trunk posture, abdominal-diaphragmatic coordination, and intra-abdominal pressure regulation. |
What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
The Gastroesophageal Reflux Disease Questionnaire (GERD-Q)
Time Frame: 1 day
|
The Gastroesophageal Reflux Disease Questionnaire (GERD-Q) is a six-item Likert-type questionnaire that assesses the frequency of GERD-related symptoms over the past week. The first four items evaluate the frequency of typical symptoms and are used for the diagnosis of the disease and monitoring response to treatment. The remaining two items assess the frequency of the disease's impact on daily life, including over-the-counter medication use and sleep disturbance. Each item is scored on a four-point scale ranging from 0 to 3 according to symptom frequency. In items 1, 2, 5, and 6, higher scores indicate increased symptom frequency, whereas in items 3 and 4, scoring is reversed, with higher symptom frequency corresponding to lower scores. |
1 day
|
|
The PROMIS GERD Scale
Time Frame: 1 day
|
The PROMIS GERD scale consists of 13 items. The questionnaire includes a total of 13 questions, each scored on a scale ranging from 0 to 4 points. The total score is obtained by summing the scores of all items. According to the scoring system of the original questionnaire, a score of 0 indicates no symptoms, scores of 1-3 indicate minimal symptoms, scores of 4-7 indicate mild symptoms, scores of 8-15 indicate moderate symptoms, and scores of 16 and above indicate severe symptoms. |
1 day
|
|
The Gastroesophageal Reflux Disease Quality of Life Questionnaire (GERD-QOL)
Time Frame: 1 day
|
The Gastroesophageal Reflux Disease Quality of Life Questionnaire (GERD-QOL) aims to assess how regurgitation and heartburn symptoms affect patients' daily life over the past 7 days. It consists of 16 items under four main domains: daily activities, treatment effect, diet, and psychological well-being. The questionnaire is rated using a five-point Likert scale. Lower total scores indicate poorer quality of life. |
1 day
|
|
Postural analysis
Time Frame: 1 day
|
The Posture Screen Lite application is a posture analysis, body composition, and movement assessment software designed for use on iOS and Android devices with integrated camera systems. In this study, posture will be assessed using the iPad-based Posture Screen Lite application. Participants will be assessed wearing appropriate clothing that leaves the upper trunk and lower legs exposed. Photographs will be taken from anterior, posterior, and right and left lateral views using a smartphone, without placing reference markers on the participant beforehand. The captured images will then be analyzed using the Posture Screen Lite software by identifying anatomical reference points on the photographs. Based on these marked points, postural deviation values and the degree of postural imbalance will be calculated by the software and reported for each participant in centimeters (cm). |
1 day
|
|
The Visual Analog Scale (VAS)
Time Frame: 1 day
|
The Visual Analog Scale (VAS) will be used to assess participants' pain intensity. The VAS is a valid and reliable method that is sensitive to small changes in clinical pain and treatment-related pain intensity. Participants will be asked to indicate their pain level on a 10-cm horizontal line, where "0" represents "no pain" and "10" represents "the worst imaginable pain." In addition, participants will be asked to mark the location(s) of their pain on a body diagram to identify pain distribution and localization. |
1 day
|
|
The Pittsburgh Sleep Quality Index (PSQI)
Time Frame: 1 day
|
The Pittsburgh Sleep Quality Index (PSQI) is a scale that evaluates sleep quality and sleep disturbances over a one-month period. The PSQI was developed by Buysse et al. (1989) and has been shown to have adequate internal consistency, test-retest reliability, and validity. The Turkish validity and reliability study was conducted by Ağargün et al. (1996), and the scale was found to be appropriate for the Turkish population. The Cronbach's alpha internal consistency coefficient is 0.80. The PSQI consists of 18 items used for scoring. It includes seven components: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleep medication, and daytime dysfunction. Some components are derived from a single item, while others are calculated by grouping multiple items. Each item is scored on a scale of 0 to 3, and the sum of the seven component scores yields the total PSQI score. |
1 day
|
Collaborators and Investigators
Sponsor
Study record dates
Study Major Dates
Study Start (Estimated)
Primary Completion (Estimated)
Study Completion (Estimated)
Study Registration Dates
First Submitted
First Submitted That Met QC Criteria
First Posted (Actual)
Study Record Updates
Last Update Posted (Actual)
Last Update Submitted That Met QC Criteria
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
- KBU-FTR-NC-08
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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