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Inspiratory Muscle Training and Diaphragmatic Breathing in GAD

1 listopada 2026 zaktualizowane przez: Nergis Yılmaz, Saglik Bilimleri Universitesi

Comparison of the Effectiveness of Inspiratory Muscle Training and Diaphragmatic Breathing Exercises in Individuals With Generalized Anxiety Disorder

This study will compare inspiratory muscle training and diaphragmatic breathing exercises in individuals with generalized anxiety disorder (GAD). It aims to investigate whether adding either breathing-based intervention to a combined exercise program improves anxiety symptoms and other health-related outcomes compared with adding progressive muscle relaxation.

Participants will be randomly assigned to one of three groups. All groups will receive the same combined exercise program. In addition, the first group will perform inspiratory muscle training, which involves breathing against resistance to strengthen the inspiratory muscles. The second group will perform diaphragmatic breathing exercises, which focus on using the diaphragm during breathing. The third group will receive Jacobson's progressive muscle relaxation technique, which involves systematically tensing and relaxing different muscle groups. All interventions will be delivered over eight weeks using a hybrid telerehabilitation approach combining face-to-face, synchronous online, and independent home-based sessions.

The study will evaluate anxiety symptoms, respiratory muscle strength, pulmonary function, functional exercise capacity, dyspnea, quality of life, depression symptoms, and heart rate variability. The findings may provide further evidence on the comparative effects of these interventions when added to a combined exercise program in individuals with GAD.

Przegląd badań

Status

Rekrutacyjny

Warunki

Interwencja / Leczenie

Szczegółowy opis

Generalized anxiety disorder (GAD) is characterized by persistent and excessive anxiety that may adversely affect individuals' daily functioning and quality of life. Although pharmacological and psychological treatments are commonly used, complementary approaches targeting respiratory function and physical activity may provide additional benefits.

This three-arm, parallel-group randomized controlled trial will compare inspiratory muscle training (IMT) and diaphragmatic breathing exercises with Jacobson's progressive muscle relaxation (PMR) in individuals with GAD. The study is designed to investigate the effects of these interventions when added to a standardized combined exercise program.

All participants will follow the same eight-week combined aerobic and resistance exercise program, consisting of three sessions per week. In addition, participants will be allocated to one of three intervention groups:

Group 1 - Inspiratory Muscle Training: Participants will perform IMT using a threshold-based inspiratory muscle training device. The training load will be adjusted progressively throughout the intervention period.

Group 2 - Diaphragmatic Breathing Exercises: Participants will perform structured diaphragmatic breathing exercises focusing on controlled breathing and diaphragmatic activation.

Group 3 - Active Control: Participants will perform Jacobson's progressive muscle relaxation technique, involving systematic contraction and relaxation of different muscle groups.

The interventions will be delivered using a hybrid telerehabilitation model consisting of one face-to-face session, one synchronous online session, and one independent home-based session per week. This approach will provide a combination of supervised and home-based intervention sessions while maintaining comparable therapist contact across groups.

All clinical and physiological assessments will be conducted face-to-face at baseline and following completion of the eight-week intervention.

The study aims to contribute to the evidence regarding respiratory-based physiotherapy interventions in GAD and to explore the feasibility of integrating these approaches into hybrid telerehabilitation programs.

Typ studiów

Interwencyjne

Zapisy (Szacowany)

51

Faza

  • Nie dotyczy

Kontakty i lokalizacje

Ta sekcja zawiera dane kontaktowe osób prowadzących badanie oraz informacje o tym, gdzie badanie jest przeprowadzane.

Kontakt w sprawie studiów

Lokalizacje studiów

Kryteria uczestnictwa

Badacze szukają osób, które pasują do określonego opisu, zwanego kryteriami kwalifikacyjnymi. Niektóre przykłady tych kryteriów to ogólny stan zdrowia danej osoby lub wcześniejsze leczenie.

Kryteria kwalifikacji

Wiek uprawniający do nauki

18 lat do 65 lat (Dorosły, Starszy dorosły)

Akceptuje zdrowych ochotników

Nie

Płeć kwalifikująca się do nauki

Wszystko

Opis

Inclusion Criteria:

Diagnosis of generalized anxiety disorder (GAD) by a psychiatrist according to DSM-5 criteria.

A score of 10 or higher on the Generalized Anxiety Disorder-7 (GAD-7) scale. Receiving clinically stable pharmacological treatment. Aged 18-65 years. No condition that prevents the use of a smartphone or access to the internet.

Exclusion Criteria:

Severe pulmonary diseases (e.g., chronic obstructive pulmonary disease [COPD] or an asthma attack) or cardiac diseases (e.g., unstable angina).

A primary psychiatric diagnosis other than generalized anxiety disorder. Orthopedic or neurological limitations that prevent exercise. Severe cardiovascular disease. Pregnancy. Substance use disorder. Recent abdominal or thoracic surgery.

Plan studiów

Ta sekcja zawiera szczegółowe informacje na temat planu badania, w tym sposób zaprojektowania badania i jego pomiary.

Jak projektuje się badanie?

Szczegóły projektu

  • Główny cel: Leczenie podtrzymujące
  • Przydział: Randomizowane
  • Model interwencyjny: Przydział równoległy
  • Maskowanie: Brak (otwarta etykieta)

Broń i interwencje

Grupa uczestników / Arm
Interwencja / Leczenie
Eksperymentalny: Inspiratory Muscle Training Group

Participants in this group will receive inspiratory muscle training in addition to the common combined exercise program.

Inspiratory muscle training will be performed using a pressure-threshold device. Training will begin at 30% of maximum inspiratory pressure, with the load increased by 5% per week. Each session will consist of two sets of 30 inspiratory efforts.

Eksperymentalny: Diaphragmatic Breathing Exercise Group

Participants in this group will perform diaphragmatic breathing exercises in addition to the common combined exercise program.

Participants will perform structured diaphragmatic breathing exercises according to the study protocol.

Aktywny komparator: Progressive Muscle Relaxation Group -

Participants in this group will perform progressive muscle relaxation in addition to the common combined exercise program.

Participants will perform progressive muscle relaxation according to the study protocol.

Co mierzy badanie?

Podstawowe miary wyniku

Miara wyniku
Opis środka
Ramy czasowe
Change in Anxiety Severity Measured by the GAD-7
Ramy czasowe: Baseline (week 1) and at the end of the intervention (week 8).

Anxiety severity will be assessed using the Generalized Anxiety Disorder-7 (GAD-7), a 7-item self-report questionnaire assessing anxiety symptoms over the previous two weeks. Total scores range from 0 to 21, with higher scores indicating greater anxiety severity. The change in total score from baseline to the end of the intervention will be evaluated.

Baseline (week 1) and at the end of the intervention (week 8).

Miary wyników drugorzędnych

Miara wyniku
Opis środka
Ramy czasowe
Change in Forced Vital Capacity (FVC)
Ramy czasowe: Baseline (week 1) and at the end of the intervention (week 8).

Pulmonary function will be assessed using spirometry. Forced vital capacity (FVC), representing the maximum volume of air that can be forcibly exhaled after a full inspiration, will be measured in liters (L).

Baseline (week 1) and at the end of the intervention (week 8).
Change in Forced Expiratory Volume in One Second (FEV1)
Ramy czasowe: Baseline (week 1) and at the end of the intervention (week 8).

Pulmonary function will be assessed using spirometry. Forced expiratory volume in one second (FEV1), representing the volume of air forcibly exhaled during the first second, will be measured in liters (L).

Baseline (week 1) and at the end of the intervention (week 8).
Change in FEV1/FVC Ratio
Ramy czasowe: Baseline (week 1) and at the end of the intervention (week 8).

The FEV1/FVC ratio will be calculated by dividing forced expiratory volume in one second (FEV1) by forced vital capacity (FVC) and will be expressed as a percentage (%).

Baseline (week 1) and at the end of the intervention (week 8).
Change in Peak Expiratory Flow (PEF)
Ramy czasowe: Baseline (week 1) and at the end of the intervention (week 8).

Peak expiratory flow (PEF) will be assessed using spirometry and expressed in liters per second (L/s).

Baseline (week 1) and at the end of the intervention (week 8).
Change in Respiratory Muscle Strength
Ramy czasowe: Baseline (week 1) and at the end of the intervention (week 8).

Respiratory muscle strength will be assessed by measuring maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP).

Baseline (week 1) and at the end of the intervention (week 8).
Change in Functional Exercise Capacity
Ramy czasowe: Baseline (week 1) and at the end of the intervention (week 8).

Functional exercise capacity will be assessed using the Six-Minute Walk Test (6MWT). The total distance walked will be recorded in meters.

Baseline (week 1) and at the end of the intervention (week 8).
Change in Sleep Quality
Ramy czasowe: Baseline (week 1) and at the end of the intervention (week 8).

Sleep quality will be assessed using the Pittsburgh Sleep Quality Index (PSQI). Total scores range from 0 to 21, with higher scores indicating poorer sleep quality.

Baseline (week 1) and at the end of the intervention (week 8).
Change in Health-Related Quality of Life
Ramy czasowe: Baseline (week 1) and at the end of the intervention (week 8).

Health-related quality of life will be assessed using the 36-Item Short Form Health Survey (SF-36), which evaluates eight health dimensions. Scores range from 0 to 100, with higher scores indicating better health status.

Baseline (week 1) and at the end of the intervention (week 8).
Change in Perceived Dyspnea
Ramy czasowe: Baseline (week 1) and at the end of the intervention (week 8), during or immediately after the relevant activity or test.

Perceived dyspnea will be assessed using the Modified Borg Dyspnea Scale, which ranges from 0 (no breathlessness) to 10 (maximum breathlessness).

Baseline (week 1) and at the end of the intervention (week 8), during or immediately after the relevant activity or test.
Change in Anxiety Symptoms Measured by the Beck Anxiety Inventory
Ramy czasowe: Baseline (week 1) and at the end of the intervention (week 8).

Anxiety symptoms will be assessed using the Beck Anxiety Inventory (BAI), a 21-item self-report questionnaire. Total scores range from 0 to 63, with higher scores indicating more severe anxiety symptoms.

Baseline (week 1) and at the end of the intervention (week 8).
Change in Depressive Symptoms
Ramy czasowe: Baseline (week 1) and at the end of the intervention (week 8).

Depressive symptoms will be assessed using the Beck Depression Inventory (BDI), a 21-item self-report questionnaire. Total scores range from 0 to 63, with higher scores indicating more severe depressive symptoms.

Baseline (week 1) and at the end of the intervention (week 8).
Change in Heart Rate Variability (RMSSD)
Ramy czasowe: Baseline (week 1) and at the end of the intervention (week 8).

Heart rate variability will be assessed using the root mean square of successive differences (RMSSD) derived from R-R intervals recorded with a Polar H10 heart rate sensor. Recordings will be obtained during a 5-minute resting period under standardized conditions and analyzed using Kubios HRV Standard software.

Baseline (week 1) and at the end of the intervention (week 8).

Współpracownicy i badacze

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Sponsor

Daty zapisu na studia

Daty te śledzą postęp w przesyłaniu rekordów badań i podsumowań wyników do ClinicalTrials.gov. Zapisy badań i zgłoszone wyniki są przeglądane przez National Library of Medicine (NLM), aby upewnić się, że spełniają określone standardy kontroli jakości, zanim zostaną opublikowane na publicznej stronie internetowej.

Główne daty studiów

Rozpoczęcie studiów (Rzeczywisty)

17 września 2026

Zakończenie podstawowe (Szacowany)

20 kwietnia 2027

Ukończenie studiów (Szacowany)

20 kwietnia 2027

Daty rejestracji na studia

Pierwszy przesłany

19 października 2026

Pierwszy przesłany, który spełnia kryteria kontroli jakości

1 listopada 2026

Pierwszy wysłany (Rzeczywisty)

3 listopada 2026

Aktualizacje rekordów badań

Ostatnia wysłana aktualizacja (Rzeczywisty)

3 listopada 2026

Ostatnia przesłana aktualizacja, która spełniała kryteria kontroli jakości

1 listopada 2026

Ostatnia weryfikacja

1 listopada 2026

Więcej informacji

Terminy związane z tym badaniem

Inne numery identyfikacyjne badania

  • IMT-GAD-2026-001

Plan dla danych uczestnika indywidualnego (IPD)

Planujesz udostępniać dane poszczególnych uczestników (IPD)?

NIE

Informacje o lekach i urządzeniach, dokumenty badawcze

Bada produkt leczniczy regulowany przez amerykańską FDA

Nie

Bada produkt urządzenia regulowany przez amerykańską FDA

Nie

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