Comparative Effects of Wim Hoff Method and Box Breathing Method in Mild COPD

NCT07506317 | Completed

• 1 other identifier: REC/RCR & AHS/24/0378 Muntaha
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

The goal of this clinical trial is to support the role of effective, non-pharmacological interventions in the management of the symptoms of mild Chronic Obstructive Pulmonary Disease (COPD) or the anxiety, dyspnea, and peak expiratory flow rate decline. The main questions it aims to answer are

• There are no significant effects of wim hoff breathing and box breathing technique on dyspnea, anxiety, and PEFR in mild COPD patients.
• There are significant effects of wim hoff breathing and box breathing technique on dyspnea, anxiety, and PEFR in mild COPD patients. There 2 study groups, group A received box breathing technique and Group B of mild COPD patients received wim hoff breathing technique.

Conditions

COPD

Keywords

Breathing techniques; Wim Hoff; Box Breathing; comparison; COPD; Mild COPD

Outcome Measures

Primary Outcomes (4)

• PEFR

  Peak Forced Expiratory Rate (PFER) is a vital measure in pulmonary health, assessing the maximum speed of exhalation to gauge lung function, particularly in asthma and COPD patients. It is measured in liters per minute using a peak flow meter, providing instant feedback on airway health. Patients monitor PFER to track airway constriction, adjusting medication as needed. The zone system include Green Zone (80-100%) indicates stable control, Yellow Zone,(50-79%) signals caution, Red Zone (below 50%) requires urgent attention.

  8 weeks

• FEV1

  Forced Expiratory Volume in 1 Second (FEV1) measures the air exhaled in one second after a deep breath, serving as a critical indicator of lung function and a key diagnostic tool for obstructive lung diseases like asthma and COPD. Measured via spirometry, FEV1 is compared to predicted values and paired with Forced Vital Capacity (FVC) to calculate the FEV1/FVC ratio, differentiating obstructive from restrictive diseases. In COPD classification, FEV1 aids in determining severity: Mild (≥80% of predicted), Moderate (50-79%), Severe (30-49%), and Very Severe (\<30%). Tracking FEV1 over time helps clinicians assess progression, adjust treatments, and manage respiratory health effectively .

  8 weeks

• STAI for anxiety

  The State-Trait Anxiety Inventory (STAI) is a psychological tool that assesses anxiety through two scales: State Anxiety (temporary anxiety linked to specific situations) and Trait Anxiety (a general, long-term tendency toward anxiety). With 40 self-report items, it measures how individuals feel at the moment (state) and their baseline anxiety levels over time (trait). Used widely in clinical and research settings, the STAI helps in diagnosing anxiety, tracking treatment progress, and providing insights into situational versus personality-based anxiety. Its dual approach enables a deeper understanding of anxiety, supporting personalized interventions and research into anxiety patterns across populations.

  8 weeks

• Borg Dyspnea scale

  The Borg Dyspnea Scale is a subjective tool for rating breathlessness, commonly used in assessing respiratory conditions like COPD, asthma, and heart failure. It ranges from 0 (no breathlessness) to 10 (maximum breathlessness), with descriptive terms for each level to help individuals rate their symptoms accurately. Widely applied in clinical, exercise, and rehabilitation settings, the scale enables healthcare providers to gauge a patient's perceived breathlessness, adjust treatment, and monitor symptom changes over time.

  8 weeks

Study Arms (2)

Box Breathing

EXPERIMENTAL

Using Box Breathing as primary intervention in addition to baseline COPD therapy

Other: Box Breathing

Wim Hoff breathing technique

EXPERIMENTAL

Using Wim Hoff breathing technique as primary intervention in addition to baseline COPD therapy

Other: Wim Hoff Breathing Technique

Interventions

Box Breathing OTHER

The protocol for box breathing, which is a powerful technique for stress management and relaxation, guided patients through a structured breathing exercise. The box breathing exercise consisted of the following steps: * Inhaled Deeply: Patients breathed in slowly through their nose, counting to 4, allowing their lungs to fill fully and gradually. * Held the Breath: They held their breath for a count of 4, maintaining a sense of calm as they allowed the air to settle. * Exhaled Slowly: They released the breath through their mouth over a count of 4, focusing on the slow, controlled release of air. * Paused Again: After exhaling, they held the breath out for a final count of 4, embracing the brief stillness before the next cycle.

Box Breathing

Wim Hoff Breathing Technique OTHER

The Wim Hof Breathing Technique was introduced as a powerful method to improve physical and mental resilience, boost energy, and enhance control over the nervous and immune systems. The protocol for the Wim Hof Breathing Technique included the following steps: Preparation: Participants began by sitting or lying down in a comfortable position in a safe, quiet environment where they could practice without disturbances. Step 1: 30-40 Deep, Rhythmic Breaths Step 2: Hold Your Breath (Retention Phase) Step 3: Recovery Breath Step 4: Repeat the Cycle Duration of Practice: Each full session of the Wim Hof Breathing Technique, including all breathing cycles, took around 15-20 minutes. These treatment sessions continued for 8 weeks.

Wim Hoff breathing technique

Eligibility Criteria

• Age: 35 Years - 50 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Male and female patients
• Age 35 and 50 years
• Patients diagnosed with mild COPD with and FEV1 80%-85% of predicted.
• Participants should have physical and cognitive ability to perform and understand exercises.
• Participants who quit smoking over 6 months

You may not qualify if:

• History of other respiratory conditions (asthma, interstitial lung disease, cystic fibrosis) excluded.
• Patients of cardiovascular conditions were not included.
• Neurological or psychiatric and cognitive disorders excluded.
• Recent history of COPD hospitalization.
• Participants formally engage in pulmonary rehabilitation programs in last 6 months.

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Bahawal Victoria Hospital BVH Bahawalpur

Chak Four Hundred Fifty-four, Punjab Province, 63100, Pakistan

Location

Related Links

• The diagnosis and treatment of COPD and its comorbidities
• COPD. Do the right thing
• The impact of age on prevalence of anxiety, depression and stress in patients with chronic obstructive pulmonary disease.
• How to use peak expiratory flow rate.

MeSH Terms

Conditions

Pulmonary Disease, Chronic Obstructive

Condition Hierarchy (Ancestors)

Lung Diseases, Obstructive; Lung Diseases; Respiratory Tract Diseases; Chronic Disease; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Qurat ul Ain, MS

  Riphah International University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: March 16, 2026
• First Posted: April 1, 2026
• Study Start: January 1, 2025
• Primary Completion: October 1, 2025
• Study Completion: October 1, 2025
• Last Updated: April 1, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)