Comparison of Box Breathing and Rhythmic Breathing Techniques in Patients With Asthma

NCT07717476 | Not Yet Recruiting

• 1 other identifier: REC/RCR & AHS/25/0315
• Study Type: interventional
• Target: 36
• Locations: 1 country
• Sites: 1

Brief Summary

Asthma is a chronic respiratory disease that can cause breathing difficulties, reduced lung function, and poor sleep quality. Breathing exercises are increasingly used as non-pharmacological interventions to improve respiratory symptoms and overall well-being in individuals with asthma. This study aims to compare the effects of two breathing techniques, Box Breathing and Rhythmic Breathing, on dyspnea (breathlessness), pulmonary function, and quality of sleep in patients with asthma. Participants with asthma will be randomly assigned to receive either Box Breathing or Rhythmic Breathing exercises in addition to standard care. Both interventions will be performed three times per week for eight weeks. The primary outcomes of this study include changes in dyspnea severity, pulmonary function measured by spirometry, and sleep quality assessed using validated questionnaires. The findings of this study may help determine which breathing technique is more effective and provide evidence for incorporating structured breathing exercises into asthma management programs.

Conditions

Asthma (Diagnosis)

Keywords

Asthma; Box Breathing; Rhythmic Breathing

Outcome Measures

Primary Outcomes (1)

• Dyspnea Severity

  Dyspnea severity will be assessed using the Modified Borg Scale, a numerical rating scale ranging from 0 to 10, where higher scores indicate greater perceived breathlessness.

  Baseline and 8 weeks (post-intervention)

Secondary Outcomes (2)

• Pulmonary Function (Forced Expiratory Volume in 1 Second [FEV₁])

  Baseline and 8 weeks (post-intervention)

• Sleep Quality

  Baseline and 8 weeks (post-intervention)

Study Arms (2)

Box Breathing Group A

EXPERIMENTAL

Participants assigned to this arm received standardized baseline respiratory care followed by Box Breathing training. The Box Breathing technique consisted of inhaling for 4 seconds, holding the breath for 4 seconds, exhaling for 4 seconds, and holding the breath again for 4 seconds. The intervention was performed for 20 minutes per session, three sessions per week, for eight weeks. Short rest periods were provided as needed during the intervention.

Behavioral: Box Breathing

Rhythmic Breathing Group

EXPERIMENTAL

Participants assigned to this arm received standardized baseline respiratory care followed by Rhythmic Breathing training. The Rhythmic Breathing technique consisted of a controlled breathing pattern using a 4:6 ratio, with inhalation through the nose for 4 seconds and exhalation through the mouth for 6 seconds. The intervention was performed for 20 minutes per session, three sessions per week, for eight weeks. Short rest periods were provided as needed during the intervention.

Behavioral: Rhythmic Breathing

Interventions

Box Breathing BEHAVIORAL

Participants assigned to the Box Breathing intervention received a structured breathing exercise protocol following standardized baseline respiratory care. The Box Breathing technique consisted of inhalation for 4 seconds, breath holding for 4 seconds, exhalation for 4 seconds, and a second breath hold for 4 seconds (4-4-4-4 pattern). The intervention was administered for 20 minutes per session, three sessions per week, for eight weeks. Short rest periods were permitted after every 5-6 breathing cycles as needed. The intervention was performed in a quiet environment and aimed to improve respiratory control, reduce dyspnea, enhance ventilatory efficiency, and promote autonomic regulation.

Box Breathing Group A

Rhythmic Breathing BEHAVIORAL

Participants assigned to the Rhythmic Breathing intervention received a structured breathing exercise protocol following standardized baseline respiratory care. The Rhythmic Breathing technique consisted of a controlled breathing pattern using a 4:6 ratio, with inhalation through the nose for 4 seconds and exhalation through the mouth for 6 seconds. The intervention was administered for 20 minutes per session, three sessions per week, for eight weeks. Short rest periods were provided every 6-7 minutes as needed. The intervention was designed to promote respiratory efficiency, improve autonomic balance, reduce dyspnea, and enhance pulmonary function and sleep quality.

Rhythmic Breathing Group

Eligibility Criteria

• Age: 18 Years - 40 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Male and female patients diagnosed with asthma.
• Age between 18 and 40 years.
• Patients with mild to moderate asthma who are clinically stable.
• Patients able to understand and follow breathing exercise instructions.
• Patients willing to provide informed consent and participate in the study.

You may not qualify if:

• Patients with severe or uncontrolled asthma.
• Patients with acute asthma exacerbation during the study period.
• Patients with other significant respiratory diseases (e.g., chronic obstructive pulmonary disease, pulmonary fibrosis).
• Patients with severe cardiovascular, neurological, or musculoskeletal disorders that may interfere with participation.
• Patients who are pregnant.
• Patients unable to perform the breathing interventions or complete study assessments.
• Patients participating in another structured respiratory rehabilitation or breathing exercise program.

Sponsors & Collaborators

• Riphah International University: lead

Study Sites (1)

Ittefaq Hospital and Ghurki Trust Hospital

Lahore, Punjab Province, 59300, Pakistan

Location

MeSH Terms

Conditions

Asthma; Disease

Condition Hierarchy (Ancestors)

Bronchial Diseases; Respiratory Tract Diseases; Lung Diseases, Obstructive; Lung Diseases; Respiratory Hypersensitivity; Hypersensitivity, Immediate; Hypersensitivity; Immune System Diseases; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Humera Ayub, MS-CPPT

  Riphah International University

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Humera Ayub, MS CPPT

CONTACT

+923045938096; humera.ayub@riphah.edu.pk

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Model Details: Participants were randomly assigned in a parallel-group design to one of two intervention arms: Box Breathing or Rhythmic Breathing. Both groups received standardized baseline respiratory care followed by their assigned breathing intervention three times per week for eight weeks. Outcomes were assessed at baseline and after completion of the intervention period by a blinded assessor.

Study Record Dates

• First Submitted: July 17, 2026
• First Posted: July 21, 2026
• Study Start: July 1, 2026
• Primary Completion (Estimated): December 10, 2026
• Study Completion (Estimated): December 10, 2026
• Last Updated: July 21, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will not share

Locations

PA (1)