IMMEDIATE EFFECT OF DEEP BREATHING EXERCISE ON HEALTHY SUBJECTS

Background: A behavioral task frequently used to assess distress tolerance is the breath holding task. The immediate effects of deep breathing exercises have different types of benefits like significant decrease of atelectatic area, increase in aerated lung area and a small increase in PaO2 is well known. There exists an interrelationship in normal healthy persons between resting HR, RR & BP and breath bolding capacity. By adding the DBE in routine physiotherapy; we can improve the distress tolerance as well as lung capacity in healthy individuals.

Eastern meditation systems, such as Taoist qi gong, tai chi and pranayama yoga, suggests that the practice of deep breathing in the pursuit of health and enlightenment is probably much older [1].
Breath control, is a technique that involves slow and rhythmic breathing.It is known that the regular practice of deep breathing exercise increases parasympathetic tone, decreases sympathetic activity, improves cardiovascular and respiratory The deepest breath that the human beings take is the first cry after birth.First cry is the maximum inspiratory effort to expand the collapsed lung permanently at the time of birth, during which the intrapleural pressure becomes -70mm of Hg [1].Benefits of practicing deep breathing have been found in Hindu Sanskrit texts from as early as the fifth century.However, the fact that it is such a vital component in functions, decreases the effect of stress and strain on the body and improves physical and mental health [2,3].Regular practice of rhythmic slow breathing has been shown to increase baroreflex sensitivity and reduce chemoreflex activation [4], and to reduce systolic, diastolic and mean blood pressures as well as heart rate variations in hypertensive patients [5].Practice of slow breathing has also been advocated for the treatment of anxiety disorders as it attenuates cardiac autonomic responses in such patients.
From the point of view of oxygen gas exchange, human lungs are highly inefficient, as suggested by the 50-60 mmHg PO2 gap between atmosphere and arterial blood observed at sea level.Controlled breathing with low rate and high tidal volume, has been shown to improve the efficiency of ventilation by increasing alveolar and reducing dead space ventilation [6].Slow deep breathing may also improve arterial oxygenation by increasing alveolar volume and gas exchange at the alveolar capillary membrane level.
A behavioral task frequently used to assess distress tolerance is the breath holding task Then subject was directed to inhale slowly up to the maximum of 5 seconds and exhale slowly up to the maximum of 5 sec.[i.e. at the rate of 6 breaths /min] for 5 minutes. 9Pulse rate, Respiratory rate, SpO 2 , PEFR and breath holding time was measured again.Breath holding time was measured after measuring all parameters.
Response Rate: All the 60 students selected from the study population of 60 giving an overall response rate of 100%.Statistical Analysis: Each parameter was computed for each subject before and after the intervention by using SPSS version 16.Willcoxon test was applied for analysis.P value < 0.05 is considered as significant.

Study design and the participants:
Interventional study was conducted with purposive sampling on immediate effect of deep breathing exercise on healthy young adults.The mean age of our study population for male 21.78±0.94yrs and female 21.24±0.98years.Height and weight of males were comparatively more 169.06±7.78cms and 66.11±9.89kgs than females.Body mass index was almost same for both the groups -table 1.

RESULTS
Respiratory rate, pulse rate, SpO2 were decreased after deep breathing session of 5 minutes.This improvement was statistically significant.Figure 1 shows there is significant increase in PEFR after deep breathing exercise for 5 minutes at the rate of 6 breathes/ min.Oxygen saturation increase significantly after the deep breathing exercise.SpO2 increase suggests that slow deep breathing improves the efficiency of ventilation.We are likely to have increased the used alveolar volume with slow deep breathing and, consequently, we have reduced dead space minute ventilation and the dead space to tidal volume ratio to a percentage, as previously reported for heart failure patients during slow deep breathing exercise [11].Moreover, because slow deep breathing is associated to a reduction of sympathetic tone, the improvement of ventilation/perfusion matching may also originate by more respiratory sinus arrhythmia [12].Finally, the reduction of sympathetic tone could lead to a reduction in metabolic rate, which, possibly combined with an increase of cardiac output, may lead to an increase of mixed venous PO2 and thus less admixture.PR decreases immediately after deep breathing.Same way SpO2 , PEFR and breath holding time increases.

DISCUSSION
Limitations & future scope of the study Sample size of the present study was less.Future research with more number of samples may want to investigate whether there is any other interrelationship between the variables used in this study.
[7].During deep breathing exercise.Voluntary hyperventilation creates a considerable diffusion gradient for carbon dioxide runoff into the alveoli from venous blood that enters the pulmonary capillaries and this can increase the breath holding time after deep breathing.Peak Expiratory Flow [PEF], which is generally measured by a peak flow meter and given in liters per minute.A decrease in PEFR indicates an increase in airway resistance and vice versa.It is a sensitive parameter and is useful for serial measurement because it will be affected before FEV, so can act as an early warning sign of small airway disease [8].The aim of the present study is to find the immediate effect of deep breathing exercise on various cardiovascular variables in healthy young individuals.Study was conducted in Physiotherapy College, Ahmadabad.60 subjects (n=60.Male=18, female=42) between the age of 20 -25 years were included in the study.Subjects who were on medication and not willing to participate were excluded from the study.Anthropometrical parameters [height in cms, weight in kg, BMI in kg/m 2 ]; Cardiorespiratory parameters like Respiratory rate [in breaths / min], Pulse rate[bpm], SpO 2 [in %] by pulse oxymeter, PEFR [in Liters/min] by Peak flow meter & Breath holding time [in seconds] up to breaking point.

A
significant drop was observed in PR and RR after 5 min session of deep breathing exercise at the rate of 6 breaths/min.These results supports the study done by G.K.Pal [13].Breath holding capacity was markedly increase after deep breathing exercise.Complex mechanisms delicately adjust breathing rate and depth to the body's metabolic needs.Deep breathing causes alveolar Pco2 decreases from its normal value of 40 mmHg to a low of 15 mm Hg.This creates a considerable diffusion gradient for carbon In summary, the present article shows the RR, CONCLUSION Poonam Nariyani, Harita Vyas.IMMEDIATE EFFECT OF DEEP BREATHING EXERCISE ON HEALTHY SUBJECTS.

Table 1 :
Represents anthropometrical parameters in young adults of both genders.
+Variables p value

Table 2 :
Shows comparison of various physiological parameters before & after deep breathing (n=60).