Clinical Research Directory

Spinal Cord Stimulation and Respiration After Injury

Respiratory motor control deficit is the leading cause of morbidity and mortality in patients with spinal cord injury. The long-term goal of this NIH-funded study is to develop a rehabilitation strategy for respiration in patients with spinal cord injury as a standard of care. Respiratory function in patients with chronic spinal cord injury can be improved by using inspiratory-expiratory pressure threshold respiratory training protocol. However, the effectiveness of this intervention is limited by the levels of functional capacity preserved below the neurological level of injury. Preliminary data obtained for this study demonstrate that electrical spinal cord stimulation applied epidurally at the lumbar level in combination with respiratory training can activate and re-organize spinal motor networks for respiration. This study is designed to investigate respiratory motor control-related responses to epidural spinal cord stimulation alone and in combination with respiratory training. By characterization of respiratory muscle activation patterns using surface electromyography in association with pulmonary functional and respiration-related cardiovascular measures, the investigators expect to determine the specific stimulation parameters needed to increase spinal excitability below level of injury to enhance responses to the input from supraspinal centers that remain after injury and to promote the neural plasticity driven by the respiratory training. This hypothesis will be tested by pursuing two Specific Aims: 1) Evaluate the acute effects of epidural spinal cord stimulation on respiratory functional and motor control properties; and 2) Evaluate the effectiveness of epidural spinal cord stimulation combined with respiratory training.

Feasibility of Breathwork Intervention With Older Adults After Knee Surgery

Postoperative complications after surgical procedures, including following total knee arthroplasty (TKA), have a negative impact on the health and well-being of surgical patients. Older adults (≥65 years) are particularly vulnerable to postoperative complications and their associated morbidities due to the biological aging process. Older adults comprise nearly half of surgical patients worldwide, and this number is expected to increase in the next 10-20 years as the aging population continues to grow. TKA is the most common procedure undergone by older adults, and the rate of TKA procedures is also expected to rise. Despite perioperative guidelines and protocols to prevent postoperative complications, the prevalence of postoperative complications following TKA is approximately 12%. Given these statistics, millions of older adults undergoing TKA may be at risk for postoperative complications and their associated morbidities in the coming decades. Therefore, additional interventions are needed to combat postoperative complications in this population. The body's natural response to surgery, also known as the surgical stress response (SSR), contributes to postoperative complications through complex mechanisms involving the autonomic nervous system (ANS). Increased sympathetic nervous system (SNS) activity, or the body's fight-or-flight response, causes dysregulation in feedback systems that regulate the stress response, potentially leading to poorer outcomes. Interventions, such as breathwork, that induce the parasympathetic nervous system (PNS), or the body's rest-and-digest response, have been shown to balance the ANS, regulate stress biology, and improve outcomes. This study will examine the feasibility of adding a breathwork intervention (Box Breathing), compared to an attention control, to standard perioperative care for older adults undergoing TKA. This study will also examine the proof of concept that Box Breathing, compared to an attention control, may help regulate the SSR by assessing an objective measure of stress-related biology, diurnal cortisol rhythm, and gathering self-report information on pain, anxiety, depression, and quality of recovery following TKA.

Effects of Controlled Breathing on Cardiorespiratory Variables in Multiple Myeloma

A randomized, parallel, double-blind, controlled, clinical trial. Two groups of participants will be included, both receiving a therapeutic exercise intervention and an educational session on the importance of proper breathing over a 6-week period. One of the groups will additionally perform a home-based controlled breathing exercise protocol. Pre- and post-intervention assessments (6 weeks) will be conducted, along with a follow-up evaluation 4 weeks after completion of the intervention. The goal is to determine the effectiveness of adding a controlled breathing exercise program to a therapeutic exercise intervention on cardiorespiratory variables in individuals with multiple myeloma.

Effects of Controlled Breathing Added to Therapeutic Exercise in Multiple Myeloma

A randomized, parallel, double-blind, controlled, multicenter clinical trial with two intervention arms. Two groups of participants will be included, both receiving a therapeutic exercise intervention and an educational session on the importance of proper breathing over a 6-week period. One of the groups will additionally perform a home-based controlled breathing exercise protocol. Pre- and post-intervention assessments (6 weeks) will be conducted, along with a follow-up evaluation 4 weeks after completion of the intervention. The goal is to determine the effectiveness of adding a controlled breathing exercise program to a therapeutic exercise intervention on somatic symptoms in individuals with multiple myeloma

A Study Of Resilience And Mental Well-Being Through Breathing Practice For Clinical Care Professionals

The purpose of this study is to assess the immediate and long-term effects of structured breathing on clinical symptoms related to mental health including anxiety, depression, perceived stress, and sleep quality.

Effect of Visual Feedback From the SpiroGym Mobile Application

The previous pilot study showed that two weeks of intensive expiratory muscle strength training (EMST) with SpiroGym was sufficient to significantly improve voluntary peak cough flow (PCF). The improvement was quantitatively comparable to that reported in other intensive EMST studies of longer duration. To explain this rapid improvement, we considered the potential contribution of SpiroGym's visual feedback. We assumed that real-time visual feedback increased training effort compared with conventional EMST performed without immediate feedback. The aim of this study is to evaluate the effect of visual feedback provided by the SpiroGym mobile application on performance during expiratory muscle strength training in patients with Parkinson's disease.

The Effects of Breathing Exercises and Music Intervention During Labor on Pain Perception, Birth Expectations, and Birth Satisfaction in Primiparous Women

This randomized controlled trial aimed to evaluate the effects of music listening and breathing exercises during labor on pain perception, birth expectations, and birth satisfaction among primiparous women. This randomized controlled trial was conducted in the delivery unit of a hospital located in the Inner Aegean Region of Turkey. The study included 90 primiparous pregnant women admitted for vaginal delivery. Participants without visual, auditory, or neurological impairments were included and randomly assigned into three groups: music intervention group, breathing exercise group, and control group (n=30 in each group). Participants were randomly assigned to one of three groups (Music Intervention, Breathing Exercise, Control) using a computer-generated randomization sequence. Allocation concealment was ensured by using sealed, opaque envelopes prepared by a researcher who was not involved in participant recruitment or assessment. In the music intervention group, participants were introduced to 12 music tracks at 36 weeks of gestation during childbirth preparation classes. Short samples of these tracks were played during the class, and the full tracks were then shared with participants via WhatsApp to encourage regular listening at home. During the prenatal period, participants received regular WhatsApp reminders every few days to listen to the music. During labor, participants were encouraged to listen to music whenever they wished. Additionally, at 4 cm, 6 cm, and 8 cm cervical dilation, all participants in this group listened to their preferred tracks from the playlist for 20 minutes. Pain intensity was measured using the Visual Analog Scale (VAS) before and after each music session. In the breathing exercise group, Lamaze breathing techniques were taught during prenatal classes and practiced throughout the labor process. They were encouraged to practice these exercises throughout labor. At 4, 6, and 8 cm cervical dilation, guided breathing exercises were conducted, and pain was assessed using the Visual Analog Scale (VAS) before and after each exercise. In the control group, participants received routine maternity care. VAS pain assessments were conducted at the same cervical dilation points (4, 6, and 8 cm), without any additional interventions. For all participants, the durations of the first, second, and third stages of labor were recorded and compared across groups. In the postpartum period, the Birth Expectation Scale and Birth Satisfaction Scale were administered. Study data included sociodemographic information, VAS pain scores, and scores from the birth expectation and satisfaction scales.

The Effects of Breathing Exercises on Exam Anxiety, Attention Deficit, and Academic Achievement in Students Preparing for University Entrance Exams

This study investigates the effects of breathing exercises on exam anxiety, attention, and academic achievement in students preparing for university entrance exams. University entrance exams are significant milestones in students' educational and career paths, often causing high levels of stress and anxiety. These psychological pressures can negatively impact learning, focus, and overall academic performance. The study will involve students who volunteer to participate and meet the inclusion criteria. Participants will be guided through structured breathing exercises designed to reduce stress and enhance concentration. The program will be conducted over several sessions, during which students will practice specific breathing techniques under supervision. Primary outcomes of the study include the assessment of changes in exam anxiety levels, attention, and academic performance. Secondary outcomes may include students' self-reported stress management skills and overall well-being. Data will be collected using validated questionnaires, attention tests, and academic performance records. The purpose of this research is to determine whether regular practice of targeted breathing exercises can provide practical benefits for students, helping them manage anxiety, improve focus, and achieve better academic outcomes. Findings from this study may also offer guidance for educators, parents, and healthcare providers on effective, low-cost interventions to support students during high-pressure academic periods. Participants are encouraged to follow instructions carefully and attend all sessions to gain the full benefit of the intervention. Participation is voluntary, and students can withdraw at any time without any negative consequences. Confidentiality of all collected data will be strictly maintained. By contributing to this research, participants will help advance understanding of non-pharmacological methods to improve student mental health and academic performance, potentially shaping future educational and stress-management programs.

Breathing Exercises on Lung Function

aim of this study is to evaluate the efficacy of pulmonary rehabilitation program as a non-pharmacological treatment method to: Improve functional capacity as assessed by six-minute walking distance (6MWD) test. Improve dyspnea level as assessed by Medical Research Council (MRC) dyspnea scale. Improve pulmonary function tests and arterial blood gas.

Breathing Exercises on Depression in Postmenopausal Women

Evaluate the effect of breathing exercises on depression and sexual function in postmenopausal women

The Effect of Breathing Exercise Applied to Intensive Care Nurses on Fatigue and Perceived Stress

The aim of this randomized controlled trial was to investigate the effect of breathing exercise on fatigue and stress in intensive care nurses. Hypotheses of the study; H11: The level of perceived stress in nurses practicing breathing exercise is lower than the nurses in the control group. H12: The level of fatigue is lower in nurses practicing breathing exercise compared to nurses in the control group. Data will be collected in the intervention and control groups with a pre-test data collection form before the intervention. Patients in the intervention group will be given breathing exercises, while patients in the control group will not receive any intervention. In the second week, interim follow-up data will be collected with the data collection form. At the end of the study; data will be collected from the intervention and control groups with post-test data collection forms.