Effects of Diaphragmatic Mobilization and Diaphragmatic Breathing Exercises on Pain and Quality of Life in Individuals with Shoulder Pain: A Randomized Controlled Trial

Okan Şahin; Deniz Kocamaz

doi:10.33438/ijdshs.976285

Research Article

Effects of Diaphragmatic Mobilization and Diaphragmatic Breathing Exercises on Pain and Quality of Life in Individuals with Shoulder Pain: A Randomized Controlled Trial

Year 2021, Volume: 4 Issue: 2, 113 - 123, 20.12.2021

Okan Şahin Deniz Kocamaz

https://doi.org/10.33438/ijdshs.976285

Abstract

Purpose: This study aimed to investigate the effects of diaphragmatic mobilization and diaphragmatic breathing exercises on pain and quality of life in individuals with shoulder pain. Methods: A total of 72 individuals with shoulder pain were included in the study. The individuals included in the study were randomly divided into 3 groups as Diaphragmatic Mobilization Group (DMG) (n=24), Diaphragmatic Breathing Group (DBG) (n=24), and control group (n=24). In addition to classical physiotherapy treatment, diaphragmatic mobilization to mobilization group and diaphragmatic breathing exercises to breathing group were applied by the physiotherapist 3 days a week for 8 weeks. On the other hand, only classical physiotherapy treatments were applied to the control group. Individuals were evaluated in terms of pain and quality of life. Pain levels assessed with the Visual Analogue Scale (VAS) and quality of life assessed with Short Form-36 (SF-36). Results: In our study, it was observed that the pain level was reduced and the quality of life was improved in all groups (p<0.05). When DMG and DBG were compared with the control group, there was found a significant difference among groups in terms of reducing pain and improving quality of life in favor of DMG and DBG (p<0.05). When DMG and DBG were compared, no statistically significant difference was found between the groups (p>0.05). Conclusion: The study results demonstrated that diaphragmatic mobilization and diaphragmatic breathing exercises are found to be effective in reducing pain and improving quality of life in individuals with shoulder pain.

Keywords

Diaphragmatic Mobilization, Diaphragmatic Breathing Exercises, Shoulder pain, Quality of life

References

Ambrosino, N., Paggiaro, P. L., Macchi, M., Filieri, M., Toma, G., Lombardi, F. A., Del Cesta, F., Parlanti, A., Loi, A. M., & Baschieri, L. (1981). A study of short-term effect of rehabilitative therapy in chronic obstructive pulmonary disease. Respiration; international review of thoracic diseases, 41(1), 40–44.
Ariëns, G. A., van Mechelen, W., Bongers, P. M., Bouter, L. M., & van der Wal, G. (2001). Psychosocial risk factors for neck pain: a systematic review. American journal of industrial medicine, 39(2),180193.
Bordoni, B., & Marelli, F. (2016). Failed back surgery syndrome: review and new hypotheses. Journal of pain research, 9, 17–22.
Bordoni, B., Marelli, F., & Bordoni, G. (2016). A review of analgesic and emotive breathing: a multidisciplinary approach. Journal of multidisciplinary healthcare, 9, 97–102.
Chang, Q., Liu, R., & Shen, Z. (2013). Effects of slow breathing rate on blood pressure and heart rate variabilities. International journal of cardiology, 169(1), e6–e8.
Donatelli R.A. (2012). Physical Therapy of the Shoulder. Fifth Edition. PhD, PT, OCS National Director of Sports Rehabilitation Physiotherapy Associates. Las Vegas, Nevada. ISBN: 978-1-4377-0740-3.
Fernández-López, I., Peña-Otero, D., Atín-Arratibel, M., Eguillor-Mutiloa, M., Bravo-Llatas, C., Genovés-Crespo, M., & Callejas-González, F. J. (2021). Effects of diaphragm muscle treatment in shoulder pain and mobility in subjects with rotator cuff injuries: A dataset derived from a pilot clinical trial. Data in brief, 35, 106867.
Friesner, S. A., Curry, D. M., & Moddeman, G. R. (2006). Comparison of two pain-management strategies during chest tube removal: relaxation exercise with opioids and opioids alone. Heart & lung: the journal of critical care, 35(4), 269–276.
Hawker, G. A., Mian, S., Kendzerska, T., & French, M. (2011). Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis care & research, 63 Suppl 11, S240–S252.
Karandikar, N., & Vargas, O. O. (2011). Kinetic chains: a review of the concept and its clinical applications. PM & R: the journal of injury, function, and rehabilitation, 3(8), 739–745.
Khan, M., Pretty, C. G., Amies, A. C., Balmer, J., Banna, H. E., Shaw, G. M., & Geoffrey Chase, J. (2017). Proof of concept non-invasive estimation of peripheral venous oxygen saturation. Biomedical engineering online, 16(1), 60.
Kocjan, J., Adamek, M., Gzik-Zroska, B., Czyżewski, D., & Rydel, M. (2017). Network of breathing. Multifunctional role of the diaphragm: a review. Advances in respiratory medicine, 85(4), 224–232.
Koçyiğit H, Aydemir Ö, Ölmez N, et al. (1999). Reliability and validity of the SF-36 for Turkish. Journal of Medicine and Treatment. 1999;12:102- 6.
Kurşun, Y. Z., Yıldız, F., Kaymaz, Ö., & Önal, S. A. (2015). Ağrılı kanser hastalarının tedavisinde analjezik basamak tedavisinin yeri [Analgesic step ladder treatment in cancer patients with pain]. Agri: Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology, 27(1), 26–34.
Kuzu M, Taş O, Tulum G. (2017). Remote Monitoring Patient Parameters System. 2nd National Biomedical Device Design and Production Symposium May 16, 2017.
Langhorne, P., Stott, D. J., Robertson, L., MacDonald, J., Jones, L., McAlpine, C., Dick, F., Taylor, G. S., & Murray, G. (2000). Medical complications after stroke: a multicenter study. Stroke, 31(6), 1223–1229.
Lee B. K. (2015). Effects of the combined PNF and deep breathing exercises on the ROM and the VAS score of a frozen shoulder patient: Single case study. Journal of exercise rehabilitation, 11(5), 276–281.
Magee DJ (2008). Orthopedic Physical Assessment. 5 th ed. St. Louis, MO: Saunders Elsevier.
Murray, C. J., Atkinson, C., Bhalla, K., Birbeck, G., Burstein, R., Chou, D., Dellavalle, R., Danaei, G., Ezzati, M., Fahimi, A., Flaxman, D., Foreman, Gabriel, S., Gakidou, E., Kassebaum, N., Khatibzadeh, S., Lim, S., Lipshultz, S. E., London, S., Lopez, … U.S. Burden of Disease Collaborators (2013). The state of US health, 1990-2010: burden of diseases, injuries, and risk factors. JAMA, 310(6), 591-608.
Neviaser, A. S., & Hannafin, J. A. (2010). Adhesive capsulitis: a review of current treatment. The American journal of sports medicine, 38(11), 2346–2356.
Nobre e Souza, M. Â., Lima, M. J., Martins, G. B., Nobre, R. A., Souza, M. H., de Oliveira, R. B., & dos Santos, A. A. (2013). Inspiratory muscle training improves antireflux barrier in GERD patients. American journal of physiology. Gastrointestinal and liver physiology, 305(11), G862–G867.
Oliveira, F., de Fontenay, B. P., Bouyer, L. J., Desmeules, F., & Roy, J. S. (2017). Effects of kinesiotaping added to a rehabilitation programme for patients with rotator cuff tendinopathy: protocol for a single-blind, randomised controlled trial addressing symptoms, functional limitations and underlying deficits. BMJ open, 7(9), e017951.
Osborne, J. D., Gowda, A. L., Wiater, B., & Wiater, J. M. (2016). Rotator cuff rehabilitation: current theories and practice. The Physician and sportsmedicine, 44(1), 85–92.
Ryan, V., Brown, H., Minns Lowe, C. J., & Lewis, J. S. (2016). The pathophysiology associated with primary (idiopathic) frozen shoulder: A systematic review. BMC musculoskeletal disorders, 17(1), 340.
Schaffer, S. D., & Yucha, C. B. (2004). Relaxation & pain management: the relaxation response can play a role in managing chronic and acute pain. The American journal of nursing, 104(8), 75–82.
Sciascia, A., & Cromwell, R. (2012). Kinetic chain rehabilitation: a theoretical framework. Rehabilitation research and practice, 2012, 853037.
Sundstrup, E., & Andersen, L. L. (2017). Hard Physical Work Intensifies the Occupational Consequence of Physician-Diagnosed Back Disorder: Prospective Cohort Study with Register Follow-Up among 10,000 Workers. International journal of rheumatology, 2017, 1037051.
Stephens, R. J., Haas, M., Moore, W. L., 3rd, Emmil, J. R., Sipress, J. A., & Williams, A. (2017). Effects of Diaphragmatic Breathing Patterns on Balance: A Preliminary Clinical Trial. Journal of manipulative and physiological therapeutics, 40(3), 169–175.
Struyf, F., Geraets, J., Noten, S., Meeus, M., & Nijs, J. (2016). A Multivariable Prediction Model for the Chronification of Non-traumatic Shoulder Pain: A Systematic Review. Pain physician, 19(2), 1–10.
Jerath, R., Crawford, M. W., Barnes, V. A., & Harden, K. (2015). Self-regulation of breathing as a primary treatment for anxiety. Applied psychophysiology and biofeedback, 40(2), 107–115.

Effects of Diaphragmatic Mobilization and Diaphragmatic Breathing Exercises on Pain and Quality of Life in Individuals with Shoulder Pain: A Randomized Controlled Trial

Year 2021, Volume: 4 Issue: 2, 113 - 123, 20.12.2021

Okan Şahin Deniz Kocamaz

https://doi.org/10.33438/ijdshs.976285

Abstract

References

Ambrosino, N., Paggiaro, P. L., Macchi, M., Filieri, M., Toma, G., Lombardi, F. A., Del Cesta, F., Parlanti, A., Loi, A. M., & Baschieri, L. (1981). A study of short-term effect of rehabilitative therapy in chronic obstructive pulmonary disease. Respiration; international review of thoracic diseases, 41(1), 40–44.
Ariëns, G. A., van Mechelen, W., Bongers, P. M., Bouter, L. M., & van der Wal, G. (2001). Psychosocial risk factors for neck pain: a systematic review. American journal of industrial medicine, 39(2),180193.
Bordoni, B., & Marelli, F. (2016). Failed back surgery syndrome: review and new hypotheses. Journal of pain research, 9, 17–22.
Bordoni, B., Marelli, F., & Bordoni, G. (2016). A review of analgesic and emotive breathing: a multidisciplinary approach. Journal of multidisciplinary healthcare, 9, 97–102.
Chang, Q., Liu, R., & Shen, Z. (2013). Effects of slow breathing rate on blood pressure and heart rate variabilities. International journal of cardiology, 169(1), e6–e8.
Donatelli R.A. (2012). Physical Therapy of the Shoulder. Fifth Edition. PhD, PT, OCS National Director of Sports Rehabilitation Physiotherapy Associates. Las Vegas, Nevada. ISBN: 978-1-4377-0740-3.
Fernández-López, I., Peña-Otero, D., Atín-Arratibel, M., Eguillor-Mutiloa, M., Bravo-Llatas, C., Genovés-Crespo, M., & Callejas-González, F. J. (2021). Effects of diaphragm muscle treatment in shoulder pain and mobility in subjects with rotator cuff injuries: A dataset derived from a pilot clinical trial. Data in brief, 35, 106867.
Friesner, S. A., Curry, D. M., & Moddeman, G. R. (2006). Comparison of two pain-management strategies during chest tube removal: relaxation exercise with opioids and opioids alone. Heart & lung: the journal of critical care, 35(4), 269–276.
Hawker, G. A., Mian, S., Kendzerska, T., & French, M. (2011). Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis care & research, 63 Suppl 11, S240–S252.
Karandikar, N., & Vargas, O. O. (2011). Kinetic chains: a review of the concept and its clinical applications. PM & R: the journal of injury, function, and rehabilitation, 3(8), 739–745.
Khan, M., Pretty, C. G., Amies, A. C., Balmer, J., Banna, H. E., Shaw, G. M., & Geoffrey Chase, J. (2017). Proof of concept non-invasive estimation of peripheral venous oxygen saturation. Biomedical engineering online, 16(1), 60.
Kocjan, J., Adamek, M., Gzik-Zroska, B., Czyżewski, D., & Rydel, M. (2017). Network of breathing. Multifunctional role of the diaphragm: a review. Advances in respiratory medicine, 85(4), 224–232.
Koçyiğit H, Aydemir Ö, Ölmez N, et al. (1999). Reliability and validity of the SF-36 for Turkish. Journal of Medicine and Treatment. 1999;12:102- 6.
Kurşun, Y. Z., Yıldız, F., Kaymaz, Ö., & Önal, S. A. (2015). Ağrılı kanser hastalarının tedavisinde analjezik basamak tedavisinin yeri [Analgesic step ladder treatment in cancer patients with pain]. Agri: Agri (Algoloji) Dernegi'nin Yayin organidir = The journal of the Turkish Society of Algology, 27(1), 26–34.
Kuzu M, Taş O, Tulum G. (2017). Remote Monitoring Patient Parameters System. 2nd National Biomedical Device Design and Production Symposium May 16, 2017.
Langhorne, P., Stott, D. J., Robertson, L., MacDonald, J., Jones, L., McAlpine, C., Dick, F., Taylor, G. S., & Murray, G. (2000). Medical complications after stroke: a multicenter study. Stroke, 31(6), 1223–1229.
Lee B. K. (2015). Effects of the combined PNF and deep breathing exercises on the ROM and the VAS score of a frozen shoulder patient: Single case study. Journal of exercise rehabilitation, 11(5), 276–281.
Magee DJ (2008). Orthopedic Physical Assessment. 5 th ed. St. Louis, MO: Saunders Elsevier.
Murray, C. J., Atkinson, C., Bhalla, K., Birbeck, G., Burstein, R., Chou, D., Dellavalle, R., Danaei, G., Ezzati, M., Fahimi, A., Flaxman, D., Foreman, Gabriel, S., Gakidou, E., Kassebaum, N., Khatibzadeh, S., Lim, S., Lipshultz, S. E., London, S., Lopez, … U.S. Burden of Disease Collaborators (2013). The state of US health, 1990-2010: burden of diseases, injuries, and risk factors. JAMA, 310(6), 591-608.
Neviaser, A. S., & Hannafin, J. A. (2010). Adhesive capsulitis: a review of current treatment. The American journal of sports medicine, 38(11), 2346–2356.
Nobre e Souza, M. Â., Lima, M. J., Martins, G. B., Nobre, R. A., Souza, M. H., de Oliveira, R. B., & dos Santos, A. A. (2013). Inspiratory muscle training improves antireflux barrier in GERD patients. American journal of physiology. Gastrointestinal and liver physiology, 305(11), G862–G867.
Oliveira, F., de Fontenay, B. P., Bouyer, L. J., Desmeules, F., & Roy, J. S. (2017). Effects of kinesiotaping added to a rehabilitation programme for patients with rotator cuff tendinopathy: protocol for a single-blind, randomised controlled trial addressing symptoms, functional limitations and underlying deficits. BMJ open, 7(9), e017951.
Osborne, J. D., Gowda, A. L., Wiater, B., & Wiater, J. M. (2016). Rotator cuff rehabilitation: current theories and practice. The Physician and sportsmedicine, 44(1), 85–92.
Ryan, V., Brown, H., Minns Lowe, C. J., & Lewis, J. S. (2016). The pathophysiology associated with primary (idiopathic) frozen shoulder: A systematic review. BMC musculoskeletal disorders, 17(1), 340.
Schaffer, S. D., & Yucha, C. B. (2004). Relaxation & pain management: the relaxation response can play a role in managing chronic and acute pain. The American journal of nursing, 104(8), 75–82.
Sciascia, A., & Cromwell, R. (2012). Kinetic chain rehabilitation: a theoretical framework. Rehabilitation research and practice, 2012, 853037.
Sundstrup, E., & Andersen, L. L. (2017). Hard Physical Work Intensifies the Occupational Consequence of Physician-Diagnosed Back Disorder: Prospective Cohort Study with Register Follow-Up among 10,000 Workers. International journal of rheumatology, 2017, 1037051.
Stephens, R. J., Haas, M., Moore, W. L., 3rd, Emmil, J. R., Sipress, J. A., & Williams, A. (2017). Effects of Diaphragmatic Breathing Patterns on Balance: A Preliminary Clinical Trial. Journal of manipulative and physiological therapeutics, 40(3), 169–175.
Struyf, F., Geraets, J., Noten, S., Meeus, M., & Nijs, J. (2016). A Multivariable Prediction Model for the Chronification of Non-traumatic Shoulder Pain: A Systematic Review. Pain physician, 19(2), 1–10.
Jerath, R., Crawford, M. W., Barnes, V. A., & Harden, K. (2015). Self-regulation of breathing as a primary treatment for anxiety. Applied psychophysiology and biofeedback, 40(2), 107–115.

There are 30 citations in total.

Details

Primary Language	English
Subjects	Sports Medicine
Journal Section	Articles
Authors	Okan Şahin 0000-0002-8637-8703 Deniz Kocamaz 0000-0002-0611-7686
Publication Date	December 20, 2021
Published in Issue	Year 2021 Volume: 4 Issue: 2

Cite

APA	Şahin, O., & Kocamaz, D. (2021). Effects of Diaphragmatic Mobilization and Diaphragmatic Breathing Exercises on Pain and Quality of Life in Individuals with Shoulder Pain: A Randomized Controlled Trial. International Journal of Disabilities Sports and Health Sciences, 4(2), 113-123. https://doi.org/10.33438/ijdshs.976285
AMA	Şahin O, Kocamaz D. Effects of Diaphragmatic Mobilization and Diaphragmatic Breathing Exercises on Pain and Quality of Life in Individuals with Shoulder Pain: A Randomized Controlled Trial. International Journal of Disabilities Sports &Health Sciences. December 2021;4(2):113-123. doi:10.33438/ijdshs.976285
Chicago	Şahin, Okan, and Deniz Kocamaz. “Effects of Diaphragmatic Mobilization and Diaphragmatic Breathing Exercises on Pain and Quality of Life in Individuals With Shoulder Pain: A Randomized Controlled Trial”. International Journal of Disabilities Sports and Health Sciences 4, no. 2 (December 2021): 113-23. https://doi.org/10.33438/ijdshs.976285.
EndNote	Şahin O, Kocamaz D (December 1, 2021) Effects of Diaphragmatic Mobilization and Diaphragmatic Breathing Exercises on Pain and Quality of Life in Individuals with Shoulder Pain: A Randomized Controlled Trial. International Journal of Disabilities Sports and Health Sciences 4 2 113–123.
IEEE	O. Şahin and D. Kocamaz, “Effects of Diaphragmatic Mobilization and Diaphragmatic Breathing Exercises on Pain and Quality of Life in Individuals with Shoulder Pain: A Randomized Controlled Trial”, International Journal of Disabilities Sports &Health Sciences, vol. 4, no. 2, pp. 113–123, 2021, doi: 10.33438/ijdshs.976285.
ISNAD	Şahin, Okan - Kocamaz, Deniz. “Effects of Diaphragmatic Mobilization and Diaphragmatic Breathing Exercises on Pain and Quality of Life in Individuals With Shoulder Pain: A Randomized Controlled Trial”. International Journal of Disabilities Sports and Health Sciences 4/2 (December 2021), 113-123. https://doi.org/10.33438/ijdshs.976285.
JAMA	Şahin O, Kocamaz D. Effects of Diaphragmatic Mobilization and Diaphragmatic Breathing Exercises on Pain and Quality of Life in Individuals with Shoulder Pain: A Randomized Controlled Trial. International Journal of Disabilities Sports &Health Sciences. 2021;4:113–123.
MLA	Şahin, Okan and Deniz Kocamaz. “Effects of Diaphragmatic Mobilization and Diaphragmatic Breathing Exercises on Pain and Quality of Life in Individuals With Shoulder Pain: A Randomized Controlled Trial”. International Journal of Disabilities Sports and Health Sciences, vol. 4, no. 2, 2021, pp. 113-2, doi:10.33438/ijdshs.976285.
Vancouver	Şahin O, Kocamaz D. Effects of Diaphragmatic Mobilization and Diaphragmatic Breathing Exercises on Pain and Quality of Life in Individuals with Shoulder Pain: A Randomized Controlled Trial. International Journal of Disabilities Sports &Health Sciences. 2021;4(2):113-2.

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