Effects of Buteyko Breathing Technique Versus Diaphragmatic Breathing on Exercise Capacity and Quality of Life in Patients with Chronic Obstructive Pulmonary Disease

Background: Chronic obstructive pulmonary disease (COPD) is a significant public health concern characterized by persistent respiratory symptoms and airflow limitation. Pulmonary rehabilitation has been shown to improve symptoms, quality of life, and physical function in patients with COPD. However, the impact of specific breathing techniques, particularly the Buteyko breathing technique and diaphragmatic breathing, on the functional capacity and respiratory performance of COPD patients remains underexplored. Objective: This study aimed to evaluate the effects of the Buteyko breathing technique versus diaphragmatic breathing on exercise capacity and quality of life in patients with COPD. Methods: A total of 48 patients with moderate to severe COPD were recruited from a pulmonary rehabilitation clinic and randomly assigned to either an intervention group (Buteyko breathing technique) or a control group (diaphragmatic breathing technique), with 24 participants in each group. The intervention group received Buteyko breathing training three times a week for eight weeks, in addition to standard care. The control group received diaphragmatic breathing training under the same conditions. The primary outcome was the distance walked in the six-minute walk test (6MWT). Secondary outcomes included the Timed Up and Go (TUG) test, Short Physical Performance Battery (SPPB) scores, Hospital Anxiety and Depression Scale (HADS) scores, Mini-Mental State Examination (MMSE) scores, and health-related quality of life assessed using the Patient Satisfaction Questionnaire (PSQ). Data were analyzed using SPSS version 25, with a significance level set at p<0.05. Ethical approval was obtained from the institutional review board, and all participants provided written informed consent. Results: The intervention group showed a significant improvement in the 6MWT distance, with a mean increase of 45 meters (p<0.01), compared to the control group’s mean increase of 10 meters. The TUG test time decreased significantly in the intervention group from 12.45 ± 1.23 seconds to 10.12 ± 1.10 seconds (p=0.002), while the control group improved from 12.78 ± 1.56 seconds to 11.34 ± 1.20 seconds. The SPPB score improved significantly in the intervention group from 8.34 ± 1.12 to 10.23 ± 1.30 (p=0.046), whereas the control group showed a modest improvement from 8.50 ± 1.10 to 9.56 ± 1.45. HADS-Anxiety scores decreased from 9.23 ± 2.45 to 7.12 ± 2.00 (p=0.025) in the intervention group, and HADS-Depression scores from 8.56 ± 2.34 to 6.34 ± 2.10 (p=0.015). MMSE scores increased in both groups but were not statistically significant. PSQ scores increased significantly in both groups post-intervention, with Group A improving from 70.45 ± 5.23 to 82.34 ± 4.78 (p=0.012) and Group B from 71.12 ± 5.10 to 78.89 ± 5.45. Conclusion: Diaphragmatic breathing training significantly enhances functional exercise capacity, reduces dyspnea, and improves quality of life in patients with moderate to severe COPD. These findings support the incorporation of diaphragmatic breathing exercises into standard pulmonary rehabilitation programs for COPD patients. Keywords: Chronic Obstructive Pulmonary Disease, Buteyko Breathing, Diaphragmatic Breathing, Pulmonary Rehabilitation, Exercise Capacity, Quality of Life, Six-Minute Walk Test, Timed Up And Go Test, Short Physical Performance