Effects of Diaphragmatic Breathing Patterns on Balance: A Preliminary Clinical Trial

J Manipulative Physiol Ther. Mar-Apr 2017;40(3):169-175. doi: 10.1016/j.jmpt.2017.01.005. Epub 2017 Mar 1.


Objective: The purpose of this study was to determine the feasibility of performing a larger study to determine if training in diaphragmatic breathing influences static and dynamic balance.

Methods: A group of 13 healthy persons (8 men, 5 women), who were staff, faculty, or students at the University of Western States participated in an 8-week breathing and balance study using an uncontrolled clinical trial design. Participants were given a series of breathing exercises to perform weekly in the clinic and at home. Balance and breathing were assessed at the weekly clinic sessions. Breathing was evaluated with Liebenson's breathing assessment, static balance with the Modified Balance Error Scoring System, and dynamic balance with OptoGait's March in Place protocol.

Results: Improvement was noted in mean diaphragmatic breathing scores (1.3 to 2.6, P < .001), number of single-leg stance balance errors (7.1 to 3.8, P = .001), and tandem stance balance errors (3.2 to 0.9, P = .039). A decreasing error rate in single-leg stance was associated with improvement in breathing score within participants over the 8 weeks of the study (-1.4 errors/unit breathing score change, P < .001). Tandem stance performance did not reach statistical significance (-0.5 error/unit change, P = .118). Dynamic balance was insensitive to balance change, being error free for all participants throughout the study.

Conclusion: This proof-of-concept study indicated that promotion of a costal-diaphragmatic breathing pattern may be associated with improvement in balance and suggests that a study of this phenomenon using an experimental design is feasible.

Keywords: Breathing Exercises; Diaphragm; Exercise; Postural Balance; Respiration.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Biomechanical Phenomena
  • Diaphragm / physiopathology*
  • Feasibility Studies
  • Female
  • Healthy Volunteers
  • Humans
  • Male
  • Postural Balance / physiology*
  • Prospective Studies
  • Respiration
  • Respiratory Mechanics / physiology*