Dysfunctional Breathing Patterns, Diaphragmatic Function, Core Stability, and Postural Control in Combat Sport Athletes: Diaphragm-Centered Neuromuscular Control Perspective and Effects of Diaphragmatic Breathing Retraining
试验速览
- 阶段
- 不适用
- 状态
- 招募中
- 入组人数
- 60
- 试验地点
- 1
- 主要终点
- Breathing Pattern_ Total Faulty Breathing Scale (TFBS) Score
研究概览
简要总结
Combat sport athletes often need to maintain a guarded posture, stabilize the trunk, react quickly, and control balance during contact or unexpected movement. These demands may be related not only to strength and conditioning, but also to the coordination between breathing and postural control. The diaphragm is the main muscle for breathing and also contributes to trunk stability through its role in pressure regulation and deep core control. However, dysfunctional breathing patterns, such as upper-chest dominant breathing, reduced lower rib expansion, or poor coordination between the chest and abdomen, may interfere with this function.
The purpose of this study is to examine dysfunctional breathing patterns in combat sport athletes and to investigate whether diaphragmatic breathing retraining can improve breathing patterns, diaphragm function, core stability, postural control, and sport-related performance. This study will first screen athletes from combat and non-combat sports to determine the prevalence of dysfunctional breathing. Combat sport athletes will then complete laboratory tests to examine the relationship between breathing pattern, posture, diaphragm function, core stability, and postural control. In the intervention part of the study, combat sport athletes with dysfunctional breathing will be randomly assigned to diaphragmatic breathing retraining plus usual training or usual training only. The study will compare the two groups to determine whether adding diaphragmatic breathing retraining provides additional benefits. The study will also examine whether the changes are maintained after training and whether baseline measures can help identify athletes who respond better to the program.
详细描述
Combat sports place high demands on the neuromuscular system. Athletes must generate force, absorb impact, maintain balance, and respond to an opponent under rapidly changing conditions. Many combat sport athletes also use protective or guarded postures during training and competition. These postures may help with short-term stability, but they may also be associated with altered trunk control, reduced movement adaptability, and increased loading on the spine and surrounding tissues.
Breathing mechanics may be one factor related to these movement-control demands. The diaphragm is not only the primary muscle for inspiration, but also contributes to trunk stabilization. Through its interaction with the abdominal wall, pelvic floor, and deep spinal muscles, the diaphragm helps regulate intra-abdominal pressure and support postural control. When breathing is dominated by the upper chest or accessory muscles, the coordination between breathing and trunk stabilization may be less efficient.
Dysfunctional breathing has been reported in physically active and athletic populations, but its role in combat sport athletes is still not well understood. Most sport-related breathing studies have focused on respiratory muscle strength or endurance. Less attention has been given to breathing pattern normalization and the integration of breathing with postural control. For this reason, the present study focuses on dysfunctional breathing as a possible neuromuscular control issue rather than only a respiratory problem.
This study includes three main stages. In the first stage, athletes from combat and non-combat sports will be screened for dysfunctional breathing and postural characteristics. This stage will estimate the prevalence of dysfunctional breathing and compare breathing patterns between sport types. A subgroup of combat sport athletes will also complete laboratory-based testing to examine whether breathing pattern is associated with diaphragm function, posture, core stability, and postural control.
In the second stage, combat sport athletes with dysfunctional breathing will participate in an intervention study. Participants will first complete a single-session breathing correction assessment to examine immediate changes in breathing pattern and diaphragm function. They will then be randomly assigned to either diaphragmatic breathing retraining plus usual training or usual training only. The breathing retraining program will last 8 weeks and will progress from breathing correction in supported positions to breathing control in upright and core-demanding positions.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 18 Years 至 50 Years（Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Aged between 18 and 50 years.
- •Currently participating regularly in combat sports, such as taekwondo, boxing, judo, karate, jiu-jitsu, or similar sports, with at least 2 years of training experience.
- •Training at least 3 times per week.
排除标准
- •Current or major musculoskeletal injury within the past year that may affect testing or training performance.
- •History of major thoracic, abdominal, or spinal surgery.
- •Known cardiopulmonary diseases, such as asthma, chronic obstructive pulmonary disease, or heart disease; neurological disorders; vestibular dysfunction; or other conditions that may affect balance.
- •Current or recent pregnancy.
- •Previous participation in breathing training or respiratory therapy, or current use of medications that may affect respiratory or neuromuscular function.
- •Inability to complete ultrasound assessment, motion analysis, or exercise testing.
- •Having a subordinate relationship or conflict of interest with the principal investigator or co-investigators, such as being a supervised student, research assistant, employee, or other related personnel.
结局指标
主要结局
Breathing Pattern_ Total Faulty Breathing Scale (TFBS) Score
时间窗: Baseline (Day 1), Day 1 (immediately after first session), Week 8 (post-intervention), Week 16 (8 weeks after intervention completion)
Breathing pattern severity assessed using the Total Faulty Breathing Scale (TFBS), a structured observational tool scored 0-12. Higher scores indicate greater breathing dysfunction. Assessed during 10 cycles of quiet and 10 cycles of deep breathing in standing. Also supported by Manual Assessment of Respiratory Motion (MARM).
Trunk Flexor Endurance _ McGill Curl-Up Hold Test
时间窗: Baseline (Day 1), Week 8 (post-intervention), Week 16 (8 weeks after intervention completion)
Description: Isometric trunk flexor endurance measured as hold time during the McGill Curl-Up Test. A longer time indicates greater endurance. Unit of Measure: seconds
Back Extensor Endurance _Biering-Sørensen Test
时间窗: Baseline (Day 1), Week 8 (post-intervention), Week 16 (8 weeks after intervention completion)
Isometric back extensor endurance measured as hold time during the Biering-Sørensen Test. A longer time indicates greater endurance. Unit of Measure: seconds
Movement Speed_10-Meter Sprint Time
时间窗: Baseline (Day 1), Week 8 (post-intervention), Week 16 (8 weeks after intervention completion)
Time to complete a 10-meter maximal sprint from a combat/two-point stance, measured with electronic timing gates. Lower time indicates better performance. Unit of Measure: seconds
Agility _ T-Test Time
时间窗: Baseline (Day 1), Week 8 (post-intervention), Week 16 (8 weeks after intervention completion)
Time to complete the agility T-test course (sprint forward, lateral shuffles, backward run around 4 cones in a T-shape). Lower time indicates better multidirectional agility. Unit of Measure: seconds
Visual Motor Reaction Time _ BlazePod System
时间窗: Baseline (Day 1), Week 8 (post-intervention), Week 16 (8 weeks after intervention completion)
Average reaction time to randomly illuminated light pods during a standardized protocol from a fighting stance, using the BlazePod system (BlazePod Ltd.). Lower time indicates faster reaction. Unit of Measure: milliseconds
Dynamic Balance _ Y Balance Test Composite Score
时间窗: Baseline (Day 1), Week 8 (post-intervention), Week 16 (8 weeks after intervention completion)
Maximum normalized reach distance in the anterior, posteromedial, and posterolateral directions during single-leg stance on the Y-Balance Test. Unit of Measure: percent of leg length
Reactive Postural Control - Time to Stabilization
时间窗: Baseline (Day 1), Week 8 (post-intervention), Week 16 (8 weeks after intervention completion)
Time to stabilization of center of pressure after an unexpected anterior pulling perturbation (10% body weight), measured via force plate. Lower time indicates better reactive postural control. Unit of Measure: seconds
Reactive Postural Control - Trunk/Pelvis Angular Displacement
时间窗: Baseline (Day 1), Week 8 (post-intervention), Week 16 (8 weeks after intervention completion)
Angular displacement of the trunk and pelvis during the stabilization phase following an unexpected anterior pulling perturbation, measured via 3D motion capture. Unit of Measure: degrees
Reactive Postural Control - Trunk/Pelvis Angular Velocity
时间窗: Baseline (Day 1), Week 8 (post-intervention), Week 16 (8 weeks after intervention completion)
Angular velocity of the trunk and pelvis during the stabilization phase following an unexpected anterior pulling perturbation, measured via 3D motion capture. Unit of Measure: degrees per second
Reactive Postural Control - Peak Ground Reaction Force
时间窗: Baseline (Day 1), Week 8 (post-intervention), Week 16 (8 weeks after intervention completion)
Peak ground reaction force during the stabilization phase following an unexpected anterior pulling perturbation, measured via force plate. Unit of Measure: percent of body weight
Reactive Postural Control - COP Path Length
时间窗: Baseline (Day 1), Week 8 (post-intervention), Week 16 (8 weeks after intervention completion)
Total center-of-pressure trajectory length during the stabilization phase following an unexpected anterior pulling perturbation, measured via force plate and normalized to foot length. Unit of Measure: mm
Reactive Postural Control - Trunk Muscle Onset Latency
时间窗: Baseline (Day 1), Week 8 (post-intervention), Week 16 (8 weeks after intervention completion)
EMG onset latency of trunk muscles relative to perturbation onset, measured via surface electromyography. Unit of Measure: milliseconds
Reactive Postural Control - Trunk Muscle EMG Amplitude
时间窗: Baseline (Day 1), Week 8 (post-intervention), Week 16 (8 weeks after intervention completion)
Normalized EMG amplitude of trunk muscles during the early stabilization phase following an unexpected anterior pulling perturbation. Unit of Measure: percent of MVIC
Maximal Inspiratory Pressure (MIP)
时间窗: Baseline (Day 1), Week 8 (post-intervention), Week 16 (8 weeks after intervention completion) Secondary
Global inspiratory muscle strength was measured in cmH₂O using a gas pressure gauge (Galemed Corporation). Participants exhale maximally, then inhale forcefully against the gauge for ≥1 second with a nose clip applied.
Maximal Expiratory Pressure (MEP)
时间窗: Baseline (Day 1), Week 8 (post-intervention), Week 16 (8 weeks after intervention completion)
Global expiratory muscle strength is measured using a gas pressure gauge. Participants inhale maximally, then exhale forcefully against the gauge for ≥1 second. Unit of Measure: cmH₂O
Diaphragmatic Excursion
时间窗: Baseline (Day 1), Day 1 (immediately after first session), Week 8 (post-intervention), Week 16 (8 weeks after intervention completion)
Maximum diaphragmatic excursion during maximal inspiration and expiration, measured by M-mode ultrasonography with a 1-5 MHz convex transducer in the right mid-clavicular subcostal region. Unit of Measure: cm
Diaphragmatic Thickening Fraction
时间窗: Baseline (Day 1), Day 1 (immediately after first session), Week 8 (post-intervention), Week 16 (8 weeks after intervention completion)
Diaphragmatic thickening fraction calculated from B-mode ultrasound measurements of diaphragm thickness at end-maximal inspiration and end-maximal expiration, using a 4-12 MHz linear transducer at the zone of apposition. Unit of Measure: percent
Proactive Core Stability - Time to Stabilization
时间窗: Baseline (Day 1), Week 8 (post-intervention), Week 16 (8 weeks after intervention completion)
Time to stabilization of center of pressure after single-leg drop landing, measured via force plate. Lower time indicates better proactive core stability. Unit of Measure: seconds
Proactive Core Stability - Trunk/Pelvis Angular Displacement
时间窗: Baseline (Day 1), Week 8 (post-intervention), Week 16 (8 weeks after intervention completion)
Angular displacement of the trunk and pelvis during the stabilization phase following single-leg drop landing, measured via 3D motion capture. Unit of Measure: degrees
Proactive Core Stability - Trunk/Pelvis Angular Velocity
时间窗: Baseline (Day 1), Week 8 (post-intervention), Week 16 (8 weeks after intervention completion)
Angular velocity of the trunk and pelvis during the stabilization phase following single-leg drop landing, measured via 3D motion capture. Unit of Measure: degrees per second
Proactive Core Stability - Peak Ground Reaction Force
时间窗: Baseline (Day 1), Week 8 (post-intervention), Week 16 (8 weeks after intervention completion)
Peak ground reaction force during the stabilization phase following single-leg drop landing, measured via force plate. Unit of Measure: percent of body weight
Proactive Core Stability - COP Path Length
时间窗: Baseline (Day 1), Week 8 (post-intervention), Week 16 (8 weeks after intervention completion)
Total center-of-pressure trajectory length during the stabilization phase following single-leg drop landing, measured via force plate and normalized to foot length. Unit of Measure: mm
Proactive Core Stability - Trunk Muscle EMG Amplitude
时间窗: Baseline (Day 1), Week 8 (post-intervention), Week 16 (8 weeks after intervention completion)
Normalized EMG amplitude of trunk muscles during the early stabilization phase following single-leg drop landing. Unit of Measure: percent of MVIC
次要结局
未报告次要终点
研究者
YI-JU TSAI
Professor
National Cheng Kung University