Investigation of the effectiveness of diaphragmatic mobilization and diaphragmatic breathing exercises in patients diagnosed with cervical disc herniation

This study was conducted to evaluate the effects of diaphragmatic mobilization and diaphragmatic breathing exercises on pain, range of motion (ROM), muscle strength and activities of daily living in individuals diagnosed with cervical disc herniation. A total of 60 individuals diagnosed with cervical disc herniation, aged 18-66, were included in the study. The participants were randomly divided into two groups as Control Group and Experimental Group. The Control Group was taught ROM and Isometric neck exercises in addition to 20 minutes of TENS and 15 minutes of hotpack application. The Experimental Group was taught diaphragmatic mobilization and diaphragmatic breathing exercises in addition to the classical protocol; treatment was continued for 8 weeks, 3 days a week. Treatment effects were evaluated using standardized measures such as pain with Visual Analog Scale (VAS), Digital Goniometer, Manual Muscle Test and Neck Disability Questionnaire. When VAS scores were examined, a more significant decrease in pain levels was recorded in the Experimental Group compared to the Control Group (p=0.001). While no significant difference was found between the groups in the range of motion of flexion (p=0.084), extension (p=0.092), right lateral flexion (p=0.129), left lateral flexion (p=0.202), a greater increase was observed in the Experimental Group in right rotation (p=0.001) and left rotation (p=0.000*) movements. Although there was no significant difference between the groups in flexor (p=0.051), extensor (p=0.864), right rotator (p=0.364) and left rotator (p=0.011) muscle strength results, when right lateral flexor (p=0.038) and left lateral flexor (p=0.001) were examined, it was seen that the Experimental Group made significant and more progress. Neck Disability Questionnaire scores decreased to a similar degree in both groups after treatment (p=0.053). These findings support that the integration of diaphragmatic mobilization and diaphragmatic breathing exercises into treatment protocols may increase the effectiveness of cervical disc herniation treatment and provide faster recovery in terms of pain, ROM and muscle strength.