Exercise group
Subjects in the exercise group were taught pursed-lip
breathing (PLB) and diaphragmatic breathing (DB), coordinated
with self-paced walking as a physical exercise.
PLB requires breathing in through the nose and breathing
out slowly through pursed-lips. Expiration time was twice
as the inspiration time to slow down the breathing rate.
Meanwhile, DB helps to reduce the work of breathing and
improves ventilation and dyspnoea. In this study, subjects
were instructed to inhale through the nose, push the stomach
out, then exhale through pursed lips slowly, pulling
the stomach in. Return demonstrations of the breathing
techniques were performed by subjects to ensure proper
practice. Subjects were advised to perform breathing and
walking exercise for one hour, which could be split into
two or three sessions to prevent fatigue. Leaflets with
pictures and instructions were given to the subjects to
facilitate daily self-practice. A diary was also given to
each subject for recording the frequency of their selfpractice
sessions. The breathing techniques of subjects
were re-assessed at the 6-week and 3-month to ensure
that proper skills were maintained. The breathing exercise
is a conventional exercise commonly used in PRP.
The breathing component in this group was different from
that in the TCQ group, as TCQ group did not require
PB, and had no restriction on time for breathing in and
Exercise group
Subjects in the exercise group were taught pursed-lip
breathing (PLB) and diaphragmatic breathing (DB), coordinated
with self-paced walking as a physical exercise.
PLB requires breathing in through the nose and breathing
out slowly through pursed-lips. Expiration time was twice
as the inspiration time to slow down the breathing rate.
Meanwhile, DB helps to reduce the work of breathing and
improves ventilation and dyspnoea. In this study, subjects
were instructed to inhale through the nose, push the stomach
out, then exhale through pursed lips slowly, pulling
the stomach in. Return demonstrations of the breathing
techniques were performed by subjects to ensure proper
practice. Subjects were advised to perform breathing and
walking exercise for one hour, which could be split into
two or three sessions to prevent fatigue. Leaflets with
pictures and instructions were given to the subjects to
facilitate daily self-practice. A diary was also given to
each subject for recording the frequency of their selfpractice
sessions. The breathing techniques of subjects
were re-assessed at the 6-week and 3-month to ensure
that proper skills were maintained. The breathing exercise
is a conventional exercise commonly used in PRP.
The breathing component in this group was different from
that in the TCQ group, as TCQ group did not require
PB, and had no restriction on time for breathing in and
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