exercise

Background and objectives: A stroke is a neurological deficit, caused due to vascular changes. Impaired postural control and balance impairments in post-stroke patients are associated with a high risk of falls among stroke patients. The perturbation-based balance training is mainly used in older adults and balance impairment. Virtual reality (VR) as a novel technology is rapidly becoming a popular intervention for improving balance. VR can visualize computer-generated environments with a full field of view through Head-mounted displays (HMD-VR). This study was conducted to assess and investigate the effect of balance exercises with smartphone-based virtual reality programs on balance in stroke patients.Methods: This was a randomized single-group pre and post-test study design. 30 subjects met the inclusion criteria and were enrolled, assigned, and received intervention. Subjects were given perturbation-based balance exercises and smartphone-based virtual reality along with conventional physiotherapy. The intervention protocol was for 6 days/week for 4 weeks period. Results: Following 4 weeks of intervention showed improvement in postural control and balance which was assessed using BBS, TUG, VR BESS, BESTest, and SIS 3.0. Paired t-test was used to differentiate the mean significance. The mean pre to post-intervention difference is 12.6 with a p - value < 0.05. TUG score improved from pre to post-intervention difference is 1.443 with a p - value < 0.05. VR BESS score improved from pre to post-intervention difference is 10.266 with a p value < 0.05. The mean BESTest pre to post-intervention difference is 11.467 with a p - value < 0.05. SIS 3.0 score improved from a pre to post-intervention difference is 20.33 with p - value < 0.05. The result of this study showed a highly significant difference in pre and post-treatment.Conclusion: The study concludes that perturbation-based balance exercises with smartphone-based virtual reality programs are a useful adjunct to improving balance in stroke patients along with conventional physiotherapy. 

Introduction: Neuromuscular training (NT) involves a series of functionally focused exercises that address aspects such as postural stability, sensory perception, and muscle strengthening. These exercises are incorporated as an integral part of a currently used training protocol. Objective: To review the main effects of NT on injury prevention in soccer players and its impact on related physical performance. Methods: Review of the literature describing different studies on NT in soccer. The following databases were used to search and retrieve the scientific articles: PubMed, Scopus, and Ebsco. Combinations of the following keywords were used to perform the search (“neuromuscular training” OR “proprioceptive training” OR “sensorimotor training”) AND (“soccer” OR “football” OR “soccer players” OR “football players”). Results: A positive trend is observed in NT for the prevention of knee and ankle injuries, in addition to improving muscle strength and motor skills such as agility and coordination. Conclusion: This review managed to identify that NT is effective in reducing the risk of injury in soccer players; however, the literature has mainly addressed lower extremity injuries. Therefore, it may be necessary for future investigations to focus on the upper extremity and trunk. Likewise, it was determined that NT has a potential impact on improving physical performance, with the variables of strength, power, speed, agility, and balance being the most studied.

Background: Clinician managers can play a crucial role in healthcare organizations, including hospitals, by combining their clinical expertise with managerial responsibilities. They bring valuable insights and firsthand experience of patient care to managerial positions, contributing to improved patient outcomes and hospital performance. However, they face unique challenges that require careful attention and solutions. Aim: This review aims to critically discuss the role of clinicians as managers, the challenges that they face, and how they exercise their influence in hospital settings. Key findings: The role of clinicians as managers is critical for effective leadership and delivery of high-quality patient care. Described as a two-way window, clinician managers bridge the gap between medicine and management by combining clinical expertise with managerial skills in a hybrid leadership approach. Studies have shown a positive impact on hospital performance, including enhanced quality care, improved patient outcomes, and potentially better financial performance. In addition, they play a vital role in fostering interdisciplinary collaboration and boosting staff engagement. However, challenges such as identity conflicts, and limited formal training, are present, especially for first-time managers. Conclusion: Adapting to the dual role of clinician and manager demands a mindset shift and the development of new skills, necessitating strategic support. This includes leadership education, organizational support, mentoring, and collaborative models to empower clinician managers. Targeted training programs, formal mentoring, and peer support networks equip them with essential skills, while workload management, well-being initiatives, and a culture of balance foster success and growth.

The current study aimed to investigate the effect of using a pilates exercise program on improving body mass index and body composition of non-physically active working women. The participants of the study were (16) working women at the University of Basrah, Iraq. A pre-posttest was utilized to collect the data, (after a 12-week cycle of exercises) in Pilates groups, the results of the study showed that there were statistically significant differences at (α ≤ 0.05) in the women’s mean scores on body mass index and body composition. The study concluded that the pilates exercise program is effective in the improvement of body mass index and body composition of non-physically active working women.

Introduction: In our fast-paced world, children’s dietary habits and behaviour are increasingly concerning, with a tendency toward indulging in sweets and snacks. Insights are derived from observations of 20 children at a crèche facility.Temptation of sweets: Children’s inherent attraction to sweet and salty snacks challenges maintaining a healthy diet. Excessive consumption can lead to health issues, recognizing the pivotal role parents and caregivers play in guiding children toward healthier choices.Significance of a balanced diet: A well-rounded and nutritious diet is crucial for a child’s physical and mental development. Providing fruits, vegetables, whole grains, and lean proteins is essential.Role of activities: Diversifying a child’s routine with engaging activities is a powerful strategy to redirect their focus from unhealthy snacks. Sports, arts, outdoor play, and educational games promote physical fitness, creativity, and cognitive development, contributing to a well-balanced lifestyle.Strategies for encouraging healthy choices:•    Lead by example: Modelling healthy habits inspires children to adopt similar behaviour.•    Educate about nutrition: Imparting knowledge about the nutritional value of foods equips children to make informed choices.•    Make healthy options accessible: Stocking the kitchen with nutritious snacks makes it convenient for children to opt for healthier alternatives.•    Limit unhealthy choices: Setting clear limits on sugary snacks helps children develop moderation and self-control.•    Create a fun and active environment: Fostering an enjoyable environment involves family outings, games, and making exercise a natural part of daily life.Results: Encouraging results were observed among the 20 children. Two children, aged around 12, demonstrated awareness of healthy habits. Excluding these two, others showed positive changes in behaviour towards sweets and snacks through activities and counselling.Conclusion: Maintaining a balance between a child’s consumption of sweets and snacks and engaging in diverse activities is crucial for overall development. A combination of nutritious choices and engaging activities guides children toward a path of health and happiness

Background: Temporomandibular Disorder (TMD) pain attributed to myalgia is a common condition and patients should get advice on the best treatment option. Objectives: The aim was to evaluate the effect of two different exercise programs, or bite splint therapy, respectively, in patients with chronic frequent primary myofascial orofacial pain. Methods: The study was a randomized clinical trial including patients fulfilling criteria of chronic frequent primary myofascial orofacial pain with a reported pain intensity of ≥ 4 on a numerical rating scale (0-10). Ninety subjects were randomized to either bite splint, home exercises, or a supervised exercise program. Two examiners blinded to the treatment modality examined the same subject at baseline and a 3-month follow-up. Non-parametric statistical methods were applied for the outcome of treatment in intended-to-treat analyses. A P-value <0.05 was considered statistically significant. Results: The pain severity index was significantly reduced (p < 0.001) in all treatment groups. Jaw opening capacity improved significantly (p < 0.05) for those randomized to bite splint and for those in the home exercise program. About 70% of the participants reported improvement in their TMD pain severity with no significant difference between treatments. Both exercise groups improved in jaw function at the 3-month follow-up compared to baseline. Those who had a bite splint reported significantly more improvement in their headaches compared to those in the exercise programs. Conclusion: Jaw exercise programs and bite splint treatments had similar positive effects on TMD pain severity attributed to myalgia after 3 months.

Weight gain can be good or bad for health. Benefits include increased health for overweight people, disease or surgical recovery, and more. Health concerns, joint and musculoskeletal disorders, respiratory issues, metabolic abnormalities, cardiovascular health, psychological impact, reduced mobility, digestive troubles, hormonal changes, and cancer risk are negative impacts. Weight gain outcomes depend on heredity, weight distribution, and health. Maintaining a healthy weight needs a balanced diet, regular exercise, and stress management. A doctor or nutritionist can offer personalized weight management advice. Stress chemicals like cortisol trigger weight gain. ACTH stimulates adrenal glands to release cortisol, which increases hunger, fat storage, insulin resistance, and muscle loss. Understanding how stress hormones like cortisol affect weight gain is vital to reducing chronic stress’s health risks. Stress reduction, a balanced diet, regular exercise, proper sleep, social support, and professional treatment can mitigate these outcomes. Ultimately, stress hormones like cortisol can cause weight gain, but a holistic strategy tackling physical and psychological stress can help people maintain a healthy weight.

Introduction: Spaced fiber bundles, less evident cell striations, deposition of collagen fiber bundles, and increased presence of fibroblasts in the cardiac tissue of rats that voluntarily and chronically ingested ethanol were observed by our research group. In addition, we observed increased proliferation and cell death of cardiomyocytes. To find out whether these changes lead to impaired heart functionality, some clinical tests were performed. Aim: to investigate whether chronic ethanol decreases the left ventricular performance assessed by exercise testing, electrocardiogram, and echocardiogram of male and female UChB strain rats. Material and methods: ten adult males and ten adult females, Wistar strain rats, named UChB (University of Chile), spontaneous high ethanol drinkers (consumption greater than 2 g ethanol / Kg body weight/day), and ten male UChB rats and ten adults female UChB rats, not exposed to ethanol, UChBC rats (controls) were used. Cardiac performance was evaluated by the stress test, electrocardiogram, and echocardiogram. Results: Exposed females showed ventricular morphological changes in the heart. The exposed females and males had the highest heart relative weight with females being larger than males. The exposed females showed altered electrocardiogram and echocardiogram. Conclusion: Chronic ethanol decreases the left ventricular cardiac performance in rats. Females are more sensitive to changes in cardiac electrical conduction.

Summary: Exercise is recommended for the treatment and prevention of type 2 diabetes. Also, to control and reduce glucose fluctuations in people with type 1 diabetes. However, the most appropriate time and the most effective intensity of exercise is still unknown, and various studies provide different results and different recommendations, and none of the studies provide a comprehensive and practical result. We conducted our studies to examine the results and determine the effect of time and intensity of exercise on blood sugar control and glucose fluctuations during the day. Methods: search in PubMed and Google Scholar with keywords morning, evening, type 1 and 2 diabetes, exercise, interval, periodic, aerobic, and glucose and blood sugar fluctuations were performed. A total of 31 articles were reviewed and finally, 10 articles that were most related to each other or had complementary information were selected. Conclusion: HIIT exercises are useful for type 2 diabetes, but they are recommended for type 1 diabetes with less pressure. Morning exercise increases glucose and evening exercise is applicable for type 1 and 2 diabetes.

Pulmonary hypertension (PH) in sickle cell disease (SCD) is associated with a mortality rate of 37%. There is an upregulation of adhesion molecules which leads to the expression of endothelin-1, a potent vasoconstrictor. A prospective, descriptive study was done to determine the safety and efficacy of macitentan in patients with SCD and PH. Continuous variables were reported as mean ± SEM or percentage where appropriate. We screened 13 patients and recruited five. All five patients were adults. Data were analyzed as appropriate by student t - test. Statistical significance was assumed at p < 0.05. Baseline pulmonary hemodynamics obtained by right heart catheterization and systemic hemodynamics were (± SEM): mean pulmonary artery pressure (MPAP) 32 ± 8 mmHg, right atrial pressure (RAP) 9 ± 4 mmHg, pulmonary vascular resistance (PVR) 257 dynes-sec/cm5 and CI 3·7 ± 0.39 l/m2. Of all parameters, only PVR and 6-min walk distance changed significantly. For the group, MPAP decreased by 15.6%, PVR by 22.5% and RAP by 25.5%. The 6-minute walk distance increased over sixteen weeks except in Patient 4 who had a 3% decrease. The mean walk distance increased in the total distance, from 464 ± 158 meters to 477 ± 190 meters (p .123). In four patients, the adverse events were mild to moderate and did not lead to study drug discontinuation. Significant improvement in pulmonary hemodynamics and exercise capacity in patients with SCD-related pulmonary arterial hypertension. We found that macitentan was safe and well tolerated.

The Blood Flow Restriction (BFR) technique is based on cuffs connected to a pressure device that induces partial arterial inflow. BFR combined with exercise has already been proven to increase strength, muscle mass, and muscular endurance. However, some BFR devices with pneumatic air bands, such as KAATSU (KA), are expensive and less accessible, making either a Sphygmomanometer Cuff (SC) or Elastic Band (EB) an interesting alternative. However, vascular parameters in response to blood flow restriction during KA, EB, and SC have not yet been compared. Purpose: The aim of this study was to compare the brachial blood flow behavior during restriction using bands such as KA, SC, and EB on the same perceived tightness. Methods: Thirty healthy men participated in a prospective crossover study. Participants underwent blood flow measurements before and during KA, SC, and EB use, with KA-perceived tightness taken as a reference. The brachial blood flow volume, the diameter of the artery, and blood flow velocity were measured before and immediately after the cuff’s inflation at a specific tightness. Results: Blood flow volume was significantly reduced in KA (52%, ES: 1.38), SC (61.7%, ES: 1.29), and EB (41.5%, ES: 1.22) (p

The study on the remote effect of fascial manipulation on knee pain presents a case report of a patient with knee pain who underwent a single session of fascial manipulation to reduce pain and improve daily activities. The report explains the anatomy of the knee joint and the potential causes of knee pain, including bony and soft tissue involvement. Fascial manipulation is a technique that involves applying mechanical force to areas of fascial dysfunction to stimulate the body’s natural inflammatory response. The therapy is based on applying physical friction to the densified connective tissue with an elbow or knuckle to raise the temperature and change the consistency of loose connective tissue rich in hyaluronic acid. The locations picked were proximal and distal to the problematic area, and no point was treated over the painful region, which is consistent with the notion of pain being caused by aberrant fascial tensions. Manipulation of the connective tissue is thought to cause mechanical stress and heat, resulting in less macromolecular crowding and defragmentation of the Hyaluronic Acid (HA) polymers and normalised fascial gliding across the connective tissue. Reduced discomfort and enhanced range of motion are two more regularly reported effects of Fascial Manipulation. The patient was urged to resume his everyday activities after each treatment session to favour typical physiological motions that would align collagen fibres along normal lines of force. The report concludes that fascial manipulation can be a beneficial technique for managing knee pain, and it can be complemented with exercises and stretches to improve outcomes.

Background: Delaying or slowing functional loss is a valuable goal of Multiple Sclerosis (MS) rehabilitation. The mHealth app-based exercise rehabilitation intervention is expected to overcome barriers related to routine care of MS. Due to the ubiquitous presence of smartphones, they offer an excellent opportunity for remote monitoring, scheduled interaction with experts, and instruction for exercise in a home environment. Challenges in MS routine care include forgotten rehabilitation steps, limited access to local MS experts, and internal barriers such as low health literacy, mobility limitations, and fatigue, alongside external obstacles like service availability and transport costs.Objectives: To develop a mHealth app that is user-centered and context-specific for rehabilitation of MS symptoms, and to evaluate its clinical and cost effectiveness in individuals with RRMS.Methods: The proposed research will be conducted in two phases; the first phase (Phase 1a) will be focused on the development of mHealth app content (ReMiT-MS app trial I). The pilot phase (Phase 1b), where a prototype of the application will be designed, and its usability will be evaluated. Finally, in the second phase (Phase 2), the clinical and cost-effectiveness of the ReMiT-MS app for the rehabilitation of individuals with RRMS will be evaluated (ReMiT-MS app trial II).Conclusion: The findings of this proposed trial may provide a telerehabilitation platform for individuals with RRMS in a resource-limited setting and establish a low-cost healthcare delivery model. In addition, the results of this research work might open a new window in healthcare delivery in India and similar settings.Trial registration:  CTRI/2022/09/045266 [Registered on 06/09/2022]

Severe alcoholic hepatitis is an ethical and clinical conundrum, wherein a liver transplant is often recommended. The adequacy of medical treatment versus the risk of recidivism after transplant is often debated. Complete recovery in 26 of 27 patients with severe alcoholic hepatitis was observed, and hence the data was retrospectively analysed.Methods: 27 patients, with severe alcoholic hepatitis, with Maddrey's discriminant function between 59.7 to 165.2 (mean 107.53), from June 2017 to May 2022, were followed up for between 11 months to 6 years. INR ranged from 1.99 to 3.7 (mean 2.709), and bilirubin was between 7.6 to 37.01, (mean 20.859). 8 patients had pre-existing liver cirrhosis. All patients received probiotics, nutritional support, physical rehabilitation, saturated fat (clarified butter/ desi ghee) supplementation, and anti-oxidant support. At 90 days, total bilirubin improved to between 1.0 to 6.8 (mean 2.625). ALT (Alanine Transaminase/ SGPT) ranged from 65 to 550 (mean ALT – 197); and AST (Aspartate Transaminase / SGOT) ranged from 58 to 810 (mean AST – 271.51). Both the AST and ALT were near normal after 90 days. One patient died due to bacterial pneumonia and sepsis; the remaining 26 patients made a complete recovery. All patients including those with diagnosed liver cirrhosis, had complete resolution of their ascites, and near-normal liver function. At the last outpatient visit, none had ascites, edema, or encephalopathy, and had normal albumin levels and INR values. Conclusion: Probiotics, nutrition, a saturated fat diet, and exercise; all have shown benefits in patients with severe alcoholic hepatitis when tested individually. Concomitant use of all the above has not been reported in the treatment of alcoholic hepatitis. The role of nutrition alone versus the contribution of nutritional deficiencies and the role of gut-derived endotoxemia need to be studied in detail. How to identify patients who need a transplant, if it is needed at all, remains a challenge.

Purpose: Lipolysis is regulated by lipolytic hormones, like insulin, cortisol, growth Hormone (GH), and catecholamines. Unregulated lipolysis results in the accumulation of free fatty acids (FFAs), leading to dysfunction of cells and death. Thus, the main aim of this study was to determine the effects of interval and traditional resistance exercise on hormonal control of adipose-tissue lipolysis in healthy young men.Methods: Twelve healthy males (Mean ± SD; age, 25.5 ± 3.1 years; Body mass index, 24.2 ± 2.0 kg/m2) performed tradition resistance exercise (TRE) at 80% of 1RM (3 sets of 6 repetitions) with 2 min passive recovery, and an interval resistance exercise (IRE) trial at 60% of 1RM (3 sets of 6 repetitions) followed by active recovery (1 set of 6 repetitions at 20% of 1RM). Three blood samples were taken before and immediately after exercise, and after one-hour recovery and were analyzed to measure epinephrine, norepinephrine, cortisol, and GH. Results: Statistical analyses of the data revealed that concentrations of cortisol and GH increased in response to resistance exercise and significantly decreased (p < 0.05) during the recovery period. Although there were no significant differences between the two protocols for cortisol concentration, GH increases following IRE were profoundly higher than TRE protocol. Epinephrine and norepinephrine increased (p < 0.05) in response to both resistance exercise trials, though, no between-group differences were found for these variables. Conclusion: The results of our study showed increases in GH, cortisol, epinephrine, and norepinephrine in two resistance exercise protocols which may lead to increases in fat oxidation.

Physiotherapy treatments employ complex approaches tailored to the patient’s diagnosis. Exercise is the primary strategy to enhance rehabilitation processes for most individuals. However, electrophysical agents, such as Photobiomodulation (PBM), that utilize specific wavelengths of light to penetrate tissues and stimulate cellular activity, can modulate various biological processes and may improve physiotherapy outcomes. This non-invasive treatment can reduce pain and inflammation, promote tissue repair, and accelerate tissue healing. Currently, PBM has numerous applications, including pain and inflammation treatment, wound healing (such as diabetic foot ulcers, pressure ulcers, post-surgery wounds, and skin grafts in burn injuries), and the management of musculoskeletal disorders (such as arthritis, tendinopathies, muscle injuries, and spinal disorders). It is also utilized to improve muscle performance and recovery in rehabilitation and sports. Additionally, transcranial PBM has shown promise in enhancing neurorehabilitative processes by facilitating the recovery of cognitive and motor functions in various types of lesions. The safety and efficacy of this treatment allow it to be incorporated alongside regular exercises and manual therapies as an adjunctive treatment, potentially enhancing outcomes in different areas of rehabilitation.

Introduction: Childhood obesity is one of the current themes of medical research, being considered not so much a multidimensional condition but primarily a real problem of worldwide interest.The aim of our randomized study was to evaluate and compare the effects of physical exercise associated with an educational program on clinical-functional status in overweight and obese children.Material and method: Participants were children hospitalized, through the emergency service, in the Pediatric Department, Craiova Municipal Clinical Hospital, between June and November 2023. 93 overweight and obese children, aged between 2 and 16 years, were evaluated (clinical, paraclinical and functional) by a multidisciplinary team and randomized into the control group (group C – 63 children) and the study group (group S – 30 children). After the resolution of the acute digestive or respiratory disease, the children in group S underwent a program to restore their functional status, based on educational measures (following the 5-2-1-0 rule) and physical exercises, for 12 weeks. Anthropometric data were measured (height, weight, body mass index); physical performance wasevaluated by gait analysis (we used the BTS G – WALK / BTS G – SENSOR 2 system, BTS Bioengineering Corp, Italy) with the determination of four parameters – the Timed Up-and-Go (TUG) test, the symmetry index, the walking test six minutes (6 MWT) and walking cadence or average cadence (steps/min) in both groups of children.The results were obtained by analyzing the differences in values obtained in the two moments T1 (initial) and T2 (after three months). The proportion of girls and boys was approximately equal within obesity class in each study group. Although we did not obtain statistically significant differences between the monitored parameters, between the two groups, for the two evaluation moments, the children in Group S had a clearly favorable evolution for physical performance parameters, whose average value was improved in T2. Anthropometric data did not change.Conclusion: The present study confirms the effectiveness of the multimodal (educational-kinetic) program for the physical performance of overweight/obese children. The sustained running of the program at home, with the involvement of the family and the school environment, is essential for the well-being of these children, with a favorable impact on the quality of life later.

Atherosclerosis Ischemic Cardiovascular Disease (ASICD), one of the leading causes of global deaths, is mainly caused due to the development of plaque on the inner walls of arteries of the human heart. Ischemia refers to the lack of enough oxygen (O2), nutrient delivery, and improper waste removal in the cardiac cells. About 90% of cardiovascular diseases in the present world are due to the formation of lipid/cholesterol-based plaques that can form under the lining of the smooth epithelial blood cells. In the US, a study published in the Journal of the American College of Cardiology estimated that poor diet is responsible for about 45% of Cardiovascular Disease. Atherosclerosis doesn’t cause much effect until and unless the plaque becomes unstable due to the accumulation of thrombus that shows Acute Coronary Syndrome. Acute Coronary Syndrome is the result of blockage of blood vessels leading to Myocardial Infarction (Unstable Angina Pectoris). Cardiac Cells require a sufficient amount of Oxygen to function properly. Thus, the demand and supply of oxygen to the cardiac cells should be properly balanced. Atherosclerosis Ischemic Cardiovascular syndrome can worsen if the person is more involved in exercise or emotional stress because at that time their body requires higher oxygen but blood flow gets disrupted due to the formation of plague. Later in the paper, we will discuss the New York Heart Association classification, followed by the top 3 poor diets that are considered to be increasing the cases of cardiovascular disease around the world.

Micronutrients are critical components of an athlete’s diet, affecting both performance and cardiovascular health. This review summarizes current studies on the importance of micronutrients in sports cardiology, focusing on their effects on energy metabolism, antioxidant defense, and cardiac function. Key findings emphasize the relevance of micronutrient sufficiency in improving athletic performance and avoiding long-term health issues linked to strenuous training programs. Micronutrients like B vitamins help energy generation pathways, while antioxidants like C and E reduce exercise-induced oxidative damage. Minerals like magnesium and iron are important for muscle function and oxygen delivery, which are required for endurance and recovery. Effective nutritional practices include balancing food intake and, if required, supplementing under medical supervision to address individual needs and enhance performance results. Future research paths will focus on individualized nutrition techniques based on genetic and metabolic profiles, allowing for more precise food recommendations for athletes. Collaboration between sports medicine and nutrition disciplines is critical for establishing evidence-based practices and improving cardiovascular health in athletes.

Background: The Intercostal Stretch Technique is one of the physiotherapy techniques that is used to solve different respiratory problems. It is used for increasing chest expansion and diaphragm excursion improvement and also intra-thoracic lung volume. Aim: The study aims to evaluate the effectiveness of the intercostal stretch technique.Methodology: A narrative review. In this study, an RCT study was used to review the intervention.Results: Several articles are used to discuss the effectiveness of the intercostal stretch technique. In stable COPD, diaphragmatic breathing and the intercostal stretch technique both work equally well to improve chest expansion and functional capacity while lowering dyspnea. Research has shown that IC stretch outperforms the anterior basal lift technique in lowering heart and respiratory rates while increasing oxygen saturation. According to this study, IC stretching in conjunction with breathing control may improve dynamic lung parameters, particularly FEV1/FVC%, more than breathing control alone. Patients with COPD have an increased functional exercise capacity and reduced dyspnea when aerobic training and respiratory muscle stretching are combined. Conclusion: Different articles demonstrated that IC stretch improved lung function, expired tidal volume, decreased dyspnea, and increased chest expansion.