2.3.2. CPTBE Group
forceful
The CPTBE group performed conservative physical therapy with breathing exercises.Conservative physical therapy, which includes muscle strengthening, mat training, and stretching, was administered for 30 min, with the difficulty level adjusted according to each patient’s level. The focus was on stability training to increase trunk stability, stretching for body flexibility, and training for muscle strengthening. The therapy was provided by a physiotherapist with over 3 years of experience, and the intervention was administered for six weeks, five days a week, with each session lasting 30 min.To integrate breathing exercises into the intervention, a 15 min conservative physical therapy was followed by a 15 min breathing exercise program, during which the MIP was measured using K5 (Power breathe, Southam, UK). The patient sat in an upright position with a straight back and waist and exhaled as much air as possible from the lungs through a mouthpiece, followed by a rapid and forceful inhalation, repeating the process 30 times (1 set). After a one-minute rest, the patient proceeded to the next set, and performed three sets in total. If the patient felt dizzy or fatigued during the exercise, it was immediately interrupted and resumed after a rest period of comfortable breathing.