The effect of diaphragmatic breathing exercise on Vo2max improvement in stroke patients at Yastroki Yogyakarta
Keywords:
diaphragmatic breathing exercise, VO2Max, strokeAbstract
In stroke conditions, blood flow to the brain is disrupted, causing sudden neurological dysfunction, with symptoms depending on the area of the brain affected. Due to the neurological dysfunction, cardiorespiratory fitness and diaphragmatic function decline, with VO2Max—an indicator of aerobic capacity—ranging from 11.7±3.7 mL/kg/min to 17.3±7.0 mL/kg/min, or approximately 50–60% of normal values. The aim of this study was to determine the effect of diaphragmatic breathing exercises on increasing VO2Max in stroke patients at Yastroki Yogyakarta. This study employed a quantitative experimental approach using a one-group pre-test and post-test design. Participants were selected using purposive sampling based on inclusion criteria, totaling 40 individuals. The exercise was conducted three times a week over four weeks. The instrument used was the Six-Minute Walking Test, with measurements taken before and after the intervention. The results of the hypothesis test using a paired sample t-test showed that Diaphragmatic Breathing Exercise was effective in improving VO2Max in stroke patients, with a p-value of 0.000 (p<0.05). Diaphragmatic Breathing Exercise can improve VO2Max in stroke patients, indicating this exercise as an effective non-pharmacological method. The clinical implications of these findings emphasize the importance of regularly implementing this exercise to manage VO2Max and prevent cardiovascular complications in stroke patients.
References
Amalia, N. P., & Rahman, M. I. (2021). Latihan Endurance Penderita Pasca Stroke Iskemik. FISIO MU: Physiotherapy Evidences, 3(1), 23–28. https://doi.org/10.23917/fisiomu.v3i1.14351
Aulyra Familah, Arina Fathiyyah Arifin, Achmad Harun Muchsin, Mochammad Erwin Rachman, & Dahliah. (2024). Karakteristik Penurunan Kebugaran Kardiorespirasi Pada Penderita Stroke Iskemik dan Stroke Hemoragik. Fakumi Medical Journal: Jurnal Mahasiswa Kedokteran, 4(6), 456–463. https://doi.org/10.33096/fmj.v4i6.468
Avula, A., Nalleballe, K., Narula, N., Sapozhnikov, S., & Dandu, V. (2020). Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID- 19 . The COVID-19 resource centre is hosted on Elsevier Connect , the company ’ s public news and information . January.
Ayu Ria Widiani, G., & Mahardika Yasa, I. M. (2023). Korelasi Tingkat Pengetahuan Terhadap Kemampuan Deteksi Dini Gejala Stroke Dengan Sikap Keluarga Terhadap Penanganan Pre Hospital. Bina Generasi : Jurnal Kesehatan, 14(2), 25–30. https://doi.org/10.35907/bgjk.v14i2.255
Cahyani, R. P., & Putri, N. W. (2020). Nursing Care for Stroke Patients Using a Forward Leaning Position and Pursed Lip Breathing Training to Improve Oxygen Saturation. Madago Nursing Journal, 1(2), 37–42.
Chang, K. W., Lin, C. M., Yen, C. W., Yang, C. C., Tanaka, T., & Guo, L. Y. (2021). The effect of walking backward on a treadmill on balance, speed of walking and cardiopulmonary fitness for patients with chronic stroke: A pilot study. International Journal of Environmental Research and Public Health, 18(5), 1–11. https://doi.org/10.3390/ijerph18052376
Daba, M., & Maulina, L. (2023). Pemberian Aktivitas Fisik Dengan Six Minuted Walking Test Pada Penurunan Kebugaran Kardiorespirasi Dengan Kondisi Stroke. 7, 2907–2912. https://doi.org/https://journal.ummat.ac.id/index.php/jpmb/article/view/17127
Haiga, Y., Prima Putri Salman, I., & Wahyuni, S. (2022). Diagnosis Stroke Iskemik dan Stroke Hemoragik dengan Penurunan Kebugaran Kardiorespirasi di RSUP Dr. M. Djamil Padang. Scientific Journal, 1(5), 391–400. https://doi.org/10.56260/sciena.v1i5.72
Jeong Min Yoon, Sang Cheol Im, K. K. (2022). Effects of diaphragmatic breathing and pursed lip breathing exercises on the pulmonary function and walking endurance in patients with chronic stroke: a randomised controlled trial. International Journal Of Therapy and Rehabilitation, 29. https://doi.org/doi: 10.12968/ijtr.2021.0027
Jerau, E. E., Sujianto, U., & Handayani, F. (2023). Respiratory Muscle Training Terhadap Kekuatan Otot Pernapasan Pada Rehabilitasi Pasca Stroke. Dunia Keperawatan: Jurnal Keperawatan Dan Kesehatan, 11(1), 36–47. https://doi.org/10.20527/jdk.v11i1.60
Khairatunnisa, S. D. M. (2017). Faktor Risiko yang Berhubungan dengan Kejadian Stroke pada Pasien di RSU H. Sahudin Kutacane Kabupaten Aceh Tenggara. Faktor Risiko Yang Berhubungan Dengan Kejadian Stroke Pada Pasien Di RSU H. Sahudin Kutacane Kabupaten Aceh Tenggara, 2(1).
Masriana, Muammar, & Yahya, M. (2021). Faktor-Faktor Yang Mempengaruhi Terjadinya Penurunan VO2Max Pada Stroke. Journal of Nursing and Midwifery, 3(3), 55–66. http://jurnal.sdl.ac.id/index.php/dij/
Ojo, I. A., Dominic, O. L., & Adeyemi, W. J. (2021). Eight Weeks Twenty Meters Walk Aerobic Exercise Improve Cardio-respiratory Fitness and Muscular Strength of Stroke Survivor Outpatients in Tertiary Hospitals in Osogbo, Nigeria. Journal of The Korean Society of Physical Medicine, 16(2), 9–21. https://doi.org/10.13066/kspm.2021.16.2.9
Oyake, K., Baba, Y., Ito, N., Suda, Y., Murayama, J., Mochida, A., Kondo, K., Otaka, Y., & Momose, K. (2019). Cardiorespiratory factors related to the increase in oxygen consumption during exercise in individuals with stroke. PLoS ONE, 14(10), 1–21. https://doi.org/10.1371/journal.pone.0217453
Pakpahan, J. E. S., & Hartati, B. (2022). Hubungan dislipidemia dengan kejadian penurunan fungsi kardiorespirasi pada stroke. Holistik Jurnal Kesehatan, 16(6), 542–551. https://doi.org/10.33024/hjk.v16i6.8089
Rahayu, T. G., & Setiyani, S. (2024). Quality of Life of Post Stroke Patients With Decreased Endurance: Descriptive Study. Proceedings of the International Conference on Nursing and Health Sciences, 5(1), 83–88. https://jurnal.globalhealthsciencegroup.com/index.php/PICNHS/article/view/2871
Rahmasari, W., Zainuddin, Z., Ambarsarie, R., Hartati, U., & Suryani. (2023). Pengaruh Latihan Penguatan Otot Diagfragma Terhadap Penurunan VO2 Pada Stroke. Malahayati Nursing Journal, 5(April). https://doi.org/https://doi.org/10.33024/mnj.v5i4.8498
Sarah Thompson, BSc, Augustine J. Devasahayam, PhD, Cynthia J. Danells, MScPT, David Jagroop, MHSc, Elizabeth L. Inness, PhD, Avril Mansfield, P. (2021). Effect of cardiorespiratory exercise during rehabilitation on functional recovery early post- stroke: a cohort study. MedRxiv, 1(165), 1–13. https://www.medrxiv.org/content/10.1101/2024.08.09.24311772v1
Seo, K., Hwan, P. S., & Park, K. (2017). The effects of inspiratory diaphragm breathing exercise and expiratory pursed-lip breathing exercise on chronic stroke patients’ respiratory muscle activation. Journal of Physical Therapy Science, 29(3), 465–469. https://doi.org/10.1589/jpts.29.465
Shetty, N., Samuel, S. R., Alaparthi, G. K., Amaravadi, S. K., Joshua, A. M., & Pai, S. (2020). Comparison of Diaphragmatic Breathing Exercises, Volume, and Flow-Oriented Incentive Spirometry on Respiratory Function in Stroke Subjects: A Non-randomized Study. Annals of Neurosciences, 27(3–4), 232–241. https://doi.org/10.1177/0972753121990193
Sinurat, R. (2021). Implementation Of The Evaluation Of The Volume Of Maximum Oxygen Update (VO2Max) Athletes Koni Rokan Hulu. 6.
Sumiarty, C., Wijaya, S., & Bogor, H. (2020). Hubungan Tingkat Pengetahuan Stroke Dengan Perilaku Pencegahan Stroke Pada Lansia Di Kelurahan Sindang Barang Kota Bogor. Jurnal Ilmiah Wijaya, 12(September), 2723–3448. www.jurnalwijaya.com;
Susilowati, E., Kusharyaningsih, R. H., & Poerwandari, D. (2020). Correlation of cardiorespiratory fitness levels with functional mobility abilitiy in post thrombotic infarction stroke patient. Indian Journal of Forensic Medicine and Toxicology, 14(2), 1546–1551. https://doi.org/10.37506/ijfmt.v14i2.3145
Thayabaranathan, T., Kim, J., Cadilhac, D. A., Thrift, A. G., Donnan, G. A., Howard, G., Howard, V. J., Rothwell, P. M., Feigin, V., Norrving, B., Owolabi, M., Pandian, J., Liu, L., & Olaiya, M. T. (2022). Global stroke statistics 2022. International Journal of Stroke, 17(9), 946–956. https://doi.org/10.1177/17474930221123175
Vivi, Agustiani, S., & Fitri, N. (2025). Hubungan Usia, Jenis Kelamin, dan Jenis Stroke Terhadap Kardiorespirasi Pasien Stroke. Jurnal Penelitian Keperawatan, 11(2407–7232), 71–80.
Yudha, A. K., & Suidah, H. (2023). Studi Korelasi Pola Makan dan Kadar Kolesterol Pada Pasien Stroke disertai dengan penurunan VO2Max. Pengembangan Ilmu Dan Praktik Kesehatan, 2(1), 48–61. https://doi.org/10.56586/pipk.v2i1.282
Zaid, M., Sala, L., Despins, L., Heise, D., Popescu, M., Skubic, M., Ahmad, S., Emter, C. A., Huxley, V. H., & Guidoboni, G. (2023). Sex differences in stroke with cardiovascular decline: insights through physiology-based modeling and the potential for non-invasive sensing via ballistocardiography. Frontiers in Cardiovascular Medicine, 10(October), 1–12. https://doi.org/10.3389/fcvm.2023.1215958