Breathing technique in pain and cognitive function: a systematic review of the literature

Breathing techniques are key components of yoga, meditation and relaxation practices that are well known for reducing anxiety and improving overall well-being. To evaluate the efficacy of breathing techniques in pain and cognitive function. We conducted a literature review searching the main literat...

Full description

Autores:
Alzate-Granados, Juan-Pablo
Solarte, Armando
López, Pedro-Javier
Barceló, Ernesto
Tipo de recurso:
Review article
Fecha de publicación:
2020
Institución:
Corporación Universidad de la Costa
Repositorio:
REDICUC - Repositorio CUC
Idioma:
eng
OAI Identifier:
oai:repositorio.cuc.edu.co:11323/10068
Acceso en línea:
https://hdl.handle.net/11323/10068
https://repositorio.cuc.edu.co/
Palabra clave:
Breathing techniques
Pain
Cognitive function
Systematic review
Breath holding
Técnicas respiratorias
Dolor
Función cognitiva
Revisión sistemática
Contención de la respiración
Rights
openAccess
License
Atribución-NoComercial-SinDerivadas 4.0 Internacional (CC BY-NC-ND 4.0)
id RCUC2_1f2df76a9a36ebd9d36a13fdfa5f8c5c
oai_identifier_str oai:repositorio.cuc.edu.co:11323/10068
network_acronym_str RCUC2
network_name_str REDICUC - Repositorio CUC
repository_id_str
dc.title.eng.fl_str_mv Breathing technique in pain and cognitive function: a systematic review of the literature
dc.title.translated.none.fl_str_mv Técnicas respiratorias en dolor y función cognitiva: revisión sistemática de la literatura
title Breathing technique in pain and cognitive function: a systematic review of the literature
spellingShingle Breathing technique in pain and cognitive function: a systematic review of the literature
Breathing techniques
Pain
Cognitive function
Systematic review
Breath holding
Técnicas respiratorias
Dolor
Función cognitiva
Revisión sistemática
Contención de la respiración
title_short Breathing technique in pain and cognitive function: a systematic review of the literature
title_full Breathing technique in pain and cognitive function: a systematic review of the literature
title_fullStr Breathing technique in pain and cognitive function: a systematic review of the literature
title_full_unstemmed Breathing technique in pain and cognitive function: a systematic review of the literature
title_sort Breathing technique in pain and cognitive function: a systematic review of the literature
dc.creator.fl_str_mv Alzate-Granados, Juan-Pablo
Solarte, Armando
López, Pedro-Javier
Barceló, Ernesto
dc.contributor.author.none.fl_str_mv Alzate-Granados, Juan-Pablo
Solarte, Armando
López, Pedro-Javier
Barceló, Ernesto
dc.subject.proposal.eng.fl_str_mv Breathing techniques
Pain
Cognitive function
Systematic review
Breath holding
topic Breathing techniques
Pain
Cognitive function
Systematic review
Breath holding
Técnicas respiratorias
Dolor
Función cognitiva
Revisión sistemática
Contención de la respiración
dc.subject.proposal.spa.fl_str_mv Técnicas respiratorias
Dolor
Función cognitiva
Revisión sistemática
Contención de la respiración
description Breathing techniques are key components of yoga, meditation and relaxation practices that are well known for reducing anxiety and improving overall well-being. To evaluate the efficacy of breathing techniques in pain and cognitive function. We conducted a literature review searching the main literature databases (medline, lilacs, Cochrane library) including randomized clinical trials. We assessed the risk of bias of the included studies using the methodology proposed by the Cochrane collaboration. In total, we found 16 studies that met the inclusion criteria, with an intermediate or unclear overall risk of bias. When combining the different breathing techniques vs control in the included studies, we found a statistically significant difference in terms of the visual analog scale (Difference of means, random effects; -1.21 [95% CI -1.75 to -0.68]; I2: 95%). Meditation-based breathing techniques would improve pain and cognitive function in patients with a painful entity or healthy volunteers. Keywords: Breathing techniques; pain; cognitive function; systematic review; breath holding
publishDate 2020
dc.date.issued.none.fl_str_mv 2020-12-07
dc.date.accessioned.none.fl_str_mv 2023-05-02T17:23:57Z
dc.date.available.none.fl_str_mv 2023-05-02T17:23:57Z
dc.type.spa.fl_str_mv Artículo de revista
dc.type.coar.fl_str_mv http://purl.org/coar/resource_type/c_2df8fbb1
dc.type.coar.spa.fl_str_mv http://purl.org/coar/resource_type/c_dcae04bc
dc.type.content.spa.fl_str_mv Text
dc.type.driver.spa.fl_str_mv info:eu-repo/semantics/article
dc.type.redcol.spa.fl_str_mv http://purl.org/redcol/resource_type/ARTREV
dc.type.version.spa.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.coarversion.spa.fl_str_mv http://purl.org/coar/version/c_970fb48d4fbd8a85
format http://purl.org/coar/resource_type/c_dcae04bc
status_str publishedVersion
dc.identifier.citation.spa.fl_str_mv Alzate-Granados, J.-P., Solarte, A., López, P.-J., & Barceló, E. (2020). Breathing technique in pain and cognitive function: a systematic review of the literature: Técnicas respiratorias en dolor y función cognitiva: revisión sistemática de la literatura. Journal of Applied Cognitive Neuroscience, 1(1), 25–42. https://doi.org/10.17981/JACN.1.1.2020.02
dc.identifier.uri.none.fl_str_mv https://hdl.handle.net/11323/10068
dc.identifier.doi.none.fl_str_mv 10.17981/JACN.1.1.2020.02
dc.identifier.eissn.spa.fl_str_mv 2745-0031
dc.identifier.instname.spa.fl_str_mv Corporación Universidad de la Costa
dc.identifier.reponame.spa.fl_str_mv REDICUC - Repositorio CUC
dc.identifier.repourl.spa.fl_str_mv https://repositorio.cuc.edu.co/
identifier_str_mv Alzate-Granados, J.-P., Solarte, A., López, P.-J., & Barceló, E. (2020). Breathing technique in pain and cognitive function: a systematic review of the literature: Técnicas respiratorias en dolor y función cognitiva: revisión sistemática de la literatura. Journal of Applied Cognitive Neuroscience, 1(1), 25–42. https://doi.org/10.17981/JACN.1.1.2020.02
10.17981/JACN.1.1.2020.02
2745-0031
Corporación Universidad de la Costa
REDICUC - Repositorio CUC
url https://hdl.handle.net/11323/10068
https://repositorio.cuc.edu.co/
dc.language.iso.spa.fl_str_mv eng
language eng
dc.relation.ispartofjournal.spa.fl_str_mv Journal of Applied Cognitive Neuroscience
dc.relation.references.spa.fl_str_mv Aamann, L., Dam, G., Rinnov, A. R., Vilstrup, H. & Gluud, L. L. (2018). Physical exercise for people with cirrhosis. Cochrane Database of Systematic Reviews, (12), 1–42. https://doi.org/10.1002/14651858.cd012678.pub2
Abdallah, S. J., Smith, B. M., Ware, M. A., Moore, M., Li, P. Z., Bourbeau, J. & Jensen, D. (2018). Effect of Vaporized Cannabis on Exertional Breathlessness and Exercise Endurance in Advanced Chronic Obstructive Pulmonary Disease. A Randomized Controlled Trial. Annals of the American Thoracic Society, 15(10), 1146–1158. https://doi.org/10.1513/AnnalsATS.201803-198OC
Abedi, P., Jahanfar, S., Namvar, F. & Lee, J. (2016). Breastfeeding or nipple stimulation for reducing postpartum haemorrhage in the third stage of labour. Cochrane Database of Systematic Reviews, (1), 1–32. https:// doi.org/10.1002/14651858.CD010845.pub2
Altenau, B., Crisp, C. C., Devaiah, C. G. & Lambers, D. S. (2017). Randomized controlled trial of intravenous acetaminophen for postcesarean delivery pain control. American Journal of Obstetrics & Gynecology, 217(3), 362.e361–362.e366. https://doi.org/10.1016/j.ajog.2017.04.030
Arsenault, M., Ladouceur, A., Lehmann, A., Rainville, P. & Piché, M. (2013). Pain modulation induced by respiration: phase and frequency effects. Neuroscience, 12(252), 501– 511. https://doi.org/10.1016/j.neuroscience.2013.07.048
Babina, R., Mohanty, P. P. & Pattnaik, M. (2016). Effect of thoracic mobilization on respiratory parameters in chronic non-specific low back pain: A randomized controlled trial. Journal of Back & Musculoskeletal Rehabilitation, 29(3), 587–595. https://doi.org/10.3233/BMR-160679
Barnes, H., McDonald, J., Smallwood, N. & Manser, R. (2019). Opioids for the palliation of refractory breathlessness in adults with advanced disease and terminal illness. Cochrane Database of Systematic Reviews, (3), 1–103. https://doi.org/10.1002/14651858.CD011008.pub2
Bayer, U., Glazachev, O. S., Likar, R., Burtscher, M., Kofler, W., Pinter, G., Stettner, H., Demschar, S., Trummer, B. & Neuwersch, S. (2017). [Adaptation to intermittent hypoxia-hyperoxia improves cognitive performance and exercise tolerance in elderly]. Advances in Gerontology, 7(3), 214–220. https://doi.org/10.1134/S2079057017030031
Boaviagem, A., Melo Junior, E., Lubambo, L., Sousa, P., Aragao, C., Albuquerque, S. & Lemos, A. (2017). The effectiveness of breathing patterns to control maternal anxiety during the first period of labor: A randomized controlled clinical trial. Complementary Therapies in Clinical Practice, 26, 30–35. https://doi.org/10.1016/j.ctcp.2016.11.004
Chan, K. K., Joo, D. A., McRae, A. D., Takwoingi, Y., Premji, Z. A., Lang, E. & Wakai, A. (2019). Chest ultrasonography versus supine chest radiography for diagnosis of pneumothorax i n trauma patients in the emergency department. Cochrane Database of Systematic Reviews, (5), 1–16. https://doi.org/10.1002/14651858.CD013031.pub2
Choo, J. K., Simons, E. F. & Sheikh, A. (2018). Glucocorticoids for the treatment of anaphylaxis. Cochrane Database of Systematic Reviews, 65(10), 1205–1211. https://doi.org/10.1111/j.1398-9995.2010.02424.x
Connolly, B., Salisbury, L., O’Neill, B., Geneen, L. J., Douiri, A., Grocott, P. W. M., Hart, N., Walsh, T. & Blackwood, B. (2018). Exercise rehabilitation following intensive care unit dischargeor recovery from critical illness. Journal of Cachexia, Sarcopenia and Muscle, (7) 1–6. https://doi.org/10.1002/jcsm.12146
Ferreira, L., Tanaka, K., Santos-Galduroz, R. F. & Fernandes, J. C. (2015). Respiratory training as strategy to prevent cognitive decline in aging: a randomized controlled trial. Clinical Interventions in Aging, (10), 593–603. https://doi.org/10.2147/CIA.S79560
Frokjaer, J. B., Bergmann, S., Brock, C., Madzak, A., Farmer, A. D., Ellrich, J. & Drewes, A. M. (2016). Modulation of vagal tone enhances gastroduodenal motility and reduces somatic pain sensitivity. Neurogastroenterology & Motility, 28(4), 592–598. https://doi.org/10.1111/nmo.12760
Gilbert-Kawai, E. T., Mitchell, K., Martin, D., Carlisle, J. & Grocott, P. W. M. (2018). Permissive hypoxaemia versus normoxaemia for mechanically ventilated critically ill patients. Cochrane Database of Systematic Reviews, (5), 1–18. https://doi.org/10.1002/14651858.CD009931.pub2
Grubić, T., Babić, M. & Štimac, D. (2019). Exploring the feasibility of a mild and short 4-week combined upper limb and breathing exercise program as a possible home base program to decrease fatigue and improve quality of life in ambulatory and non-ambulatory multiple sclerosis individuals. Neurological Sciences, 40(4), 733–743. https:// doi.org/10.1007/s10072-019-3707-0
Grubić, T., Babić, M. & Štimac, D. (2019). Exploring the feasibility of a mild and short 4-week combined upper limb and breathing exercise program as a possible home base program to decrease fatigue and improve quality of life in ambulatory and non-ambulatory multiple sclerosis individuals. Neurological Sciences, 40(4), 733–743. https:// doi.org/10.1007/s10072-019-3707-0
Gunay, S., Eser, I., Ozbey, M., Agar, M., Koruk, I. & Kurkcuoglu, I. C. (2016). Evaluation of two different respiratory physiotherapy methods after thoracoscopy with regard to arterial blood gas, respiratory function test, number of days until discharge, cost analysis, comfort and pain control. Nigerian Journal of Clinical Practice, 19(3), 353–358. https://doi.org/10.4103/1119-3077.179279
Janssens, L., McConnell, A. K., Pijnenburg, M., Claeys, K., Goossens, N., Lysens, R., Troosters, T. & Brumagne, S. (2015). Inspiratory muscle training affects proprioceptive use and low back pain. Medicine & Science in Sports & Exercise, 47(1), 12–19. https://doi.org/10.1249/MSS.0000000000000385
Knips, L., Bergenthal, N., Streckmann, F., Monsef, I., Elter, T. & Skoetz, N. (2019). Aerobic physical exercise for adult patients with haematological malignancies. Cochrane Database of Systematic Reviews, (1), 1–104. https://doi.org/10.1002/14651858.CD009075.pub3
Larkey, L. K., Roe, D. J., Smith, L. & Millstine, D. (2016). Exploratory outcome assessment of Qigong/Tai Chi Easy on breast cancer survivors. Complementary Therapies in Medicine, 29, 196–203. https://doi.org/10.1016/j. ctim.2016.10.006
Lee, A. L., Gordon, C. S. & Osadnik, C. R. (2018). Exercise training for bronchiectasis. Cochrane Database of Systematic Reviews, (8), 1–12. https://doi.org/10.1002/14651858.CD013110
Lee, J. M., Lee, S. K., Lee, S. J., Hwang, W. S., Jang, S. W. & Park, E. Y. (2016). Comparison of remifentanil with dexmedetomidine for monitored anaesthesia care in elderly patients during vertebroplasty and kyphoplasty. Journal of International Medical Research, 44(2), 307–316. https://doi.org/10.1177/0300060515607385
Lee, M.-H. & Jang, S.-H. (2019). The effects of the neck stabilization exercise on the muscle activity of trunk respiratory muscles and maximum voluntary ventilation of chronic stroke patients. Journal of Back & Musculoskeletal Rehabilitation, 32(6), 863–868. https://doi.org/10.3233/BMR170839
Lewis, S. R., Nicholson, A., Reed, S. S., Kenth, J. J., Alderson, P. & Smith, A. F. (2019). Anaesthetic and sedative agents used for electrical cardioversion. Cochrane Database of Systematic Reviews, (3), 1–78. https:/doi.org/10.1002/14651858.CD010824.pub2
Mah, G. T., Turgeon, R. D., Loh, G., Tejani, A. M. & Sweet, D. D. (2019). Ketamine and propofol in combination for adult procedural sedation and analgesia in the emergency department. Cochrane Database of Systematic Reviews, (1). 1–21. https://doi.org/10.1002/14651858.CD011456
Mesgarpour, B., Heidinger, B. H., Roth, D., Schmitz, S., Walsh, C. D. & Herkner, H. (2019). Harms of off-label erythropoiesis-stimulating agents for critically ill people. Cochrane Database of Systematic Reviews, (8), 1–196. https://doi.org/10.1002/14651858.cd010969.pub2
Movahedi, M., Ghafari, S., Nazari, F. & Valiani, M. (2017). The effects of acupressure on pain severity in female nurses with chronic low back pain. Iranian journal of nursing and midwifery research, 22(5), 339–342. https://doi. org/10.4103/ijnmr.IJNMR_108_16
Nyer, M., Gerbarg, P., Silveri, M., Johnston, J., Scott, T., Nauphal, M., Owen, L., Nielsen, G., Mischoulon, D., Brown, R., Fava, M. & Streeter, C. (2018). A randomized controlled dosing study of Iyengar yoga and coherent breathing for the treatment of major depressive disorder: Impact on suicidal ideation and safety findings. Complementary Therapies in Medicine, 37, 136–142. https://doi.org/10.1016/j.ctim.2018.02.006
Oh, Y.-J., Park, S.-H. & Lee, M.-M. (2020). Comparison of Effects of Abdominal Draw-In Lumbar Stabilization Exercises with and without Respiratory Resistance on Women with Low Back Pain: A Randomized Controlled Trial. Medical Science Monitor, 26, e921295-1–e921295-8. https://doi.org/10.12659/MSM.921295
Park, S.-H. & Lee, M.-M. (2019). Effects of a Progressive Stabilization Exercise Program Using Respiratory Resistance for Patients with Lumbar Instability: A Randomized Controlled Trial. Medical Science Monitor, 25, 1740–1748. https://doi.org/10.12659/MSM.913036
Patrician, A., Tymko, M. M., Caldwell, H. G., Howe, C. A., Coombs, G. B., Stone, R., Hamilton, A., Hoiland, R. L. & Ainslie,
P. N. (2019). The Effect of an Expiratory Resistance Mask with Dead Space on Sleep, Acute Mountain Sickness, Cognition, and Ventilatory Acclimatization in Normobaric Hypoxia. High Altitude Medicine & Biology, 20(1), 61–70. https://doi.org/10.1089/ham.2018.0074
Peppone, L. J., Janelsins, M. C., Kamen, C., Mohile, S. G., Sprod, L. K., Gewandter, J. S., Kirshner, J. J., Gaur, R., Ruzich, J., Esparaz, B. T. & Mustian, K. M. (2015). The effect of YOCAS© R yoga for musculoskeletal symptoms among breast cancer survivors on hormonal therapy. Breast Cancer Research & Treatment, 150(3), 597–604. https://doi.org/10.1007/s10549-015-3351-1
Pettersson, H., Faager, G. & Westerdahl, E. (2015). Improved oxygenation during standing performance of deep breathing exercises with positive expiratory pressure after cardiac surgery: A randomized controlled trial. Journal of Rehabilitation Medicine, 47(8), 748–752. https://doi.org/10.2340/16501977-1992
Phattharasupharerk, S., Purepong, N., Eksakulkla, S. & Siriphorn, A. (2019). Effects of Qigong practice in office workers with chronic non-specific low back pain: A randomized control trial. Journal of Bodywork & Movement Therapies, 23(2), 375–381. https://doi.org/10.1016/j.jbmt.2018.02.004
Pollok, J., van Agteren, J. E. M. & CarsonChahhoud, K. V. (2018). Pharmacological interventions for the treatment of depression in chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews, (12), 1–53. https://doi.org/10.1002/14651858.CD012346.pub2
Ratcliff, C. G., Prinsloo, S., Chaoul, A., Zepeda, S. G., Cannon, R., Spelman, A., Yang, W. T. & Cohen, L. (2019). A Randomized Controlled Trial of Brief Mindfulness Meditation for Women Undergoing Stereotactic Breast Biopsy. Journal of the American College of Radiology, 16(5), 691–699. https://doi.org/10.1016/j.jacr.2018.09.009
Rietberg, M. B., Veerbeek, J. M., Gosselink, R., Kwakkel, G. & van Wegen, E. E. H. (2017). Respiratory muscle training for multiple sclerosis. Cochrane Database of Systematic Reviews, (12), 1–37. https://doi. org/10.1002/14651858.CD009424.pub2
Sagkal, T. & Ciray, N. (2016). Effects of Reiki on Pain and Vital Signs When Applied to the Incision Area of the Body After Cesarean Section Surgery: A Single-Blinded, Randomized, Double-Controlled Study. Holistic Nursing Practice, 30(6), 368–378. https://doi.org/10.1097/HNP.0000000000000172
Sagkal, T. S. & Eser, I. (2015). Effects of Reiki on Post-cesarean Delivery Pain, Anxiety, and Hemodynamic Parameters: A Randomized, Controlled Clinical Trial. Pain Management Nursing, 16(3), 388–399. https://doi. org/10.1016/j.pmn.2014.09.005
Saoji, A. A., Raghavendra, B. R., Madle, K. & Manjunath, N. K. (2018). Additional Practice of Yoga Breathing With Intermittent Breath Holding Enhances Psychological Functions in Yoga Practitioners: A Randomized Controlled Trial. Explore: The Journal of Science & Healing, 14(5), 379–384. https://doi.org/10.1016/j.explore.2018.02.005
Seyyed-Rasooli, A., Salehi, F., Mohammadpoorasl, A., Goljaryan, S., Seyyedi, Z. & Thomson, B. (2016). Comparing the effects of aromatherapy massage and inhalation aromatherapy on anxiety and pain in burn patients: A single-blind randomized clinical trial. Burns, 42(8), 1774–1780. https://doi.org/10.1016/j. burns.2016.06.014
Sharon, H., Maron-Katz, A., Ben-Simon, E., Flusser, Y., Hendler, T., Tarrasch, R. & Brill, S. (2016). Mindfulness meditation modulates pain through endogenous opioids. The American Journal of Medicine, 129(7), 755–758. https://doi.org/10.1016/j.amjmed.2016.03.002
Skoglund, L. & Jansson, E. (2007). Qigong reduces stress in computer operators. Complementary Therapies in Clinical Practice, 13(2), 78–84. https://doi.org/10.1016/j.ctcp.2006.09.003
Smith, K. E. & Norman, G. J. (2017). Brief relaxation training is not sufficient to alter tolerance to experimental pain in novices. PLoS ONE, 12(5), 1–13. https://doi.org/10.1371/journal.pone.0177228
Smith, S. R., Draganic, B., Pockney, P., Holz, P., Holmes, R., McManus, B. & Carroll, R. (2015). Transversus abdominis plane blockade in laparoscopic colorectal surgery: a double-blind randomized clinical trial. International Journal of Colorectal Disease, 30(9), 1237–1245. https://doi.org/10.1007/s00384-015-2286-7
Sud, S., Sud, M., Friedrich, J. O., Wunsch, H., Meade, M. O., Ferguson, N. D. & Adhikari, K. J. N. (2018). High-frequency oscillatory ventilation versus conventional ventilation for acute respiratory distress syndrome. Cochrane Database of Systematic Reviews, (4). 1–49. https://doi.org/10.1002/14651858.CD004085.pub4
Telles, S., Bhardwaj, A. K., Gupta, R. K., Sharma, S. K., Monro, R. & Balkrishna, A. (2016). A Randomized Controlled Trial to Assess Pain and Magnetic Resonance Imaging-Based (MRI-Based) Structural Spine Changes in Low Back Pain Patients After Yoga Practice. Medical Science Monitor, 22, 3228–3247. https://doi.org/10.12659/MSM.896599
Telles, S., Sharma, S. K., Gupta, R. K., Bhardwaj, A. K. & Balkrishna, A. (2016). Heart rate variability in chronic low back pain patients randomized to yoga or standard care. BMC Complementary & Alternative Medicine, 16(1), 279. https://doi.org/10.1186/s12906-016-1271-1
Tomas-Carus, P., Branco, J. C., Raimundo, A., Parraca, J. A., Batalha, N. & Biehl-Printes, C. (2018). Breathing Exercises Must Be a Real and Effective Intervention to Consider in Women with Fibromyalgia: A Pilot Randomized Controlled Trial. Journal of Alternative & Complementary Medicine, 24(8), 825–832. https:// doi.org/10.1089/acm.2017.0335
Tomas-Carus, P., Garrido, M., Branco, J. C., Castano, M. Y., Gomez, M. A. & Biehl-Printes, C. (2019). Non-supervised breathing exercise regimen in women with fibromyalgia: A quasi-experimental exploratory study. Complementary Therapies in Clinical Practice, 35, 170–176. https://doi.org/10.1016/j.ctcp.2019.02.006
Vojislav, M., Ramanathana, D. & Mishraa, J. (2020). Respiratory regulation & interactions with neurocognitive circuitry. Neuroscience & Biobehavioral Reviews, 112, 95–106. https://doi.org/10.1016/j.neubiorev.2020.02.001
Wall, B. F., Magee, K., Campbell, S. G. & Zed, P. J. (2019). Capnography versus standard monitoring for emergency department procedural sedation and analgesia. Cochrane Database of Systematic Reviews, (3), 1–42. https://doi.org/10.1002/14651858.CD010698.pub2
Warttig, S., Alderson, P., Evans, J. W. D., Lewis, S. R., Kourbeti, I. S. & Smith, A. F. (2019). Automated monitoring compared to standard care for the early detection of sepsis in critically ill patients. Cochrane Database of Systematic Reviews, (6), 1–25. https://doi.org/10.1002/14651858.CD012404.pub2
Wongwilairat, K., Buranruk, O., Eungpinichpong, W., Puntumetakul, R. & Kantharadussadee-Triamchaisri, S. (2018). Muscle stretching with deep and slow breathing patterns: a pilot study for therapeutic development. Journal of Complementary & Integrative Medicine, 16(2), 1–9. https://doi.org/10.1515/jcim-2017-0167
Yuksel, H., Cayir, Y., Kosan, Z. & Tastan, K. (2017). Effectiveness of breathing exercises during the second stage of labor on labor pain and duration: a randomized controlled trial. The Journal of Integrative Medicine, 15(6), 456– 461. https://doi.org/10.1016/S2095-4964(17)60368-6
Zhang, W. H., Zhang, H., Grant, S. J., Wan, X. & Li, G. (2018). Single herbal medicine for diabetic retinopathy. Cochrane Database of Systematic Reviews, (12), 1–41. https://doi.org/10.1002/14651858.CD007939.pub2
dc.relation.citationendpage.spa.fl_str_mv 42
dc.relation.citationstartpage.spa.fl_str_mv 25
dc.relation.citationissue.spa.fl_str_mv 1
dc.relation.citationvolume.spa.fl_str_mv 1
dc.rights.license.spa.fl_str_mv Atribución-NoComercial-SinDerivadas 4.0 Internacional (CC BY-NC-ND 4.0)
dc.rights.uri.spa.fl_str_mv https://creativecommons.org/licenses/by-nc-nd/4.0/
dc.rights.accessrights.spa.fl_str_mv info:eu-repo/semantics/openAccess
dc.rights.coar.spa.fl_str_mv http://purl.org/coar/access_right/c_abf2
rights_invalid_str_mv Atribución-NoComercial-SinDerivadas 4.0 Internacional (CC BY-NC-ND 4.0)
https://creativecommons.org/licenses/by-nc-nd/4.0/
http://purl.org/coar/access_right/c_abf2
eu_rights_str_mv openAccess
dc.format.extent.spa.fl_str_mv 18 páginas
dc.format.mimetype.spa.fl_str_mv image/png
dc.publisher.spa.fl_str_mv Corporación Universidad de la Costa
dc.publisher.place.spa.fl_str_mv Colombia
dc.source.spa.fl_str_mv https://revistascientificas.cuc.edu.co/JACN/article/view/3330
institution Corporación Universidad de la Costa
bitstream.url.fl_str_mv https://repositorio.cuc.edu.co/bitstreams/c16c3c0d-e9a6-41b2-aa65-b9f74874c0a9/download
https://repositorio.cuc.edu.co/bitstreams/0f4a2f4a-40aa-4f1a-b1f0-1e1f4626ec47/download
https://repositorio.cuc.edu.co/bitstreams/0eb8e9df-144c-4b06-85ac-be855a41c2e5/download
https://repositorio.cuc.edu.co/bitstreams/88b6dbd3-ec6a-4fe2-bde6-910b7023da30/download
bitstream.checksum.fl_str_mv d624f91b5d095e75fe8fc62ea45c7884
2f9959eaf5b71fae44bbf9ec84150c7a
8edd5b281d2769ca8fb44f5185eb1b4e
e4f32bfb518bb6400089b5916dc976bb
bitstream.checksumAlgorithm.fl_str_mv MD5
MD5
MD5
MD5
repository.name.fl_str_mv Repositorio de la Universidad de la Costa CUC
repository.mail.fl_str_mv repdigital@cuc.edu.co
_version_ 1811760854632235008
spelling Atribución-NoComercial-SinDerivadas 4.0 Internacional (CC BY-NC-ND 4.0)https://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Alzate-Granados, Juan-PabloSolarte, ArmandoLópez, Pedro-JavierBarceló, Ernesto2023-05-02T17:23:57Z2023-05-02T17:23:57Z2020-12-07Alzate-Granados, J.-P., Solarte, A., López, P.-J., & Barceló, E. (2020). Breathing technique in pain and cognitive function: a systematic review of the literature: Técnicas respiratorias en dolor y función cognitiva: revisión sistemática de la literatura. Journal of Applied Cognitive Neuroscience, 1(1), 25–42. https://doi.org/10.17981/JACN.1.1.2020.02https://hdl.handle.net/11323/1006810.17981/JACN.1.1.2020.022745-0031Corporación Universidad de la CostaREDICUC - Repositorio CUChttps://repositorio.cuc.edu.co/Breathing techniques are key components of yoga, meditation and relaxation practices that are well known for reducing anxiety and improving overall well-being. To evaluate the efficacy of breathing techniques in pain and cognitive function. We conducted a literature review searching the main literature databases (medline, lilacs, Cochrane library) including randomized clinical trials. We assessed the risk of bias of the included studies using the methodology proposed by the Cochrane collaboration. In total, we found 16 studies that met the inclusion criteria, with an intermediate or unclear overall risk of bias. When combining the different breathing techniques vs control in the included studies, we found a statistically significant difference in terms of the visual analog scale (Difference of means, random effects; -1.21 [95% CI -1.75 to -0.68]; I2: 95%). Meditation-based breathing techniques would improve pain and cognitive function in patients with a painful entity or healthy volunteers. Keywords: Breathing techniques; pain; cognitive function; systematic review; breath holdingLas técnicas de respiración son componentes clave de las prácticas de yoga, meditación y relajación que son bien conocidas por reducir la ansiedad y mejorar el bienestar general. Evaluar la eficacia de las técnicas respiratorias en el dolor y la función cognitiva. Realizamos una revisión de la literatura a través de las principales bases de datos especializadas (medline, lilacs, Cochrane library) incluyendo ensayos clínicos aleatorizados. El riesgo de sesgo de los estudios incluidos se evaluó mediante la metodología propuesta el Manual Cochrane para las Revisiones Sistemáticas. En total, encontramos 16 estudios que cumplieron con los criterios de inclusión, con un riesgo general de sesgo intermedio o poco claro. Al combinar las diferentes técnicas de respiración versus control en los estudios incluidos, se encontró una diferencia estadísticamente significativa en términos de la escala analógica visual (diferencia de medias, efectos aleatorios; -1,21 [IC del 95%: -1,75 a -0,68]; I2: 95 %). Las técnicas de respiración basadas en la meditación mejorarían el dolor y la función cognitiva en pacientes con una entidad dolorosa o voluntarios sanos. Palabras clave: Técnicas respiratorias; dolor; función cognitiva; revisión sistemática; contención de la respiración18 páginasimage/pngengCorporación Universidad de la CostaColombiahttps://revistascientificas.cuc.edu.co/JACN/article/view/3330Breathing technique in pain and cognitive function: a systematic review of the literatureTécnicas respiratorias en dolor y función cognitiva: revisión sistemática de la literaturaArtículo de revistahttp://purl.org/coar/resource_type/c_dcae04bchttp://purl.org/coar/resource_type/c_2df8fbb1Textinfo:eu-repo/semantics/articlehttp://purl.org/redcol/resource_type/ARTREVinfo:eu-repo/semantics/publishedVersionhttp://purl.org/coar/version/c_970fb48d4fbd8a85Journal of Applied Cognitive NeuroscienceAamann, L., Dam, G., Rinnov, A. R., Vilstrup, H. & Gluud, L. L. (2018). Physical exercise for people with cirrhosis. Cochrane Database of Systematic Reviews, (12), 1–42. https://doi.org/10.1002/14651858.cd012678.pub2Abdallah, S. J., Smith, B. M., Ware, M. A., Moore, M., Li, P. Z., Bourbeau, J. & Jensen, D. (2018). Effect of Vaporized Cannabis on Exertional Breathlessness and Exercise Endurance in Advanced Chronic Obstructive Pulmonary Disease. A Randomized Controlled Trial. Annals of the American Thoracic Society, 15(10), 1146–1158. https://doi.org/10.1513/AnnalsATS.201803-198OCAbedi, P., Jahanfar, S., Namvar, F. & Lee, J. (2016). Breastfeeding or nipple stimulation for reducing postpartum haemorrhage in the third stage of labour. Cochrane Database of Systematic Reviews, (1), 1–32. https:// doi.org/10.1002/14651858.CD010845.pub2Altenau, B., Crisp, C. C., Devaiah, C. G. & Lambers, D. S. (2017). Randomized controlled trial of intravenous acetaminophen for postcesarean delivery pain control. American Journal of Obstetrics & Gynecology, 217(3), 362.e361–362.e366. https://doi.org/10.1016/j.ajog.2017.04.030Arsenault, M., Ladouceur, A., Lehmann, A., Rainville, P. & Piché, M. (2013). Pain modulation induced by respiration: phase and frequency effects. Neuroscience, 12(252), 501– 511. https://doi.org/10.1016/j.neuroscience.2013.07.048Babina, R., Mohanty, P. P. & Pattnaik, M. (2016). Effect of thoracic mobilization on respiratory parameters in chronic non-specific low back pain: A randomized controlled trial. Journal of Back & Musculoskeletal Rehabilitation, 29(3), 587–595. https://doi.org/10.3233/BMR-160679Barnes, H., McDonald, J., Smallwood, N. & Manser, R. (2019). Opioids for the palliation of refractory breathlessness in adults with advanced disease and terminal illness. Cochrane Database of Systematic Reviews, (3), 1–103. https://doi.org/10.1002/14651858.CD011008.pub2Bayer, U., Glazachev, O. S., Likar, R., Burtscher, M., Kofler, W., Pinter, G., Stettner, H., Demschar, S., Trummer, B. & Neuwersch, S. (2017). [Adaptation to intermittent hypoxia-hyperoxia improves cognitive performance and exercise tolerance in elderly]. Advances in Gerontology, 7(3), 214–220. https://doi.org/10.1134/S2079057017030031Boaviagem, A., Melo Junior, E., Lubambo, L., Sousa, P., Aragao, C., Albuquerque, S. & Lemos, A. (2017). The effectiveness of breathing patterns to control maternal anxiety during the first period of labor: A randomized controlled clinical trial. Complementary Therapies in Clinical Practice, 26, 30–35. https://doi.org/10.1016/j.ctcp.2016.11.004Chan, K. K., Joo, D. A., McRae, A. D., Takwoingi, Y., Premji, Z. A., Lang, E. & Wakai, A. (2019). Chest ultrasonography versus supine chest radiography for diagnosis of pneumothorax i n trauma patients in the emergency department. Cochrane Database of Systematic Reviews, (5), 1–16. https://doi.org/10.1002/14651858.CD013031.pub2Choo, J. K., Simons, E. F. & Sheikh, A. (2018). Glucocorticoids for the treatment of anaphylaxis. Cochrane Database of Systematic Reviews, 65(10), 1205–1211. https://doi.org/10.1111/j.1398-9995.2010.02424.xConnolly, B., Salisbury, L., O’Neill, B., Geneen, L. J., Douiri, A., Grocott, P. W. M., Hart, N., Walsh, T. & Blackwood, B. (2018). Exercise rehabilitation following intensive care unit dischargeor recovery from critical illness. Journal of Cachexia, Sarcopenia and Muscle, (7) 1–6. https://doi.org/10.1002/jcsm.12146Ferreira, L., Tanaka, K., Santos-Galduroz, R. F. & Fernandes, J. C. (2015). Respiratory training as strategy to prevent cognitive decline in aging: a randomized controlled trial. Clinical Interventions in Aging, (10), 593–603. https://doi.org/10.2147/CIA.S79560Frokjaer, J. B., Bergmann, S., Brock, C., Madzak, A., Farmer, A. D., Ellrich, J. & Drewes, A. M. (2016). Modulation of vagal tone enhances gastroduodenal motility and reduces somatic pain sensitivity. Neurogastroenterology & Motility, 28(4), 592–598. https://doi.org/10.1111/nmo.12760Gilbert-Kawai, E. T., Mitchell, K., Martin, D., Carlisle, J. & Grocott, P. W. M. (2018). Permissive hypoxaemia versus normoxaemia for mechanically ventilated critically ill patients. Cochrane Database of Systematic Reviews, (5), 1–18. https://doi.org/10.1002/14651858.CD009931.pub2Grubić, T., Babić, M. & Štimac, D. (2019). Exploring the feasibility of a mild and short 4-week combined upper limb and breathing exercise program as a possible home base program to decrease fatigue and improve quality of life in ambulatory and non-ambulatory multiple sclerosis individuals. Neurological Sciences, 40(4), 733–743. https:// doi.org/10.1007/s10072-019-3707-0Grubić, T., Babić, M. & Štimac, D. (2019). Exploring the feasibility of a mild and short 4-week combined upper limb and breathing exercise program as a possible home base program to decrease fatigue and improve quality of life in ambulatory and non-ambulatory multiple sclerosis individuals. Neurological Sciences, 40(4), 733–743. https:// doi.org/10.1007/s10072-019-3707-0Gunay, S., Eser, I., Ozbey, M., Agar, M., Koruk, I. & Kurkcuoglu, I. C. (2016). Evaluation of two different respiratory physiotherapy methods after thoracoscopy with regard to arterial blood gas, respiratory function test, number of days until discharge, cost analysis, comfort and pain control. Nigerian Journal of Clinical Practice, 19(3), 353–358. https://doi.org/10.4103/1119-3077.179279Janssens, L., McConnell, A. K., Pijnenburg, M., Claeys, K., Goossens, N., Lysens, R., Troosters, T. & Brumagne, S. (2015). Inspiratory muscle training affects proprioceptive use and low back pain. Medicine & Science in Sports & Exercise, 47(1), 12–19. https://doi.org/10.1249/MSS.0000000000000385Knips, L., Bergenthal, N., Streckmann, F., Monsef, I., Elter, T. & Skoetz, N. (2019). Aerobic physical exercise for adult patients with haematological malignancies. Cochrane Database of Systematic Reviews, (1), 1–104. https://doi.org/10.1002/14651858.CD009075.pub3Larkey, L. K., Roe, D. J., Smith, L. & Millstine, D. (2016). Exploratory outcome assessment of Qigong/Tai Chi Easy on breast cancer survivors. Complementary Therapies in Medicine, 29, 196–203. https://doi.org/10.1016/j. ctim.2016.10.006Lee, A. L., Gordon, C. S. & Osadnik, C. R. (2018). Exercise training for bronchiectasis. Cochrane Database of Systematic Reviews, (8), 1–12. https://doi.org/10.1002/14651858.CD013110Lee, J. M., Lee, S. K., Lee, S. J., Hwang, W. S., Jang, S. W. & Park, E. Y. (2016). Comparison of remifentanil with dexmedetomidine for monitored anaesthesia care in elderly patients during vertebroplasty and kyphoplasty. Journal of International Medical Research, 44(2), 307–316. https://doi.org/10.1177/0300060515607385Lee, M.-H. & Jang, S.-H. (2019). The effects of the neck stabilization exercise on the muscle activity of trunk respiratory muscles and maximum voluntary ventilation of chronic stroke patients. Journal of Back & Musculoskeletal Rehabilitation, 32(6), 863–868. https://doi.org/10.3233/BMR170839Lewis, S. R., Nicholson, A., Reed, S. S., Kenth, J. J., Alderson, P. & Smith, A. F. (2019). Anaesthetic and sedative agents used for electrical cardioversion. Cochrane Database of Systematic Reviews, (3), 1–78. https:/doi.org/10.1002/14651858.CD010824.pub2Mah, G. T., Turgeon, R. D., Loh, G., Tejani, A. M. & Sweet, D. D. (2019). Ketamine and propofol in combination for adult procedural sedation and analgesia in the emergency department. Cochrane Database of Systematic Reviews, (1). 1–21. https://doi.org/10.1002/14651858.CD011456Mesgarpour, B., Heidinger, B. H., Roth, D., Schmitz, S., Walsh, C. D. & Herkner, H. (2019). Harms of off-label erythropoiesis-stimulating agents for critically ill people. Cochrane Database of Systematic Reviews, (8), 1–196. https://doi.org/10.1002/14651858.cd010969.pub2Movahedi, M., Ghafari, S., Nazari, F. & Valiani, M. (2017). The effects of acupressure on pain severity in female nurses with chronic low back pain. Iranian journal of nursing and midwifery research, 22(5), 339–342. https://doi. org/10.4103/ijnmr.IJNMR_108_16Nyer, M., Gerbarg, P., Silveri, M., Johnston, J., Scott, T., Nauphal, M., Owen, L., Nielsen, G., Mischoulon, D., Brown, R., Fava, M. & Streeter, C. (2018). A randomized controlled dosing study of Iyengar yoga and coherent breathing for the treatment of major depressive disorder: Impact on suicidal ideation and safety findings. Complementary Therapies in Medicine, 37, 136–142. https://doi.org/10.1016/j.ctim.2018.02.006Oh, Y.-J., Park, S.-H. & Lee, M.-M. (2020). Comparison of Effects of Abdominal Draw-In Lumbar Stabilization Exercises with and without Respiratory Resistance on Women with Low Back Pain: A Randomized Controlled Trial. Medical Science Monitor, 26, e921295-1–e921295-8. https://doi.org/10.12659/MSM.921295Park, S.-H. & Lee, M.-M. (2019). Effects of a Progressive Stabilization Exercise Program Using Respiratory Resistance for Patients with Lumbar Instability: A Randomized Controlled Trial. Medical Science Monitor, 25, 1740–1748. https://doi.org/10.12659/MSM.913036Patrician, A., Tymko, M. M., Caldwell, H. G., Howe, C. A., Coombs, G. B., Stone, R., Hamilton, A., Hoiland, R. L. & Ainslie,P. N. (2019). The Effect of an Expiratory Resistance Mask with Dead Space on Sleep, Acute Mountain Sickness, Cognition, and Ventilatory Acclimatization in Normobaric Hypoxia. High Altitude Medicine & Biology, 20(1), 61–70. https://doi.org/10.1089/ham.2018.0074Peppone, L. J., Janelsins, M. C., Kamen, C., Mohile, S. G., Sprod, L. K., Gewandter, J. S., Kirshner, J. J., Gaur, R., Ruzich, J., Esparaz, B. T. & Mustian, K. M. (2015). The effect of YOCAS© R yoga for musculoskeletal symptoms among breast cancer survivors on hormonal therapy. Breast Cancer Research & Treatment, 150(3), 597–604. https://doi.org/10.1007/s10549-015-3351-1Pettersson, H., Faager, G. & Westerdahl, E. (2015). Improved oxygenation during standing performance of deep breathing exercises with positive expiratory pressure after cardiac surgery: A randomized controlled trial. Journal of Rehabilitation Medicine, 47(8), 748–752. https://doi.org/10.2340/16501977-1992Phattharasupharerk, S., Purepong, N., Eksakulkla, S. & Siriphorn, A. (2019). Effects of Qigong practice in office workers with chronic non-specific low back pain: A randomized control trial. Journal of Bodywork & Movement Therapies, 23(2), 375–381. https://doi.org/10.1016/j.jbmt.2018.02.004Pollok, J., van Agteren, J. E. M. & CarsonChahhoud, K. V. (2018). Pharmacological interventions for the treatment of depression in chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews, (12), 1–53. https://doi.org/10.1002/14651858.CD012346.pub2Ratcliff, C. G., Prinsloo, S., Chaoul, A., Zepeda, S. G., Cannon, R., Spelman, A., Yang, W. T. & Cohen, L. (2019). A Randomized Controlled Trial of Brief Mindfulness Meditation for Women Undergoing Stereotactic Breast Biopsy. Journal of the American College of Radiology, 16(5), 691–699. https://doi.org/10.1016/j.jacr.2018.09.009Rietberg, M. B., Veerbeek, J. M., Gosselink, R., Kwakkel, G. & van Wegen, E. E. H. (2017). Respiratory muscle training for multiple sclerosis. Cochrane Database of Systematic Reviews, (12), 1–37. https://doi. org/10.1002/14651858.CD009424.pub2Sagkal, T. & Ciray, N. (2016). Effects of Reiki on Pain and Vital Signs When Applied to the Incision Area of the Body After Cesarean Section Surgery: A Single-Blinded, Randomized, Double-Controlled Study. Holistic Nursing Practice, 30(6), 368–378. https://doi.org/10.1097/HNP.0000000000000172Sagkal, T. S. & Eser, I. (2015). Effects of Reiki on Post-cesarean Delivery Pain, Anxiety, and Hemodynamic Parameters: A Randomized, Controlled Clinical Trial. Pain Management Nursing, 16(3), 388–399. https://doi. org/10.1016/j.pmn.2014.09.005Saoji, A. A., Raghavendra, B. R., Madle, K. & Manjunath, N. K. (2018). Additional Practice of Yoga Breathing With Intermittent Breath Holding Enhances Psychological Functions in Yoga Practitioners: A Randomized Controlled Trial. Explore: The Journal of Science & Healing, 14(5), 379–384. https://doi.org/10.1016/j.explore.2018.02.005Seyyed-Rasooli, A., Salehi, F., Mohammadpoorasl, A., Goljaryan, S., Seyyedi, Z. & Thomson, B. (2016). Comparing the effects of aromatherapy massage and inhalation aromatherapy on anxiety and pain in burn patients: A single-blind randomized clinical trial. Burns, 42(8), 1774–1780. https://doi.org/10.1016/j. burns.2016.06.014Sharon, H., Maron-Katz, A., Ben-Simon, E., Flusser, Y., Hendler, T., Tarrasch, R. & Brill, S. (2016). Mindfulness meditation modulates pain through endogenous opioids. The American Journal of Medicine, 129(7), 755–758. https://doi.org/10.1016/j.amjmed.2016.03.002Skoglund, L. & Jansson, E. (2007). Qigong reduces stress in computer operators. Complementary Therapies in Clinical Practice, 13(2), 78–84. https://doi.org/10.1016/j.ctcp.2006.09.003Smith, K. E. & Norman, G. J. (2017). Brief relaxation training is not sufficient to alter tolerance to experimental pain in novices. PLoS ONE, 12(5), 1–13. https://doi.org/10.1371/journal.pone.0177228Smith, S. R., Draganic, B., Pockney, P., Holz, P., Holmes, R., McManus, B. & Carroll, R. (2015). Transversus abdominis plane blockade in laparoscopic colorectal surgery: a double-blind randomized clinical trial. International Journal of Colorectal Disease, 30(9), 1237–1245. https://doi.org/10.1007/s00384-015-2286-7Sud, S., Sud, M., Friedrich, J. O., Wunsch, H., Meade, M. O., Ferguson, N. D. & Adhikari, K. J. N. (2018). High-frequency oscillatory ventilation versus conventional ventilation for acute respiratory distress syndrome. Cochrane Database of Systematic Reviews, (4). 1–49. https://doi.org/10.1002/14651858.CD004085.pub4Telles, S., Bhardwaj, A. K., Gupta, R. K., Sharma, S. K., Monro, R. & Balkrishna, A. (2016). A Randomized Controlled Trial to Assess Pain and Magnetic Resonance Imaging-Based (MRI-Based) Structural Spine Changes in Low Back Pain Patients After Yoga Practice. Medical Science Monitor, 22, 3228–3247. https://doi.org/10.12659/MSM.896599Telles, S., Sharma, S. K., Gupta, R. K., Bhardwaj, A. K. & Balkrishna, A. (2016). Heart rate variability in chronic low back pain patients randomized to yoga or standard care. BMC Complementary & Alternative Medicine, 16(1), 279. https://doi.org/10.1186/s12906-016-1271-1Tomas-Carus, P., Branco, J. C., Raimundo, A., Parraca, J. A., Batalha, N. & Biehl-Printes, C. (2018). Breathing Exercises Must Be a Real and Effective Intervention to Consider in Women with Fibromyalgia: A Pilot Randomized Controlled Trial. Journal of Alternative & Complementary Medicine, 24(8), 825–832. https:// doi.org/10.1089/acm.2017.0335Tomas-Carus, P., Garrido, M., Branco, J. C., Castano, M. Y., Gomez, M. A. & Biehl-Printes, C. (2019). Non-supervised breathing exercise regimen in women with fibromyalgia: A quasi-experimental exploratory study. Complementary Therapies in Clinical Practice, 35, 170–176. https://doi.org/10.1016/j.ctcp.2019.02.006Vojislav, M., Ramanathana, D. & Mishraa, J. (2020). Respiratory regulation & interactions with neurocognitive circuitry. Neuroscience & Biobehavioral Reviews, 112, 95–106. https://doi.org/10.1016/j.neubiorev.2020.02.001Wall, B. F., Magee, K., Campbell, S. G. & Zed, P. J. (2019). Capnography versus standard monitoring for emergency department procedural sedation and analgesia. Cochrane Database of Systematic Reviews, (3), 1–42. https://doi.org/10.1002/14651858.CD010698.pub2Warttig, S., Alderson, P., Evans, J. W. D., Lewis, S. R., Kourbeti, I. S. & Smith, A. F. (2019). Automated monitoring compared to standard care for the early detection of sepsis in critically ill patients. Cochrane Database of Systematic Reviews, (6), 1–25. https://doi.org/10.1002/14651858.CD012404.pub2Wongwilairat, K., Buranruk, O., Eungpinichpong, W., Puntumetakul, R. & Kantharadussadee-Triamchaisri, S. (2018). Muscle stretching with deep and slow breathing patterns: a pilot study for therapeutic development. Journal of Complementary & Integrative Medicine, 16(2), 1–9. https://doi.org/10.1515/jcim-2017-0167Yuksel, H., Cayir, Y., Kosan, Z. & Tastan, K. (2017). Effectiveness of breathing exercises during the second stage of labor on labor pain and duration: a randomized controlled trial. The Journal of Integrative Medicine, 15(6), 456– 461. https://doi.org/10.1016/S2095-4964(17)60368-6Zhang, W. H., Zhang, H., Grant, S. J., Wan, X. & Li, G. (2018). Single herbal medicine for diabetic retinopathy. Cochrane Database of Systematic Reviews, (12), 1–41. https://doi.org/10.1002/14651858.CD007939.pub2422511Breathing techniquesPainCognitive functionSystematic reviewBreath holdingTécnicas respiratoriasDolorFunción cognitivaRevisión sistemáticaContención de la respiraciónPublicationORIGINALBreathing technique in pain and cognitive function. a systematic review of the literature.pdfBreathing technique in pain and cognitive function. a systematic review of the literature.pdfArtículoapplication/pdf893057https://repositorio.cuc.edu.co/bitstreams/c16c3c0d-e9a6-41b2-aa65-b9f74874c0a9/downloadd624f91b5d095e75fe8fc62ea45c7884MD51LICENSElicense.txtlicense.txttext/plain; charset=utf-814828https://repositorio.cuc.edu.co/bitstreams/0f4a2f4a-40aa-4f1a-b1f0-1e1f4626ec47/download2f9959eaf5b71fae44bbf9ec84150c7aMD52TEXTBreathing technique in pain and cognitive function. a systematic review of the literature.pdf.txtBreathing technique in pain and cognitive function. a systematic review of the literature.pdf.txtExtracted texttext/plain47445https://repositorio.cuc.edu.co/bitstreams/0eb8e9df-144c-4b06-85ac-be855a41c2e5/download8edd5b281d2769ca8fb44f5185eb1b4eMD53THUMBNAILBreathing technique in pain and cognitive function. a systematic review of the literature.pdf.jpgBreathing technique in pain and cognitive function. a systematic review of the literature.pdf.jpgGenerated Thumbnailimage/jpeg13409https://repositorio.cuc.edu.co/bitstreams/88b6dbd3-ec6a-4fe2-bde6-910b7023da30/downloade4f32bfb518bb6400089b5916dc976bbMD5411323/10068oai:repositorio.cuc.edu.co:11323/100682024-09-17 14:11:41.675https://creativecommons.org/licenses/by-nc-nd/4.0/open.accesshttps://repositorio.cuc.edu.coRepositorio de la Universidad de la Costa CUCrepdigital@cuc.edu.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