Authors : Nisha Bhimrao Khandare; Dr. Ashishkumar Sanjay Patil

Volume/Issue : Volume 11 - 2026, Issue 10 - October

Google Scholar : https://tinyurl.com/bdhmtcd8

DOI : https://doi.org/10.38124/ijisrt/26Oct121

Note : A published paper may take 4-5 working days from the publication date to appear in PlumX Metrics, Semantic Scholar, and ResearchGate.

Abstract : Background: Chronic rhinosinusitis is a long-lasting inflammatory disease which can have an impact on nasal symptoms, sleep, everyday activities and emotional well-being. The Sino-Nasal Outcome Test-22 is generally used for evaluating the extent of sinonasal symptoms and health-related quality of life. Breathing-based treatments, such as diaphragmatic breathing and Bhramari pranayama, might help with respiratory control and relaxation; yet there is still limited evidence regarding their combined application in chronic rhinosinusitis.  Aim: To evaluate the changes in the Sino-Nasal Outcome Test-22 scores in adults suffering from chronic rhinosinusitis as a result of a programme that involves combined diaphragmatic breathing and Bhramari pranayama.  Methods: The study was a single-group pre-post interventional study involving 58 people aged between 21 and 44 years who had chronic rhinosinusitis. The participants were recruited through convenience sampling in Jalgaon, Maharashtra. Health-related quality of life was evaluated both before and after the intervention with the use of the 22-item Sino-Nasal Outcome Test. The intervention consisted of diaphragmatic breathing and Bhramari pranayama, and the pre- and postintervention scores were compared using a paired-samples t-test.  Results: The average score before the intervention was 47.33 and the standard deviation was 11.28; after the intervention the average score was 30.57 and the standard deviation 9.82. The mean decrease was 16.76 points with a standard deviation of 6.91. The paired-samples t-test revealed a statistically significant difference between the pre-intervention and postintervention scores, the t value being 18.474 and the degrees of freedom 57, and the p value was less than 0.001. The thesis states that 48 participants, which is 82.8 per cent, had an improvement of at least 12 points.  Conclusion: The participants of Sino-Nasal Outcome Test-22 scores were reduced as a result of the combined breathing programme. However, since the study involved only one group without including a control group, the changes cannot be solely attributed to the intervention and further controlled studies are required to verify these results.

Keywords : Chronic Rhinosinusitis; Diaphragmatic Breathing; Bhramari Pranayama; Quality of Life; Sino-Nasal Outcome Test22.

References :

1. Hirsch AG, Stewart WF, Sundaresan AS, Young AJ, Kennedy TL, Greene JS, et al. Nasal and sinus symptoms and chronic rhinosinusitis in a population-based sample. Allergy. 2017;72(2):274-281.
2. Phillips KM, Hoehle LP, Caradonna DS, Gray ST, Sedaghat AR. Minimal clinically important difference for the 22-item Sinonasal Outcome Test in medically managed patients with chronic rhinosinusitis. Clin Otolaryngol. 2018;43(5):1328-1334. doi:10.1111/coa.13177.
3. Phillips KM, Houssein FA, Boeckermann LM, Singerman KW, Liu DT, Sedaghat AR. Multi-institutional minimal clinically important difference of the 22-item Sino-Nasal Outcome Test in medically managed chronic rhinosinusitis. Rhinology. 2021;59(6):552-559. doi:10.4193/Rhin21.253.
4. Singerman KW, Phillips KM, Sedaghat AR. Minimal clinically important difference for subdomains of the 22-item Sino-Nasal Outcome Test in medically managed chronic rhinosinusitis patients. Int Forum Allergy Rhinol. 2022;12(9):1196-1199. doi:10.1002/alr.22967.
5. Hamasaki H. Effects of diaphragmatic breathing on health: a narrative review. Medicines (Basel). 2020;7(10):65. doi:10.3390/medicines7100065.
6. Zaccaro A, Piarulli A, Laurino M, Garbella E, Menicucci D, Neri B, et al. How breath-control can change your life: a systematic review on psycho-physiological correlates of slow breathing. Front Hum Neurosci. 2018;12:353. doi:10.3389/fnhum.2018.00353.
7. Abishek K, Bakshi SS, Bhavanani AB. The efficacy of yogic breathing exercise Bhramari pranayama in relieving symptoms of chronic rhinosinusitis. Int J Yoga. 2019;12. [Complete page range and DOI should be verified from the published article before submission.]
8. Chetry D, Chhetri A, Rajak DK, Rathore V, Gupta A. Exploring the health benefits of Bhramari pranayama (humming bee breathing): a comprehensive literature review. Indian J Physiol Pharmacol. 2024;68:71-85. doi:10.25259/IJPP_325_2023.