The effects of breathing and coughing exercises on respiratory parameters in COVID-19 patients

Abstract

Introduction and aim. COVID-19 primarily affects the respiratory system, often resulting in pneumonia and dyspnea that may persist after recovery. This study aimed to evaluate the effect of deep breathing and coughing exercises using a Triflow device on respiratory parameters in patients with COVID-19 pneumonia. Material and methods. This single-blinded randomized controlled study was conducted with 326 patients diagnosed with COVID-19 pneumonia. Participants were randomly assigned to an experimental group (n=163) or a control group (n=163). The experimental group performed exercises for 10 consecutive days. The control group received routine hospital care, which included routine nurse-led monitoring of vital signs, peripheral oxygen saturation (SpO2) assessment, medical treatment per clinical guidelines, and supportive care, but no structured breathing-exercise education. Data were analyzed using descriptive statistics, ANOVA, chi-square, and post hoc tests. Results. After 10 days of intervention, Dyspnea-12 scores decreased more markedly in the experimental group than in the control group (mean change ?15 vs. ?8 points; p<0.001). Arterial oxygen and SpO2 levels also improved significantly in the experimental group compared to controls (p<0.001), while respiratory rate decreased to a greater extent (p<0.001). No adverse effects were observed. Conclusion. Deep breathing and coughing exercises with the Trilow device significantly reduced the severity of dyspnea and improved oxygenation in COVID-19 pneumonia patients. These findings suggest that incorporating structured respiratory exercises into standard care may enhance clinical outcomes and support recovery in this population. © 2026 Rzeszow University Press. All rights reserved.