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Updated: Jan 17, 2026

Investigation into Deep Breathing through Measurement of Ventilatory Parameters and Observation of Breathing Patterns
Published on: September 16, 2019
Validation of breathing exercises and diaphragm manual therapy protocol in sports PLAYERS: A Delphi study
Imma Vergara-Busquets1, Xantal Borràs-Boix2, Cristina Lidón-Moyano1
1Department of Physiotherapy, Universitat Internacional de Catalunya C/ Josep Trueta s/n. 08017 Sant Cugat del Vallés, Barcelona, Spain.
Background:
Core stability is maintained mainly by abdominal and lumbar function, including the diaphragm muscle, connecting trunk's muscle activity and lower limbs movement. However, the diaphragm training is not frequently included in core training sessions, especially in sports injury prevention and treatment.
Objective:
The aim of the study is designing and validating a protocol of rib cage mobility, using the Delphi Method.
Methods:
A clinical practice protocol was designed based on breathing exercise and diaphragm and ribs manual therapy, twice a week for eight weeks. Delphi Method was used to validate the protocol by a committee of eight experts on manual therapy and breathing rehabilitation, who rated the exercises. Then, the coefficient of variation of the answers was calculated, and the questionnaire repeated until the consensus was reached.
Results:
In the second round of questions, the 87,5 % (n = 7) of the experts were "Totally agree" in 4 out of the 5 exercises described. Consensus was determined as the coefficient of variation of the answers decreased after two rounds, and the validation was concluded.
Conclusions:
The clinical protocol of breathing exercises and manual therapy of the ribs and muscle diaphragm has been designed and later successfully validated using the Delphi method.
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