Clinical Application of Abdominal Breathing Training and Evaluation of Physical and Mental Benefits in Anxiety Patients

Jiajin Chai¹Shikun Li¹Li He¹Jiayuan Yang¹Ting Wu¹Kunyan Ou¹Xichen Chen²Kaicheng Ma^1*Shouping Zhao^3*

• ¹Kunming Medical University Affiliated Mental Health Center, Kunming, China
• ²First Affiliated Hospital of Kunming Medical University, Kunming, China
• ³Department of Geriatrics, Kunming Medical University Affiliated Mental Health Center, Kunming, China

Abstract Background: Anxiety disorders represent highly prevalent mental health conditions globally (lifetime prevalence: ~7-14%). Current pharmacological treatments carry risks of dependence and metabolic side effects, while psychological therapies face accessibility limitations. There is an urgent need to develop safe, accessible non-pharmacological interventions. This single-blind randomized controlled trial systematically evaluated the efficacy and sustainability of an 8-week standardized abdominal breathing training program in alleviating anxiety symptoms and modulating autonomic nervous function in patients with anxiety disorders. Methods: A total of 120 outpatient participants (aged 18-65 years) meeting ICD-10 diagnostic criteria for Generalized Anxiety Disorder were recruited. Participants were randomly assigned to either an intervention group (abdominal breathing training, n=60) or a control group (treatment-as-usual, n=60). The intervention group received professionally supervised training consisting of 3-4 daily sessions of 10-15 minutes each (inhale:exhale ratio = 1:2; inhalation 3-5 sec/exhalation 5-7 sec). Adherence was monitored via respiratory sensors (mean adherence rate: 92.4%). Assessments using the Self-Rating Anxiety Scale (SAS) and physiological measurements—including heart rate (HR), respiratory rate (RR), blood pressure (BP), and heart rate variability (HRV-LF/HF ratio)—were conducted at baseline, post-intervention (8 weeks), and at 4-week follow-up (intervention group only). Key Results: Anxiety Symptom Improvement: Two-way repeated measures ANOVA revealed a significant group×time interaction effect on SAS scores (P<0.05). Post-intervention, the intervention group exhibited a significant reduction in SAS scores compared to baseline (67.57±8.88 vs. 71.80±3.99, P<0.001), reflecting a 5.9% decrease, and scores were significantly lower than the control group (70.43±4.33, P=0.027). At 4-week follow-up, despite a slight rebound, SAS scores in the intervention group remained significantly below baseline (68.57±8.11, P<0.05). Physiological Optimization: For physiological indicators, significant group × time interaction effects were observed (all P<0.05). Post-intervention, the intervention group showed significant reductions in heart rate (77.08±10.30 vs. 83.37±9.67 bpm), respiratory rate (17.37±1.78 vs. 18.60±1.83 breaths/min), systolic blood pressure (114.12±11.97 vs. 122.63±12.18 mmHg), and diastolic blood pressure (74.40±6.75 vs. 80.28±7.58 mmHg) (all P<0.05). Concurrently, the HRV-LF/HF ratio increased significantly (P=0.008). Conclusion: Standardized abdominal breathing training significantly alleviates anxiety symptoms (effect size Cohen’s d = 0.61) and induces sustained physiological improvements in autonomic regulation (effects maintained 4 weeks post-intervention).