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This study evaluated the effect of a six-week deep slow breathing (DSB) program on pain, physical function, and heart rate variability (HRV) in subjects with lower extremity joint pain. Twenty subjects were assigned into training (n = 10) and control (n = 10) groups. The training group participated in a six-week DSB program consisting of weekly training sessions and at-home breathing exercises. DSB exercises focused on prolonging the exhalation and the pause following exhalation. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was used to assess pain and physical function, and HRV data were obtained before and after intervention. Results revealed no significant interactions between group and time for any of the variables. There was no significant main effect for group, but there was a significant main effect (p<0.025) and a large effect size for time on both pain (ηp2 = 0.454) and physical function (ηp2 = 0.506). There were no significant main effects (p>0.017) for group and time on LF power (group ηp2 = 0.039, time ηp2 = 0.061), HF power (group ηp2 = 0.039, time ηp2 = 0.039), and LF/HF ratio (group ηp2 = 0.036, time ηp2 = 0.169). Results indicated that the six-week DSB program was not sufficient to alleviate pain or improve physical function in subjects with lower extremity joint pain. Although the pain was not alleviated, other beneficial effects such as better coping with the pain were reported in the majority of training subjects. As this is the first study to examine the use of DSB for lower extremity joint pain and dysfunction, further research is needed to investigate the efficacy and applicability of DSB.

Introduction:The elliptical trainer, developed to simulate running while minimizing joint loads, elicits a unique lower extremity biomechanical response. The purpose of this study was to examine the angular kinematics, peak net joint moments, and peak joint powers at the hip, knee and ankle joints while exercising at three different ramp settings on the elliptical trainer exercise machine (Precor EFX).Methods: Twenty-six healthy individuals with no history of lower extremity injury and with previous experience exercising on an elliptical trainer volunteered for this study. Motion was captured with two cameras as subjects performed exercise at three ramp conditions. The pedal resistance was kept constant at the lowest setting. The pedals of the elliptical were fitted with three orthogonal load cells. Video and force data were synchronized and used to perform a 2D inverse dynamics analysis.Results: As the ramp inclination increased, subjects demonstrated greater amounts of ankle dorsiflexion, knee flexion, hip flexion and lesser degrees of plantar flexion and hip extension (p <.000). Mean peak moments at the ankle joint were not significantly different across the ramp settings, but peak knee extensor and hip flexor moments increased while knee flexor and hip extensor at the hip decreased (p <.000). As the ramp inclination increased, peak positive power at both the knee and hip significantly decreased and negative power decreased at the knee joint (p <.000), though the effect size for these changes was small. Conclusions:The hip and knee joints were observed as the primary sources of power during exercise on the elliptical trainer at the lowest resistance setting.