Frontiers in neuroscience · 2026
Respiratory modulation of neurophysiology and symptoms in athletes with sports-related concussion: a randomized crossover trial.
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Wang Wendi, Zhu Hongyu, Gao Xiaolin, Yu Tao, Yan Xin, Wang Gonghao, Zhang Zhiqiang
Аннотация
OBJECTIVES: This study examined the effects of two breathing interventions on athletes with persistent post-concussive symptoms. Resonance breathing (RB) is a slow breathing technique at an individual's resonance frequency. Pelvic floor resonance breathing (PRB) combines diaphragmatic breathing with pelvic floor muscle activation.
METHODS: A randomized crossover trial was conducted using a 3-1-3 week design. Two intervention phases were separated by a 1-week washout period. Twenty-six male rugby athletes with persistent post-concussive symptoms were included. Participants were assigned to different intervention sequences. Outcomes included the Rivermead Post-Concussion Symptoms Questionnaire, electroencephalography (EEG), heart rate variability (HRV), and skin sympathetic nerve activity (SKNA). Measurements were taken at baseline and after each intervention.
RESULTS: Total symptom scores decreased after both interventions (p < 0.01). Somatic symptom scores were lower after PRB (p < 0.05), whereas emotional symptom scores were lower after RB (p < 0.05). EEG results showed different pre-post patterns between interventions. PRB was associated with broader pre-post changes in β and θ bands, whereas RB showed more localized pre-post changes in β, θ, and δ bands. Heart rate was lower and HRV total power was higher after both interventions (p < 0.05). The LF/HF ratio and SKNA burst area were higher after RB (p < 0.05), whereas SKNA burst threshold and frequency were higher after PRB (p < 0.05). Correlation analysis suggested an association between prefrontal activity and SKNA changes in PRB.
CONCLUSION: Both RB and PRB were associated with symptom improvement and changes in neuro-autonomic function. The two interventions showed different patterns. These findings support the use of breathing interventions as non-pharmacological approaches in concussion rehabilitation.
METHODS: A randomized crossover trial was conducted using a 3-1-3 week design. Two intervention phases were separated by a 1-week washout period. Twenty-six male rugby athletes with persistent post-concussive symptoms were included. Participants were assigned to different intervention sequences. Outcomes included the Rivermead Post-Concussion Symptoms Questionnaire, electroencephalography (EEG), heart rate variability (HRV), and skin sympathetic nerve activity (SKNA). Measurements were taken at baseline and after each intervention.
RESULTS: Total symptom scores decreased after both interventions (p < 0.01). Somatic symptom scores were lower after PRB (p < 0.05), whereas emotional symptom scores were lower after RB (p < 0.05). EEG results showed different pre-post patterns between interventions. PRB was associated with broader pre-post changes in β and θ bands, whereas RB showed more localized pre-post changes in β, θ, and δ bands. Heart rate was lower and HRV total power was higher after both interventions (p < 0.05). The LF/HF ratio and SKNA burst area were higher after RB (p < 0.05), whereas SKNA burst threshold and frequency were higher after PRB (p < 0.05). Correlation analysis suggested an association between prefrontal activity and SKNA changes in PRB.
CONCLUSION: Both RB and PRB were associated with symptom improvement and changes in neuro-autonomic function. The two interventions showed different patterns. These findings support the use of breathing interventions as non-pharmacological approaches in concussion rehabilitation.