Comparative Effects of Deep Breathing and Vagus Nerve Stimulation on Psychosocial and Autonomic Outcomes in Mothers of Children with Cerebral Palsy: A Randomized Controlled Trial.

BACKGROUND

This randomized controlled trial examined the effects of deep breathing exercises (DBEs) and transcutaneous auricular vagus nerve stimulation (VNS) on psychosocial and autonomic outcomes in mothers of children with cerebral palsy.

METHODS

Thirty-nine participants were randomly assigned to the DBE (n = 20) or VNS (n = 19) group and received three sessions per week for three weeks. The outcomes included the Pittsburgh Sleep Quality Index (PSQI), Beck Depression Inventory (BDI), Zarit Burden Interview (ZBI), Composite Autonomic Symptom Score-31 (COMPASS-31), heart rate variability (HRV), and the Nordic Musculoskeletal Questionnaire-Extended Version (NMQ-E).

RESULTS

Both interventions produced significant within-group improvements in sleep quality, depressive symptoms, caregiver burden, and autonomic symptom burden (p < .05). In contrast, the HRV parameters showed no significant within-group changes (p > .05). Between-group analyses indicated a greater reduction in BDI scores in the VNS group (d = 0.74), whereas improvements in the PSQI (d = 0.43), ZBI (d = 0.08), and COMPASS-31 (d = 1.19) scores were comparable between the two groups. NMQ-E pain scores decreased in six regions of the DBE group and seven areas of the VNS group, with small-to-moderate between-group effect sizes across body regions; however, none of these differences reached statistical significance (p > .05).

CONCLUSION

Both interventions were effective, with VNS demonstrating more substantial antidepressant effects and broader pain reduction, whereas DBE remains a simple, low-cost, and scalable option for caregiver support.