The multiple breathing training program consisted of five structured breathing exercises designed to improve inspiratory muscle strength, expiratory muscle strength, and breath control. Each exercise was performed for three sets, and the total training duration was approximately 40 minutes per session.

The program included the following components:

Inspiratory Muscle Training (PowerBreathe device): Participants performed resisted inhalation to strengthen the inspiratory muscles (10 repetitions per set).

Expiratory Muscle Training (Balloon with control device): Participants exhaled into a balloon while maintaining pressure according to their measured maximal expiratory pressure (MEP) (10 repetitions per set).

Inspiratory Training (Tri-Flow device): Participants inhaled through the device to elevate and maintain the floating balls, promoting sustained inspiratory effort (10 repetitions per set).

Expiratory Training (Windmill device): Participants exhaled to rotate the windmill,

The multiple breathing training program consisted of five structured breathing exercises designed to improve inspiratory muscle strength, expiratory muscle strength, and breath control. Each exercise was performed for three sets, and the total training duration was approximately 40 minutes per session.

The program included the following components:

Inspiratory Muscle Training (PowerBreathe device): Participants performed resisted inhalation to strengthen the inspiratory muscles (10 repetitions per set).

Expiratory Muscle Training (Balloon with control device): Participants exhaled into a balloon while maintaining pressure according to their measured maximal expiratory pressure (MEP) (10 repetitions per set).

Inspiratory Training (Tri-Flow device): Participants inhaled through the device to elevate and maintain the floating balls, promoting sustained inspiratory effort (10 repetitions per set).

Expiratory Training (Windmill device): Participants exhaled to rotate the windmill, e

Participants were seated in a chair and wore a nasal clip during the assessment. They first performed three cycles of slow, normal breathing, followed by a demonstration of forced inspiration and expiration, and then returned to normal breathing.

Participants were seated in a chair and wore a nasal clip during the assessment. They first performed three cycles of slow, normal breathing, followed by a demonstration of forced inspiration and expiration, and then returned to normal breathing.

Participants were instructed to breathe in and out as quickly and forcefully as possible for 15 seconds.

Participants were instructed to exhale fully to functional residual capacity (FRC), then place the mouthpiece securely and perform a maximal inspiratory effort sustained for 1-2 seconds.

Participants inhaled fully to total lung capacity (TLC), maintained a tight seal on the mouthpiece, and then performed a maximal expiratory effort for 1-2 seconds.

Participants were instructed to sit upright with their hands placed on their hips. They were then asked to perform a maximal exhalation followed by a maximal inhalation. The researcher measured chest expansion using a measuring tape at the following anatomical levels: upper chest: at the axillary line, midway between the 2nd and 4th ribs, middle chest: at the level of the xiphoid process, midway between the 4th and 6th ribs, and lower chest: at the level of the 10th rib.