Chronic Obstructive Pulmonary Disease (COPD) is a progressive respiratory disorder characterized by airflow limitation, breathlessness, and reduced quality of life. Breathing exercises are commonly used in pulmonary rehabilitation to improve respiratory efficiency and functional capacity. Among these techniques, pursed lip breathing (PLB) helps slow expiration, reduce air trapping, and improve ventilation, while alternate nostril breathing (ANB), a yogic breathing technique, may enhance respiratory control and relaxation.

The purpose of this study is to determine the effects of pursed lip breathing alone compared with the combined effect of pursed lip breathing and alternate nostril breathing on pulmonary function and quality of life in patients with Grade I COPD. This randomized controlled trial will include approximately 40 participants diagnosed with mild COPD. The participants will be divided into two groups: one group will perform pursed lip breathing exercises, while the other group will perform a combination of pursed lip breathing and alternate nostril breathing.

Pulmonary function tests and quality of life assessments will be used as outcome measures to evaluate the effectiveness of these interventions. The study aims to determine whether combining both breathing techniques provides greater improvement in respiratory function and patient well being than pursed lip breathing alone. The findings may contribute to developing more effective physiotherapy based pulmonary rehabilitation strategies for patients with COPD.

Chronic Obstructive Pulmonary Disease (COPD) is a progressive respiratory condition characterized by persistent airflow limitation, chronic inflammation of the airways, and reduced lung function. It is commonly associated with long term exposure to harmful particles or gases, especially cigarette smoke. Patients with COPD often experience symptoms such as breathlessness, chronic cough, sputum production, and reduced exercise tolerance, which significantly affect their daily activities and overall quality of life. Pulmonary rehabilitation, particularly breathing exercises, plays an important role in the physiotherapy management of COPD.

Among the commonly used breathing techniques, pursed lip breathing is widely recommended for patients with COPD. This technique helps slow down expiration, prevents airway collapse, reduces air trapping, and improves ventilation efficiency. As a result, it may decrease dyspnea and enhance oxygen exchange. Another breathing technique, alternate nostril breathing, is a yogic breathing exercise that promotes better control of respiration, improves relaxation, and may enhance respiratory muscle coordination.

The purpose of this study is to investigate the effect of pursed lip breathing alone and in combination with alternate nostril breathing on patients with Grade I COPD. The study aims to determine whether the combined use of these breathing techniques can provide additional benefits compared to pursed lip breathing alone. By improving breathing patterns and respiratory mechanics, these interventions may help patients manage symptoms more effectively and enhance their functional capacity.

This research will follow an interventional study design in which participants will be divided into two groups. One group will receive pursed lip breathing exercises, while the second group will perform both pursed lip breathing and alternate nostril breathing. The intervention will be conducted over a specified period under proper supervision and guidance.

The findings of this study may contribute to the development of more effective physiotherapy based breathing exercise programs for patients with mild COPD and may support the integration of combined breathing techniques in pulmonary rehabilitation programs.

Inclusion Criteria:

• Patients diagnosed with Grade I COPD (FEV₁ > 80% predicted)
• Age between 40 to 65 years.
• Both male and female patients.
• Patients able to follow verbal instructions and perform breathing exercises.
• Patients willing to provide written informed consent.

Exclusion Criteria:

• History of orthopedic conditions limiting sitting or breathing exercises.
• Recent respiratory infections or COPD exacerbations within the past 4 weeks.
• Neurological or cognitive impairments.
• Recent thoracic or abdominal surgeries.
• Regular practitioners of yoga or alternate nostril breathing.

In this study, single blinding will be applied. The outcome assessor will be blinded to the group allocation of the participants. This means that the person responsible for measuring and recording the outcomes, including the Pulmonary Function Test and questionnaire assessments, will not know whether the participant belongs to Group A (pursed lip breathing) or Group B (pursed lip breathing combined with alternate nostril breathing).