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EFFECT OF BALLOON BLOWING EXERCISE ON PEAK EXPIRATORY FLOW RATE IN YOUNG HEALTY
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EFFECT OF BALLOON BLOWING EXERCISE ON PEAK EXPIRATORY FLOW RATE
IN YOUNG HEALTY ADULTS Page
Introduction
The lungs are a pair of respiratory organs situated in the thoracic cavity. Each Lung
invaginates the corresponding cavity. The right and left lung separated by the mediastinum
the lungs are spongy in texture. In the young adults are grey in colour gradually, they become
mottled black because of the deposition of inhaled of carbon dioxide. The right lung weight
about 700g it is about 50-100g heavier than the left lung.
A peak flowmeter is a tool that measures the peak expiratory flow rate (PEFR). The PEFR is
the amount of air a person can quickly force out of their lungs in one breath. People can use a
peak flow meter to monitor their ability to exhale (breath out). This can help people with lung
diseases including asthma, chronic obstructive pulmonary diseases (COPD).
Respiratory system
Respiration is the process by which oxygen is taken in carbon dioxide is given out
Normal respiratory rate
 New born : 30-60/min
 Early childhood :20-40/min
 Late childhood : 15-25/min
 Adult : 12-16/min
Types of Respiration
 External Respiration
 Internal Respiration
External Respiration: That involves exchange of respiratory gases i.e. O2 and Co2 between
lungs and blood.
Internal Respiration: That involves exchange of gases between blood and tissue.
Phases of Respiration
 Inspiration during which air enters the lungs from atmosphere
 Expiration during which air leaves the lungs
During normal breathing inspiration is an active process. Expiration is passive process.
Functional respiratory tract
Respiratory tract is the anatomical structure through which air moves in and out. It
Includes nose, pharynx, trachea, bronchi.

Pleura
Each Lung is enclosed by a bilayered serousmembrane called pleura (or) pleural sac.

EFFECT OF BALLOON BLOWING EXERCISE ON PEAK EXPIRATORY FLOW RATE

IN YOUNG HEALTY ADULTS Page
It has two layers
 Inner visceral layer – It Is attached firmly surface of the lungs
 parietal layer– It is outer layer which is attached to the wall of thoracic cavity.
Pleural Cavity: It is the normal space between the two layers of pleura.
Intrapleural Fluid: Which is secreted by the visceral layer of the pleura.
It act as lubricant to prevent friction between two layers of pleura.
Mechanies of Respiration
Respiration occurs in the phases namely inspiration and expiration. During inspiration,
thoracic cage enlarges and lung expand So that air enters the lungs easily. During expiration,
the thoracic cage and lungs decrease in size and attain the Pre-inspiration position so that air
leaves the lungs easily.
Muscle of respiration
1) Inspiratory muscles
Muscle involved in inspiratory movement as known as inspiratory muscles
 Primary inspiratory muscles - are the diaphragm, which supplies by phrenic nerve
(C3-C5) and external intercostal muscle. Supplied by intercostal nerves
 Accessary inspiratory muscles – are the sternocleidomastoid, Scalene anterior
serrati, elevators of scapula and pectoralis are the accessary inspiratory muscles
2) Expiratory muscles
Muscle involved in expiratory movements are known as expiratory muscles
 Primary Expiratory muscles - Are the intercostal muscles, which are inverted by
intercostal nerves
 Accessary expiratory muscles – Are the abdominal muscles – External obliques,
Internal obliques, Pyramidalis, Rectus Abdominis, transfers verse abdominis
Movement of thoracic
Inspiration causes enlargement of thoracic cage. Thoracic cage enlarges because of increase
in all diameter anterio posterior, transfers and vertical diameter.
Anterio posterior and transfers diameter or increased by the elevation of ribs. Vertical
diameter is increased by the bescent of diaphragm.
Movement of Lungs
During inspiration due to the enlargement of thoracic cage, the negative pressure is increased
in the thoracic cavity. It causes expansion of the lungs during expiration of the thoracic cavity
decreases in size to the pre inspiratory position. It compress the lung tissues so that the air is
expelled out of lungs.

Lung Volume
Static lung volumes are the volumes of air breathed by an individual.

EFFECT OF BALLOON BLOWING EXERCISE ON PEAK EXPIRATORY FLOW RATE

IN YOUNG HEALTY ADULTS Page
Static lung volumes are of four types:
1. Tidal volume
2. Inspiratory reserve volume
3. Expiratory reserve volume
4. Residual volume
1. Tidal Volume: It is the volume of air breathed in and out of lungs in a single normal
depth respiratory. Tidal volume signifies the normal depth of breathing.
The normal value=500ml (0.5l)
 Inspiratory reserve volume: It is an additional volume of air that can be inspired
forcefully after the end of normal inspiration
Normal Value – 3,300ml (3.3l)
 Expiratory reserve volume: It is the additional volume of the air that can be expired
out forcefully, after normal expiration.
Normal value – 1000ml (1l)
 Residual Volume: It Is the volume of air remaining in lungs even after forced
expiration. It helps the blood in between breathing and during expiration. It maintain
the volume of thelung.
Normal value -1200ml (1.2l)
Lung Capacities
o Inspiratory capacity: It is the maximum volume of air that can be inhaled following a
resting state. It is calculated from the sum of inspiratory reserve volume and tidal
volume.
IC=IRV+TV
o Total lung Capacity: It is the maximum volume of air the lungs can accommodate or
sum of all volume compartments or volume of air in lungs after maximum inspiration.
The normal value is about 5000ml
o Vital Capacity: It is the total amount of air inhaled after maximal inhalation. The
value is about 4800ml and it varies according to age and body size.
o Functional Residual capacity: It is the amount of air remaining in the lungs at the end
of the normal exhalation. It is calculated by adding together residual and expiratory
reserve volume.
The normal value is about 1800-2200ml.
People with asthma they develop narrowing of the airways, which lowers the amount of air
they can exhale. The PEFR often changes in response to a flare-up of asthma. Whether,
exposure to allergens, infection or even exercise can all affect asthma symptoms. In some
cases, a decreases PERF is an early sign of an impending asthma attack. Peak flowmeter can
also help with other lung conditions, such as COPD, people with COPD also develop acute
narrowing of airways and inflammation by monitoring their PEFR people with COPD can
determine what is normal for them. The meter measures the forced air in litres per minute.
Peak flow predictions vary based on age, height, and gender.
The typical peak flow measurement is between 400-700ltrs per minute for adults
For example, if your personal best peak flow is 400 LPM the zone will be:

EFFECT OF BALLOON BLOWING EXERCISE ON PEAK EXPIRATORY FLOW RATE

IN YOUNG HEALTY ADULTS Page
  Green zone: 300 LPM to 400LPM
(80% -100%).
 Yellow zone: 200LPM to 300 LPM (50%-80%).
 Red zone: less than 200 LPM (50%)

Balloon blowing exercises are the types of expiratory exercises, which are mainly given to
improve the expiratory flow rate and strength of respiratory muscles in respiratory condition.
Blowing Balloon works out the intercostal muscles that are responsible for spreading and
elevating the diaphragm and ribcage. This allows the lungs to taken oxygen during inhalation
and carbon dioxide while exhale.
Need for study

Hypothesis
Null Hypothesis: There will be no significant effect of Balloon blowing exercise in young
healthy adults.
Alternative hypothesis: There will be significant effect of Balloon blowing exercise in
young healthy adults.
Aim of the study
To investigate peak expiratory flow rate before and after the performance of a balloon
blowing exercise in young healthy adults .
Materials and methods
 Study design: Exploratory study
 Sample size: 100
 Sample method: Convenience sampling

Selective criteria
 Inclusion criteria

EFFECT OF BALLOON BLOWING EXERCISE ON PEAK EXPIRATORY FLOW RATE

IN YOUNG HEALTY ADULTS Page
 Age Group of 18-25 years
Both Gender
Having no health issues
 Exclusion criteria
More than 25 years
Any known disease of lung/respiratory system
Procedure for Intervention
 Sit in comfortable position, maintain the same position each time.
 It has been made sure the red marker is at the bottom of the meter.
 The Subject was asked to take a deep breath to filling their lungs completely.
 The mouth piece was placed in their mouth the lips should tightly hold the peek flow
meter’s mouth piece.
 Blow the air out as hard and as fast as possible in a single blow.
 Number by the red marker on the meter is written.
 Place the red marker back at the bottom of the peek flow meter& repeat the steps
3times.
 Note down the highest of the three readings on sheet of paper.

Discussion
The Study investigated the effect of Balloon blowing exercise on pulmonary function in 18-
25 years.
When Measurement of pulmonary function before and after the experiment were compared,
it was found that the lung capacity increased in forced vital capacity.
Balloon Blowing Exercise helps to maintain the optimal breathing, posture and stability.
The study concerns about the activation and the contraction of the transverse thoracic
muscles.
The balloon resistance most likely increased contraction of diaphragm muscles, which is
active during forced exhalation, and the respiratory cycle, with resistance, required
lengthening and contracting of both the internal and external intercostal muscles, which
active during both phases of respiration.
Respiratory exercise with an assisted device such as peak flow meter, the balloon are found to
be effective not only in healthy young populations with neurological disorders with cardio
respiratory effects
These effects improved pulmonary function, Exercise performance, respiratory function and
respiratory muscle strength maintenance or improvement of chest and lumbar mobility and
correction of abnormal breathing patterns. Thus, these treatments are used to prevent
complication of lungs
Conclusion

EFFECT OF BALLOON BLOWING EXERCISE ON PEAK EXPIRATORY FLOW RATE

IN YOUNG HEALTY ADULTS Page
The study concluded that balloon blowing exercises improved peak expiratory flow rate and
can be used as alternative method to improve respiratory functions.

Reference
 Chauhan. N. Gunjal S et.al (2018). Effect of balloon blowing exercise on peak expiratory
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 Angelina .K et.al, 2017 Effectiveness of balloon exercise on level of dyspnoea among

patients with lower respiratory tract disorder. Journal of lung pulmonary and respiratory
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 Jun H J. Kim K. J, Nam K W, Kim et.al, CH Effects of exercises on lung capacity and
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EFFECT OF BALLOON BLOWING EXERCISE ON PEAK EXPIRATORY FLOW RATE

IN YOUNG HEALTY ADULTS Page
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REVIEW OF LITERATURE
o Aditi sanjay Aawaskar, Richa Bisen et.al:
Aug 2021 conducted a study on comparison between Effect of Balloon blowing
exercise in semi-flower (45 degree). Upright and 90/90 bridge with ball position on
peak flow rate in healthy individuals and proved that accordance to objectives.
Comparison at peak expiratory flow rate values in pre-post exercise in the positions

EFFECT OF BALLOON BLOWING EXERCISE ON PEAK EXPIRATORY FLOW RATE

IN YOUNG HEALTY ADULTS Page
 shows that there is improvement of group A (semi-flower position) >group C (90/90
bridge with ball position)> group B ( upright position )

o Mahfooz Ahmed et.al, April 2017 conducted study on age specific peak expiratory
flow nomogram in children and proved that thus region specific nomograms for peak
expiratory flow rate for assessing the severity and monitoring of airway obstruction in
relation to age , sex, weight and height of children can be determined.

o N A R Nik Hisamuddin et.al, 2009 conducted a study on co-relations b/w

capnographic wave forms and peakflow meter measurement in emergency department
management asthma and proved that peak flow measurements showed significant
improvements.

o Sharat Gupta et.al, 2013 July. Conducted astudy on peak expiratory floe rate of
healthy school children living at high altitudeand the study suggests that besides
anthropometric and socio economic factors , altitude is an important determinant of
lung function.

o Hyum-ju Jun et.al, :Jun 2016 conducted study on effects of breathing exercises on
lung capacity and muscle activities elderly smoker and provide that FBE ( feedback
breathing exercises) and BBE (balloon blowing exercise) improved the pulmonary
functions, of elderly smokers demonstrating the potential benefits of the development
of various training methods using balloons and group programmes including
recreational factors for increasing respiratory muscle strength.

o Zeynep, Kizileik Ozkon et.al, : May-Jun 2021 conducted study on the effect of
balloon blowing exercise on post operative pulmonary functions in patients ,
undergoing total hip arthroplasty and provide that the patients who performed balloon
blowing exercise increased their FVC( forced vital capacity) and FEV1 (forced
expiratory volume during the first sec.,)

o Vadivelon kanniappan and varalakshmi Manivannal : July 2020 conducted study

Efficacy of balloon blowing exercise on peak expiratory flow rate in young adult
smokers and proved that there is an improvement in peak expiratory floe rate after the
application of balloon blowing exercise among young adult smokers .

o Kyochul Seo, Misuk Cho : October 2018 conducted study on the effects of a balloon
blowing exercise in 90/90 bridge position using a ball on the pulmonary function of
females in their twenties and proved that there is differences b/w the experimental and
control groups before and after the experiment, the experimental group showed a
greater improvement in VC.

EFFECT OF BALLOON BLOWING EXERCISE ON PEAK EXPIRATORY FLOW RATE

IN YOUNG HEALTY ADULTS Page
SUBJECT AGE GENDER PRE-PEAK POST-PEAK
EXPIRATORY EXPIRATORY
FLOW FLOW
1 20 M N 350
2 20 M 350 400
3 21 M 350 400
4 20 M 350 350
5 19 M N 350

EFFECT OF BALLOON BLOWING EXERCISE ON PEAK EXPIRATORY FLOW RATE

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6 19 M N 350
7 18 M 400 450
8 18 M 450 500
9 19 F N 350
10 19 F N 350
11 19 F N 350
12 18 F N 350
13 18 F N 350
14 18 F N 350
15 18 F 350 350
16 18 F N 350
17 20 F N 350
18 18 F N 350
19 18 F N 350
20 18 M 400 450
21 18 M 350 400
22 19 M 350 500
23 19 M 350 400
24 18 M 450 500
25 18 M 450 500
26 19 F N 350
27 20 F N 350
28 18 F N 350
29 18 F N 350
30 18 F N 350
31 19 F N 350
32 18 F N 350
33 20 F N 350
34 22 F N 350
35 18 M 400 450
36 19 F N 350
37 19 M 400 450
38 18 F N 350
39 19 M N 350
40 19 F N 350

SUBJECT AGE GENDER PRE-PEAK POST-PEAK

EXPIRATORY EXPIRATORY
FLOW FLOW
41 19 M 350 450
42 19 F N 350
43 19 M 450 500
44 19 F N 350
45 19 M 550 550
46 19 F N 350
47 20 M 450 500

EFFECT OF BALLOON BLOWING EXERCISE ON PEAK EXPIRATORY FLOW RATE

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48 18 M N 350
49 20 M N 400
50 19 M 400 450
51 18 M 350 350
52 19 M 400 500
53 23 M 430 450
54 19 M N 400
55 20 M 350 450
56 19 M N 400
57 18 M 450 450
58 19 M 530 550
59 19 M 400 400
60 19 M 350 350
61 18 M N 350
62 20 M 400 400
63 18 F 350 350
64 18 M N 350
65 18 M 350 350
66 19 M N 350
67 19 M N 350
68 19 M 350 400
69 19 M N 350
70 19 M 350 350
71 19 M N 350
72 20 M 350 350
73 18 M 350 350
74 21 M N 350
75 20 M 400 400
76 18 M N 350
77 18 M 500 550
78 21 M 450 500
79 18 M 350 400
80 19 M 400 400

SUBJECT AGE GENDER PRE- PEAK POST-PEAK

EXPIRATORY EXPIRATORY
FLOW FLOW
81 18 M N 350
82 19 M 500 550
83 18 M 450 500
84 18 M 350 350
85 22 M 450 500
86 20 M 350 450
87 18 M 400 400
88 18 M 400 430
89 18 M N 400

EFFECT OF BALLOON BLOWING EXERCISE ON PEAK EXPIRATORY FLOW RATE

IN YOUNG HEALTY ADULTS Page
90 18 M 450 450
91 18 M N 350
92 18 M N 350
93 19 M 550 550
94 22 F 350 400
95 21 M 450 450
96 20 F 350 350
97 20 M 420 470
98 20 F N 350
99 23 F N 350
100 18 M 350 500

EFFECT OF BALLOON BLOWING EXERCISE ON PEAK EXPIRATORY FLOW RATE

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 SL.
NO DEMOGRAPHIC FREQUENC
. VARIABLES Y (f) %(f)
1 AGE GROUP
18-19 75 75
20-22 23 23
23-25 2 2

2 GENDER
MALE 69 69
FEMALE 31 31

EFFECT OF BALLOON BLOWING EXERCISE ON PEAK EXPIRATORY FLOW RATE

IN YOUNG HEALTY ADULTS Page
 75%
80%

70%

60%

50%

%(f)
40%

30% 23%

20%

2%
10%

0%
18-19 20-22 23-25

EFFECT OF BALLOON BLOWING EXERCISE ON PEAK EXPIRATORY FLOW RATE

IN YOUNG HEALTY ADULTS Page