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Effects of Modified Diaphragmatic Training on Gastroesophageal Reflux Disease Questionnaire Score, Diaphragmatic Excursion, and Maximum Inspiratory Pressure in Adults with Gastroesophageal Reflux Disease After COVID-19: A Single-Blinded Randomized Control

ACTA MEDICA INDONESIANA · Vol. 55 No. 3 (2023)

ISSN
2338-2732, 0125-9326
Published
2023-11-01
Publisher
The Indonesian Society of Internal Medicine
Language
eng

Abstract

Background: Although diaphragmatic training has been shown to improve gastroesophageal reflux disease (GERD) symptoms, its effectiveness in adults with GERD after COVID-19 has not been evaluated. This study examined the effectiveness of modified diaphragmatic training (MDT) on GERD questionnaire (GERDQ) score, diaphragmatic excursion, and maximum inspiratory pressure (MIP) in adults with GERD after COVID-19. Methods: This single-blinded randomized control trial was conducted at Persahabatan Hospital from February to April 2023. The medical records of 364 patients with persistent gastrointestinal symptoms were evaluated; among these potential participants, 302 had symptoms before, and 62 after, COVID-19 infection. Fifty of these patients fulfilled the study inclusion and exclusion criteria and were randomly assigned to the intervention (n = 25) or control (n = 25) groups. Four weeks of diaphragmatic training were followed by MDT or standard diaphragmatic training. A follow-up assessment was conducted 30 days after the beginning of the training. Results: The GERDQ score was significantly decreased in the pre–post-intervention group (10.44 ± 2.00 vs 1.84 ± 2.17) and the control group (8.64 ± 0.57 vs 3.32 ± 1.49), with p < 0.001. The intervention group showed significant improvements in the right diaphragmatic excursion (RDE) (44% vs 11.87%), left diaphragmatic excursion (LDE) (46.61% vs 13.62%), and MIP (75.26% vs 23.97%) compared with the control group. Conclusion: MDT in adults after COVID-19 with GERD enhanced diaphragmatic excursion and MIP and decreased symptoms of gastroesophageal reflux by 8.60 points of GERDQ. Respiratory symptoms and other side effects were comparable between the groups.

Keywords

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40 authors · 167 co-authorship links · showing the 40 most connected

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Co-authorOrganisationJoint articles
Siti SetiatiAffiliation unknown6
Hamzah ShatriAffiliation unknown5
Dadang MakmunAffiliation unknown4
Murdani AbdullahAffiliation unknown4
Adityo SusiloAffiliation unknown4
Ikhwan RinaldiAffiliation unknown3
Andhika RachmanAffiliation unknown3
Idrus AlwiAffiliation unknown3
Cleopas Martin RumendeAffiliation unknown2
Saskia Aziza NursyirwanAffiliation unknown2
Amanda Pitarini UtariAffiliation unknown2
Anna ArianeAffiliation unknown2
Achmad FauziAffiliation unknown2
Budi WiwekoAffiliation unknown2
Cosphiadi IrawanAffiliation unknown2
Evy YunihastutiAffiliation unknown2
Rahmi IstantiAffiliation unknown2
Lies Dina LiastutiAffiliation unknown2
Harry IsbagioAffiliation unknown1
Bambang SetyohadiAffiliation unknown1
Faisal YunusAffiliation unknown1
Widjajalaksmi WidjajalaksmiAffiliation unknown1
Dwi R HelianthiAffiliation unknown1
Christina SimadibrataAffiliation unknown1
Adiningsih SrilestariAffiliation unknown1
Edy R WahyudiAffiliation unknown1
Radhiyatam MardhiyahAffiliation unknown1
Ening KrisnuhoniAffiliation unknown1
Rabbinu Rangga PribadiAffiliation unknown1
Mardiastuti H WahidAffiliation unknown1
Rike SyahniarAffiliation unknown1

Affiliations come from OpenAlex; journal OAI-PMH metadata carries none. Authors without an OpenAlex ID are matched by name, which can merge or split people.

Metadata source: OAI-PMH (metadata jurnal) http://www.actamedindones.org/index.php/ijim/oai, first harvested 8 Nov 2026, last seen 8 Nov 2026.
Original metadata (oai_dc) 
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	<dc:title xml:lang="en-US">Effects of Modified Diaphragmatic Training on Gastroesophageal Reflux Disease Questionnaire Score, Diaphragmatic Excursion, and Maximum Inspiratory Pressure in Adults with Gastroesophageal Reflux Disease After COVID-19: A Single-Blinded Randomized Control</dc:title>
	<dc:creator>Widjanantie, Siti Chandra</dc:creator>
	<dc:creator>Syam, Ari Fahrial</dc:creator>
	<dc:creator>Nusdwinuringtyas, Nury</dc:creator>
	<dc:creator>Susanto, Agus Dwi</dc:creator>
	<dc:creator>Hidayat, Rudy</dc:creator>
	<dc:creator>Kekalih, Aria</dc:creator>
	<dc:creator>Rachmawati, Maria Regina</dc:creator>
	<dc:creator>Choi, Won Ah</dc:creator>
	<dc:creator>Kang, Seong Woong</dc:creator>
	<dc:subject xml:lang="en-US">COVID-19</dc:subject>
	<dc:subject xml:lang="en-US">diaphragmatic training</dc:subject>
	<dc:subject xml:lang="en-US">gastroesophageal reflux disease questionnaire score</dc:subject>
	<dc:subject xml:lang="en-US">diaphragmatic excursion</dc:subject>
	<dc:subject xml:lang="en-US">maximal inspiratory pressure</dc:subject>
	<dc:subject xml:lang="en-US">gastroenterology</dc:subject>
	<dc:description xml:lang="en-US">Background: Although diaphragmatic training has been shown to improve gastroesophageal reflux disease (GERD) symptoms, its effectiveness in adults with GERD after COVID-19 has not been evaluated. This study examined the effectiveness of modified diaphragmatic training (MDT) on GERD questionnaire (GERDQ) score, diaphragmatic excursion, and maximum inspiratory pressure (MIP) in adults with GERD after COVID-19. Methods: This single-blinded randomized control trial was conducted at Persahabatan Hospital from February to April 2023. The medical records of 364 patients with persistent gastrointestinal symptoms were evaluated; among these potential participants, 302 had symptoms before, and 62 after, COVID-19 infection. Fifty of these patients fulfilled the study inclusion and exclusion criteria and were randomly assigned to the intervention (n = 25) or control (n = 25) groups. Four weeks of diaphragmatic training were followed by MDT or standard diaphragmatic training. A follow-up assessment was conducted 30 days after the beginning of the training. Results: The GERDQ score was significantly decreased in the pre–post-intervention group (10.44 ± 2.00 vs 1.84 ± 2.17) and the control group (8.64 ± 0.57 vs 3.32 ± 1.49), with p &amp;lt; 0.001. The intervention group showed significant improvements in the right diaphragmatic excursion (RDE) (44% vs 11.87%), left diaphragmatic excursion (LDE) (46.61% vs 13.62%), and MIP (75.26% vs 23.97%) compared with the control group. Conclusion: MDT in adults after COVID-19 with GERD enhanced diaphragmatic excursion and MIP and decreased symptoms of gastroesophageal reflux by 8.60 points of GERDQ. Respiratory symptoms and other side effects were comparable between the groups.</dc:description>
	<dc:publisher xml:lang="en-US">The Indonesian Society of Internal Medicine</dc:publisher>
	<dc:date>2023-11-01</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:type xml:lang="en-US">Single blinded-randomized control trial</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>http://www.actamedindones.org/index.php/ijim/article/view/2465</dc:identifier>
	<dc:source xml:lang="en-US">Acta Medica Indonesiana; Vol. 55 No. 3 (2023): Acta Medica Indonesiana; 269</dc:source>
	<dc:source>2338-2732</dc:source>
	<dc:source>0125-9326</dc:source>
	<dc:language>eng</dc:language>
	<dc:relation>http://www.actamedindones.org/index.php/ijim/article/view/2465/pdf</dc:relation>
	<dc:rights xml:lang="en-US">Copyright (c) 2023 Siti Chandra Widjanantie, Ari Fahrial Syam, Nury Nusdwinuringtyas, Agus Dwi Susanto, Rudy Hidayat, Aria Kekalih, Maria Regina Rachmawati, Won Ah Choi, Seong Woong Kang</dc:rights>
</oai_dc:dc>