In the control group, participants received conventional diaphragmatic breathing exercises. The participants were placed in a half-lying position and their hands were placed just below the anterior costal margin, on the rectus abdominus muscle, and inhaled slowly through the nose for 3 seconds, from functional remaining capacity to total lung capacity. Exhalation was performed slowly through the mouth. They were asked to relax their shoulders and upper chest so they could feel the rise and fall of their abdomen with the hand resting on it.15 (link) The method of performing diaphragmatic breathing exercises is shown in Figure 2A. The exercises were performed for 5 minutes and 4 times per day under the supervision of the therapist. They were asked to breathe normally in between the sets of the diaphragmatic breathing exercise.11 (link)

Two intervention exercises for patients following abdominal surgery. (A) Diaphragmatic breathing. (B) Volume incentive spirometry.

In the VIS group, VIS was administered to the patient who was also placed in a half-lying position. A pillow was placed beneath the patient’s knees. The participants were instructed to hold the volume-oriented incentive spirometry and perform slow, deep inhalation, avoiding any forceful expiration.16 (link) The process was first demonstrated to the patient to ensure that they understood the technique’s use before performing it. The method of performing VIS is shown in Figure 2B. The treatment was performed for 5 minutes and 4 times per day under the supervision of the therapist. Both two groups received routine postoperative rehabilitation education before surgery and began to receive treatment guidance 2 days before surgery.