{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T16:50:49Z","timestamp":1789404649218,"version":"build-2803163510"},"reference-count":33,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T00:00:00Z","timestamp":1755216000000},"content-version":"vor","delay-in-days":226,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pain Research and Management"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>\n                    <jats:bold>Objective:<\/jats:bold>\n                    Despite the availability of studies, there is a lack of available literature on the treatment of psychological and gastrointestinal causes of noncardiac chest pain (NCCP). Physiotherapeutic techniques involving diaphragmatic breathing, Jacobson\u2019s relaxation and dynamic neuromuscular stabilization (DNS) could address these causes through the activation of parasympathetic system. Hence, this study aims to evaluate the combined effect of diaphragmatic breathing, Jacobson\u2019s relaxation and DNS along with pharmacological therapy on patients with gastrointestinal and psychological causes of NCCP.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Design:<\/jats:bold>\n                    Randomized controlled trial.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Setting:<\/jats:bold>\n                    Cardiology OPD of a tertiary care hospital.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Subjects:<\/jats:bold>\n                    Eighty\u2010eight subjects with NCCP.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Methods:<\/jats:bold>\n                    The intervention group received diaphragmatic breathing, Jacobson\u2019s relaxation technique, DNS and pharmacological treatment for 4\u2009weeks. The control group was given pharmacological treatment with patient education. The Beck Depression Inventory (BDI) score, Hamilton Depression Rating Scale (HDRS) score, gastroesophageal reflux disease (GERD) questionnaire score and Numerical Pain Rating Scale (NPRS) score were measured at baseline and after 4\u2009weeks of intervention.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Results:<\/jats:bold>\n                    The baseline characteristics and outcome measures were assessed, and no significant differences were noted in their mean values (\n                    <jats:italic>p<\/jats:italic>\n                    &gt; 0.05). After 4\u2009weeks of intervention, a statistically significant difference was observed in BDI, HDRS, GERD questionnaire score and NPRS in both the groups (\n                    <jats:italic>p<\/jats:italic>\n                    &lt; 0.001). However, the GERD questionnaire and NPRS showed statistically significant decrease in the intervention group (GERD questionnaire: 28.39\u2009\u00b1\u20099.74 and NPRS: 4.57\u2009\u00b1\u20090.91) compared with the control group (GERD questionnaire: 35.54\u2009\u00b1\u200912.23 and NPRS: 4.95\u2009\u00b1\u20090.96) with\n                    <jats:italic>p<\/jats:italic>\n                    &lt; 0.05.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    The diaphragmatic breathing exercises, Jacobson\u2019s relaxation technique and DNS are beneficial for reducing GERD symptoms and pain in patients with NCCP. These techniques are safe and cost\u2010effective treatment for addressing the psychological and gastrointestinal causes of NCCP. These can be incorporated along with the pharmacological treatment to enhance the outcomes. However, future researches with long\u2010term follow\u2010ups are required.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Trial Registration:<\/jats:bold>\n                    Clinical Trials Registry \u2010 India: CTRI\/2025\/02\/081294\n                  <\/jats:p>","DOI":"10.1155\/prm\/8124858","type":"journal-article","created":{"date-parts":[[2025,8,16]],"date-time":"2025-08-16T04:34:52Z","timestamp":1755318892000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Effect of Diaphragmatic Breathing Exercise, Jacobson\u2019s Relaxation Technique and Dynamic Neuromuscular Stabilization on Gastrointestinal and Psychological Causes of Noncardiac Chest Pain: A Randomized Controlled Trial"],"prefix":"10.1155","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-9672-6465","authenticated-orcid":false,"given":"Anusha Rajesh","family":"Suryavanshi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6753-1154","authenticated-orcid":false,"given":"Prem","family":"Venkatesan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1672-2652","authenticated-orcid":false,"given":"Ranjan","family":"Shetty","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7319-7165","authenticated-orcid":false,"given":"Mrudula","family":"Pawar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,15]]},"reference":[{"key":"e_1_2_14_1_2","doi-asserted-by":"publisher","DOI":"10.5056\/jnm.2011.17.2.110"},{"key":"e_1_2_14_2_2","doi-asserted-by":"publisher","DOI":"10.1159\/000486440"},{"key":"e_1_2_14_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0016-5085(97)70025-8"},{"key":"e_1_2_14_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-017-2493-8"},{"key":"e_1_2_14_5_2","doi-asserted-by":"publisher","DOI":"10.1159\/000486440"},{"key":"e_1_2_14_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/0005-7967(89)90007-7"},{"key":"e_1_2_14_7_2","doi-asserted-by":"publisher","DOI":"10.5056\/jnm.2011.17.2.110"},{"key":"e_1_2_14_8_2","first-page":"255","article-title":"Noncardiac Chest Pain: Current Treatment","volume":"3","author":"Schey R.","year":"2007","journal-title":"Gastroenterology and Hepatology"},{"key":"e_1_2_14_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/apt.13458"},{"key":"e_1_2_14_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/2050312115580799"},{"key":"e_1_2_14_11_2","article-title":"Impact of Jacobson Progressive Muscle Relaxation (JPMR) and Deep Breathing Exercises on Anxiety, Psychological Distress and Quality of Sleep of Hospitalized Older Adults","volume":"10","author":"Khakha D. 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