Breathing Techniques for the Enhancement of Cognitive Function and Stress Reduction in 14–17-Year-Old Adolescent Athletes: A Scoping Review

Starting with 3 self-regulated slow-breath cycles

seated with the eyes closed and hands placed on the stomach – 5 minutes of strictly nasal diaphragmatic breathing

6-bpm frequency with the inspiration-expiration rate of 4:6

guided by coach, providing verbal cues for “inhale” and “exhale”

exposed to descriptions of stressful scenarios at the midpoint of the intervention during the warm-up phase

8 weeks;

5 minute sessions 3 times per week at the beginning of training practice

Trait anxiety State-Trait Anxiety Inventory (STAI Form Y-2)

Perceived stress (Perceived Stress Scale (PSS10)

Emotional and subjective well-being (Positive and Negative Affect Schedule (PANAS))

Satisfaction with Life Scale (SWLS)

Subjective Happiness Scale (SHS)

Physiological stress tolerance (Co2 tolerance test – Co2TT)

Except for positive affect (p = .008), all psychological and well-being markers showed no significant differences when compared to the control group after the intervention, as well as when comparing pre- and post-intervention periods within EG

Significant improvements in Co2 tolerance (p < .001)

introduction about the mind-body connection and encouragement to relax and slow down the breathing rate;

abdominal breathing through pursed lips (5 min)

participants encouraged to focus on positive emotions (12 min)

The real time visual biofeedback was implemented by a picture displayed on the screen; it changed colour depending on low, medium, or high coherence levels

concluding with an affirmation and information regarding the benefits derived (3 min)

Anxiety (State-Trait Anxiety Inventory – STAI A-state)

Self Esteem (Rosenberg Self Esteem Scale)

HRV(Photoplethysmographic (PPG) ear sensor, real-time recording and analysis of HRV data using the emWave PC Stress Relief System, analyzed using Kubios HRV 2.0 software)

Brain waves(EEG data using 19 monopolar electrode sites according to the International 10/20 System)

significantly reduced anxiety (p < 0.001)

showed a substantial and statistically significant improvement in HRVindices(HF p = 0.005;LF p = 0.014;IC p < 0.001)

substantial and statistically significant changes in power spectra of theta (p < 0.001) andalpha (p = 0.0004) brain waves, and alpha asymmetry(F8- F7 p = 0.005; P4- P5 p = 0.032; O1–O2 p = 0.019)

Breathing techniques were an integral part of the Psychological Skills Training (PST) program implemented in the study

specifically included in Session 6 “Relaxation” with the primary goal to teach participants “Breathing to regulate physiological arousal” and to personalize the training protocol for breathing relaxation

No other exact instructions provided

The breathing technique was introduced at week 6 of the PST training program

Skills Inventory for Archery and Shooting (PSIAS)

Intrinsic Motivation Inventory (IMI)

Sports Anxiety Scale (SAS)

Trait Sport Confidence Inventory (TSCI).

comfort when breathing (relaxation)

recalling of a previous crisis during a competition (crisis),

imagery of perfect performance (success)

Individual counselling interviews

The perceived competence (p = 0.049)and confidence in the sport confidence (p = 0.049)improved significantly after PST

HRV analysis indicated that the ratio of low frequency power to high-frequency power (LF/HF ratio) decreased significantly during imagery of crisis and success (p = 0.038), reflecting the increased responsiveness of the autonomic nervous system to stress

PST contributes to the balance of the autonomic nervous system for better performance

During initial monitoring sessions, athletes were guided to breathe at several specific, controlled rates: 6.5, 6, 5.5, 5, and 4.5 breaths per minute via smartphone application (Breath/Breath +) providing real-time feedback

A Polar H7 monitor collected HRV data to be analysed by Kubios HRV software, identifying the optimal breathing rate, or “resonant frequency” after the monitoring sessions

The recovery-stress state (the short French version of the Recovery-Stress Questionnaire for Athletes – RESTQ36-R-Sport)

Perceived control (Mastery scale)

Perceived stress (Perceived stress scale)

HRV-BFBasync protocol significantly predictslower levels of biopsychosocial stress states (Sport specific stress β = –15.96; Total Stress β = –13.09) and cognitive stress (Perceived Stress β = –16.35)

No significant effects werefound for biopsychosocial recovery scales and cognitive perceived control

Integrating HRV-BFBasync can help athletes better manage the stress associated with their training programs

Sectional Breathing(Vibhagiya Pranayama): sitting in a comfortable posture, inhalation by expanding abdominal, thoracic and upper lobar chest for 10 repetitions in each section separately, followed by a full yogic breath (combining the sequence of abdominal, thoracic, and upper lobar breathing for inhalation and reverse order for exhalation) practiced at a frequency of 4 breaths/minute

Yogic Bellows Breathing (Bhastrika Pranayama): forceful rhytmical nasal inhalations (abdomen expanding) and exhalations (abdomen contracting) through the left nostril, then the right nostril, and finally both nostrils for 10 rounds each (one set), followed by a 20-second breath retention and slow exhalation

Alternate Nostril Breathing (Nadi Shodhana): complete exhalation, inhalation through the left nostril (closing the right), tucking the chin to the jugular notch and holding the breath by closing both nostrils, raising the head and exhaling through the right nostril (closing the left), then vice versa. Inhalation, breath holding, and exhalation were each performed for 8 seconds, resulting in a respiratory rate of 2.5 breaths/minute

Slow Vital Capacity (SVC)

Inspiratory Reserve Volume (IRV)

Forced Vital Capacity (FVC)

Maximum Voluntary Ventilation (MVV)

Minute ventilation (MV)

Peak Expiratory Flow (PEF)

The Sport Anxiety Scale-2 (SAS-2)

The number of strokes per breath

significantly improved lung functions, specifically in Maximal Voluntary Ventilation (MVV) p = 0.038, and Forced Vital Capacity (FVC) p = 0.026

significant increase in the number of strokes per breath (p = 0.001), indicating enhanced performance.

significant reduction in sport anxiety, particularly self-reported Total Sport Anxiety (t = 2.45, p = 0.031), Concentration Disruption (t = 2.635, p = 0.022), and Somatic Complaints (t = 2.343, p = 0.037)