Pulmonary: Respiration and Postural Control

Important information:

The chest, back, and stomach muscles help us breathe and stay balanced while sitting, standing, reaching, and bending. If these muscles are weak, there is less support for breathing. When this happens, the muscles will focus on the immediate needs of breathing and work less on keeping the body in the proper position.

If your child uses all their muscle strength to breathe, it will limit their ability to sit or stand upright while completing daily tasks. Practicing the breathing exercises below can help to strengthen trunk muscles and improve your child's breathing and posture.

How to practice belly breathing (diaphragmatic breathing):

The diaphragm is a large dome-shaped muscle at the base of your lungs. This breathing technique helps strengthen the diaphragm and engages core muscles, which can improve overall stability and movement efficiency.

Lying down:

  1. Lie comfortably on your back and place one hand on your chest and one hand on your belly.

  2. Take a slow breath through your nose, feeling your belly rise. Keep the hand on your chest as still as possible.

  3. Release your breath through your mouth and you’ll feel your belly flattened.

  4. Repeat steps 1-3.

Sitting or standing:

  1. Sit or stand up straight and place one hand on your chest and one hand on your belly.

  2. Take a slow breath through your nose, feeling your belly rise. Keep the hand on your chest as still as possible.

  3. Release your breath through your mouth and you’ll feel your belly flattened.

  4. Repeat steps 1-3.

Other recommended breathing exercises:

These are different activities and games that you and your child can do to strengthen the muscles that help your child breathe and support posture.

  • Keep your mouth closed and breathe in through your nose slowly for a count of 2. Next, pucker your lips and slowly breathe out through your mouth for a count of 4.

  • Pucker your lips. Blow out slowly to fog a mirror. Have fun drawing shapes on the foggy mirror.

  • Blow cotton balls across a table with a long, slow exhale.

  • Have a race blowing small pom-poms across the table with a straw.

  • Sit on a therapy ball. Slowly breathe in while lifting your arms above your head and looking up. Then slowly breathe out while lowering your arms and head.

  • Sit on a therapy ball and take a slow deep breath in through your nose and as you breathe out, make "sss" or "mmm" sounds for as long as you can.

  • Sit on a therapy ball and hold your breath for a count of 5, repeat. This strengthens the diaphragm.

  • Count out loud or sing a song while doing a task. Practice with a soft voice and a loud voice to challenge your breath control.

Reviewed on December 2025, by Jacqueline Vicencio, PT, DPT