Niazi Journal of Medical & Dental SciencesXXXX-XXXX2024-12-311465810.58398/0007.000006articleFarhan Hameed KhaliqBushra EjazHussain Memorial Hospital, Lahore, PakistanHussain Memorial Hospital, Lahore, PakistanAn estimated 262 million people live with asthma globally, and control remains inadequate for a large share of them despite pharmacotherapy. Diaphragmatic stretching and respiratory training have each shown promise as nonpharmacological adjuncts, but they have rarely been compared directly. In a two-arm quasi-experimental study at a private hospital outpatient department in Lahore, Pakistan, 100 adults with clinically stable mild-to-moderate asthma were enrolled consecutively and assigned alternately to diaphragmatic stretching or respiratory training (50 per arm); both arms attended supervised 30-minute sessions three times weekly across 14 weeks. Forced expiratory volume in one second (FEV1; primary outcome), forced vital capacity (FVC), six-minute walk test (6MWT), Asthma Control Test (ACT), and University of California, San Diego Shortness of Breath Questionnaire (UCSD SOBQ) were assessed at baseline and at 14 weeks. All five outcomes improved within both groups (p < 0.001). Between-group comparisons of changes in scores favored diaphragmatic stretching throughout: an FEV1 of 0.20 L (95% CI of 0.07 to 0.33), an FVC of 0.20 L (0.10 to 0.30), a 6MWT of 39.9 m (27.6 to 52.2), an ACT of 1.98 points (1.16 to 2.80), and a UCSD SOBQ of −5.08 points (−6.33 to −3.83); all p ≤ 0.003, and analysis of covariance adjusted for baseline values yielded concordant results. More participants reached the predefined minimal clinically important difference (MCID) with diaphragmatic stretching for FEV1 (60% vs 32%), FVC (58% vs 36%), the 6MWT (70% vs 14%), the ACT (54% vs 22%), and the UCSD SOBQ (60% vs 2%). Compared with respiratory training, diaphragmatic stretching therefore improved pulmonary function, exercise tolerance, and asthma-related symptoms more. Because allocation was not randomized and the groups differed at baseline, confirmation in randomized controlled trials is needed.