This study aimed to compare 2 protocols recommended to patients with chronic cervical cord injury: each protocol included breathing exercises (inhalation-oriented or exhalation-oriented) and facilitation maneuver for the accessory respiratory muscles. Seventeen patients with chronic cervical cord injury volunteered to participate in this study, and we randomized these patients into 2 groups: the inhalation-oriented breathing exercise group (IOBEG) and exhalation-oriented breathing exercise group (EOBEG), consisting of 8 and 9 patients, respectively. Patients in the IOBEG performed inspiratory exercises using intermittent positive pressure breathing devices, while those in the EOBEG performed expiratory exercises using incentive spirometry. All exercises were performed by the subjects twice a day for 4 weeks, with each session lasting an average of 20 min. The outcomes were assessed on the basis of the pre- and post-treatment values of vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and FEV1/FVC. In the IOBEG, no significant differences were observed between the pre- and post-treatment values of any of the measured variables (p>.05); however, in the EOBEG, significant improvement was noted in the VC, FVC, FEV1 measured (p<.05) after the treatment. In addition, the rates of change in the values of VC, FVC, and FEV1 differed significantly between the 2 groups (p<.05). These findings suggest that the EOBEs can enhance respiratory function and are clinically feasible in patients with chronic cervical cord injury. Further studies will be undertaken to evaluate the clinical application of these findings.