Breathing exercises for asthma

a randomised controlled trial

M. Thomas*, R. K. McKinley, S. Mellor, G. Watkin, E. Holloway, J. Scullion, D. E. Shaw, A. Wardlaw, D. Price, I. Pavord

*Corresponding author for this work

Research output: Contribution to journalArticle

85 Citations (Scopus)

Abstract

Background: The effect of breathing modification techniques on asthma symptoms and objective disease control is uncertain. Methods: A prospective, parallel group, single-blind, randomised controlled trial comparing breathing training with asthma education (to control for non-specific effects of clinician attention) was performed. Subjects with asthma with impaired health status managed in primary care were randomised to receive three sessions of either physiotherapist-supervised breathing training (n = 94) or asthma nurse-delivered asthma education (n = 89). The main outcome was Asthma Quality of Life Questionnaire (AQLQ) score, with secondary outcomes including spirometry, bronchial hyper-responsiveness, exhaled nitric oxide, induced sputum eosinophil count and Asthma Control Questionnaire (ACQ), Hospital Anxiety and Depression (HAD) and hyperventilation (Nijmegen) questionnaire scores. Results: One month after the intervention there were similar improvements in AQLQ scores from baseline in both groups but at 6 months there was a significant between-group difference favouring breathing training (0.38 units, 95% CI 0.08 to 0.68). At the 6-month assessment there were significant between-group differences favouring breathing training in HAD anxiety (1.1, 95% CI 0.2 to 1.9), HAD depression (0.8, 95% CI 0.1 to 1.4) and Nijmegen (3.2, 95% CI 1.0 to 5.4) scores, with trends to improved ACQ (0.2, 95% CI 0.0 to 0.4). No significant between-group differences were seen at 1 month. Breathing training was not associated with significant changes in airways physiology, inflammation or hyper-responsiveness. Conclusion: Breathing training resulted in improvements in asthma-specific health status and other patient-centred measures but not in asthma pathophysiology. Such exercises may help patients whose quality of life is impaired by asthma, but they are unlikely to reduce the need for anti-inflammatory medication.

Original languageEnglish
Pages (from-to)55-61
Number of pages7
JournalThorax
Volume64
Issue number1
DOIs
Publication statusPublished - 1 Jan 2009

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Breathing Exercises
Asthma
Randomized Controlled Trials
Respiration
Anxiety
Depression
Quality of Life
Health Status
Education
Hyperventilation
Physical Therapists
Spirometry
Sputum
Eosinophils

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Thomas, M., McKinley, R. K., Mellor, S., Watkin, G., Holloway, E., Scullion, J., ... Pavord, I. (2009). Breathing exercises for asthma: a randomised controlled trial. Thorax, 64(1), 55-61. https://doi.org/10.1136/thx.2008.100867

Breathing exercises for asthma : a randomised controlled trial. / Thomas, M.; McKinley, R. K.; Mellor, S.; Watkin, G.; Holloway, E.; Scullion, J.; Shaw, D. E.; Wardlaw, A.; Price, D.; Pavord, I.

In: Thorax, Vol. 64, No. 1, 01.01.2009, p. 55-61.

Research output: Contribution to journalArticle

Thomas, M, McKinley, RK, Mellor, S, Watkin, G, Holloway, E, Scullion, J, Shaw, DE, Wardlaw, A, Price, D & Pavord, I 2009, 'Breathing exercises for asthma: a randomised controlled trial', Thorax, vol. 64, no. 1, pp. 55-61. https://doi.org/10.1136/thx.2008.100867
Thomas M, McKinley RK, Mellor S, Watkin G, Holloway E, Scullion J et al. Breathing exercises for asthma: a randomised controlled trial. Thorax. 2009 Jan 1;64(1):55-61. https://doi.org/10.1136/thx.2008.100867
Thomas, M. ; McKinley, R. K. ; Mellor, S. ; Watkin, G. ; Holloway, E. ; Scullion, J. ; Shaw, D. E. ; Wardlaw, A. ; Price, D. ; Pavord, I. / Breathing exercises for asthma : a randomised controlled trial. In: Thorax. 2009 ; Vol. 64, No. 1. pp. 55-61.
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abstract = "Background: The effect of breathing modification techniques on asthma symptoms and objective disease control is uncertain. Methods: A prospective, parallel group, single-blind, randomised controlled trial comparing breathing training with asthma education (to control for non-specific effects of clinician attention) was performed. Subjects with asthma with impaired health status managed in primary care were randomised to receive three sessions of either physiotherapist-supervised breathing training (n = 94) or asthma nurse-delivered asthma education (n = 89). The main outcome was Asthma Quality of Life Questionnaire (AQLQ) score, with secondary outcomes including spirometry, bronchial hyper-responsiveness, exhaled nitric oxide, induced sputum eosinophil count and Asthma Control Questionnaire (ACQ), Hospital Anxiety and Depression (HAD) and hyperventilation (Nijmegen) questionnaire scores. Results: One month after the intervention there were similar improvements in AQLQ scores from baseline in both groups but at 6 months there was a significant between-group difference favouring breathing training (0.38 units, 95{\%} CI 0.08 to 0.68). At the 6-month assessment there were significant between-group differences favouring breathing training in HAD anxiety (1.1, 95{\%} CI 0.2 to 1.9), HAD depression (0.8, 95{\%} CI 0.1 to 1.4) and Nijmegen (3.2, 95{\%} CI 1.0 to 5.4) scores, with trends to improved ACQ (0.2, 95{\%} CI 0.0 to 0.4). No significant between-group differences were seen at 1 month. Breathing training was not associated with significant changes in airways physiology, inflammation or hyper-responsiveness. Conclusion: Breathing training resulted in improvements in asthma-specific health status and other patient-centred measures but not in asthma pathophysiology. Such exercises may help patients whose quality of life is impaired by asthma, but they are unlikely to reduce the need for anti-inflammatory medication.",
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