The Role of Breathing Training in Asthma Management

Anne Bruton; Mike Thomas


Curr Opin Allergy Clin Immunol. 2011;11(1):53-57. 

In This Article

Abstract and Introduction


Purpose of review There is considerable public interest in the use of breathing modification techniques in the treatment of asthma. Surveys suggest many people with asthma use them, often without the knowledge of their medical attendants. Extravagant claims have been made about the effectiveness of some techniques, resulting in scepticism from orthodox clinicians. The evidence supporting breathing training for asthma was previously weak, and limited by the small size and methodological limitations of published research.
Recent findings The evidence base for the effectiveness of breathing training has recently improved, with reports from several larger and more methodologically robust controlled trials. These trials are reviewed in this study, and the findings placed in context. Trials have investigated a variety of breathing training programmes delivered by different therapists in different ways. All incorporate some instruction in breathing pattern, usually focusing on slow, regular, nasal, abdominal breathing and reduced ventilation, with patients instructed to practise exercises at home and when symptomatic.
Summary Current evidence suggests that breathing training programmes can be effective in improving patient-reported outcomes such as symptoms, quality of life and psychological impact; and may reduce the use of rescue bronchodilator medication. There is little evidence that airways physiology, hyper-responsiveness or inflammation is affected by such training. The optimal way of providing breathing training within the context of routine asthma care is still uncertain.


Although pharmacotherapy for asthma is effective and can provide control for many patients,[1] surveys repeatedly show that outcomes remain sub-optimal. A recent European survey[2•] showed that less than half of adults with asthma achieved good symptom control. Many patients have concerns about taking regular medication, particularly inhaled corticosteroids. Surveys of complementary and alternative medicine in asthma show high level of use, with up to 79% of adults and 78% of children reporting trying various treatments including breathing modification.[3•] Breathing techniques are amongst the most commonly used complementary techniques, with up to 30% of asthma patients reporting having used them to control their symptoms.[4] There are many breathing techniques available for use in asthma, including inspiratory muscle training and pursed-lip breathing, as well as breathing retraining regimens. In this review the focus is on breathing retraining regimens.


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