Asthma is a lung disease, that comprises underlying inflammation and tightening of the small tubes in the airways (called airway obstruction), which occurs in response to asthma triggers such as animal danders or pollen (also called bronchial hyperresponsiveness). The high prevalence of asthma worldwide is a major public health problem because of the high healthcare costs associated with hospitalisation and medication. Breathing exercises are a non-pharmacological intervention that has been used routinely in the treatment of patients with asthma. Breathing exercises aim to control the hyperventilation symptoms of asthma and can be performed as the Papworth Method, the Buteyko breathing technique, yoga or any other similar intervention that manipulates the breathing pattern.
We wanted to look at available evidence for the effectiveness of breathing exercises in adults with asthma.
We found 13 studies involving 906 adults with mild to moderate asthma. Eleven studies compared breathing exercises with inactive controls and two with asthma education control groups. Overall, improvements in quality of life, asthma symptoms and numbers of exacerbations were reported. Six of the eleven studies that assessed lung function showed a significant difference favouring breathing exercises. No adverse effects related to the intervention were described, which indicates that this is a safe and well-tolerated intervention in people with asthma.
Quality of the evidence
The trials were different in terms of type of breathing exercises performed, number of participants enrolled, number and duration of sessions completed, outcomes reported and statistical presentation of data. As a result, we were not able to compare the results from these trials using a meta-analysis for all outcomes. Meta-analysis was possible for only two outcomes (asthma symptoms and change in Asthma Quality of Life Questionnaire—AQLQ), each of which was reported in only two studies. Both meta-analyses showed a significant difference favouring breathing exercises. The methods used to conduct these studies were not as well reported as we would have liked, and so the quality of the trials was unclear. Overall the quality of the evidence included in the review was very low.
Even though individual trials reported positive effects of breathing exercises, no conclusive evidence in this review supports or refutes the efficacy of such intervention in the treatment of adult patients with asthma.