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Breathing exercises for asthma: a randomised controlled trial

Breathing exercises for asthma: a randomised controlled trial
Breathing exercises for asthma: a randomised controlled trial
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.
0040-6376
55-61
Thomas, M
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McKinley, R.K.
66276122-95eb-4988-a563-8618d6a23b97
Mellor, S.
25b1b997-a942-443b-b958-11e155616d28
Watkinson, G.
ed2937d4-9dbc-4f69-9f1e-7f87c683b097
Holloway, E.
34cb7f46-e319-4510-9468-e2ed445b4b70
Scullion, J.
9deb16c8-aea6-4cff-a712-61b6b8bf3963
Shaw, D.E.
2e6f56af-d391-4af8-8fa3-b0fa8f15c8cc
Wardlaw, A.
93172652-b49a-4c85-b826-a703d523bc33
Price, D.
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Pavord, I.
6a96cdc5-1713-4e2a-925f-7caf6134c717
Thomas, M
997c78e0-3849-4ce8-b1bc-86ebbdee3953
McKinley, R.K.
66276122-95eb-4988-a563-8618d6a23b97
Mellor, S.
25b1b997-a942-443b-b958-11e155616d28
Watkinson, G.
ed2937d4-9dbc-4f69-9f1e-7f87c683b097
Holloway, E.
34cb7f46-e319-4510-9468-e2ed445b4b70
Scullion, J.
9deb16c8-aea6-4cff-a712-61b6b8bf3963
Shaw, D.E.
2e6f56af-d391-4af8-8fa3-b0fa8f15c8cc
Wardlaw, A.
93172652-b49a-4c85-b826-a703d523bc33
Price, D.
7534eb51-9b20-4840-9604-f34a428c855c
Pavord, I.
6a96cdc5-1713-4e2a-925f-7caf6134c717

Thomas, M, McKinley, R.K., Mellor, S., Watkinson, G., Holloway, E., Scullion, J., Shaw, D.E., Wardlaw, A., Price, D. and Pavord, I. (2009) Breathing exercises for asthma: a randomised controlled trial. Thorax, 64, 55-61. (doi:10.1136/thx.2008.100867). (PMID:19052047)

Record type: Article

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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More information

e-pub ahead of print date: 3 December 2008
Published date: January 2009
Organisations: Primary Care & Population Sciences

Identifiers

Local EPrints ID: 337232
URI: http://eprints.soton.ac.uk/id/eprint/337232
ISSN: 0040-6376
PURE UUID: f3a936a5-c768-459e-9a18-c89c85293195

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Date deposited: 20 Apr 2012 08:43
Last modified: 14 Mar 2024 10:51

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Contributors

Author: M Thomas
Author: R.K. McKinley
Author: S. Mellor
Author: G. Watkinson
Author: E. Holloway
Author: J. Scullion
Author: D.E. Shaw
Author: A. Wardlaw
Author: D. Price
Author: I. Pavord

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