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Breathing exercises for asthma

Mike Thomas, Anne Bruton
Breathe 2014 10: 312-322; DOI: 10.1183/20734735.008414
Mike Thomas
1Primary Care and Population Sciences, Faculty of Medicine, University of Southampton, UK
3Southampton NIHR Respiratory Biomedical Research Unit, Southampton, UK
4Wessex NIHR CLAHRC, Southampton, UK
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  • For correspondence: D.M.Thomas@soton.ac.uk
Anne Bruton
2Faculty of Health Sciences, University of Southampton, UK
3Southampton NIHR Respiratory Biomedical Research Unit, Southampton, UK
4Wessex NIHR CLAHRC, Southampton, UK
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Abstract

Educational aims

  • To summarise the evidence of the role of breathing control approaches in the management of asthma

  • To provide information on the content of evidence-based breathing exercises programmes

Summary Asthma is a complex, multi-dimensional condition that affects patients in many ways. Having asthma is inherently stressful and psychological problems are common and associated with poor asthma outcomes. Although most patients in clinical trials can achieve high levels of control with optimised pharmacotherapy, in “real-life” practice, poor control is common, with over-reliance on rescue bronchodilator medication and ongoing symptoms and quality-of-life impairment. Many patients are interested in non-pharmacological treatments to improve asthma control, particularly breathing control exercises but, until recently, the evidence base has been inadequate. The place of breathing exercises has been controversial, partly because some proponents have made exaggerated, implausible claims of effectiveness. Recent evidence, however, has resulted in endorsement of breathing exercises as add-on treatment in asthma in systematic reviews and guidelines.

This review summarises the current evidence of effectiveness of breathing exercises programmes as an adjuvant treatment to pharmacological strategies for people with asthma. The types of breathing training programmes used and the content of effective programmes are discussed. We conclude that patients whose asthma continues to cause symptoms and quality-of-life impairment, despite adequate pharmacological treatment, or who have high bronchodilator use, should be offered access to an effective breathing training programme as a part of holistic, integrated asthma care.

Key points

  • Asthma is frequently poorly controlled despite effective modern medication

  • Psychological factors can be as important as physiological ones in affecting symptom perception and disease impact

  • Breathing exercises can improve patient-reported outcomes and psychological state

  • Breathing exercises should be offered to all asthma patients with symptoms or impaired quality of life despite standard treatment

Footnotes

  • Statement of Interest

    None declared.

  • ©ERS 2014

Breathe articles are open access and distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0.

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Breathing exercises for asthma
Mike Thomas, Anne Bruton
Breathe Dec 2014, 10 (4) 312-322; DOI: 10.1183/20734735.008414

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Breathing exercises for asthma
Mike Thomas, Anne Bruton
Breathe Dec 2014, 10 (4) 312-322; DOI: 10.1183/20734735.008414
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Jump To

  • Article
    • Abstract
    • Introduction: the need for innovations in asthma management strategies
    • Asthma outcomes and the “whole patient”: beyond the pharmacological
    • Breathing exercises for asthma
    • Breathing retraining
    • Evidence for breathing exercises in asthma
    • Targeting: who benefits from breathing training?
    • Integrating breathing exercises into routine care
    • Conclusion
    • Footnotes
    • References
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  • PDF

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