Buteyko Clinical Trials 1998-2017

Clinical Trials Investigating the Buteyko Method for Asthma

There are currently nineteen clinical trials investigating the Buteyko Method as an adjunct for asthma, including six studies in collaboration with Buteyko Clinic Instructor and Director of Education at Buteyko Clinic, Patrick McKeown.

Trials investigating the Buteyko Method showed positive results including improved asthma control, improvements to lung function and reduced need for asthma medication.

Comments from the papers include:
“If a drug could show these results, then it is likely that it would be used widely in asthma control” (Hassan et al, 2012)

“This study demonstrated that the BBT (Buteyko Breathing Technique) can effectively improve the total serum IgE, the ventilatory function in terms of FVC, FEV 1, PEF, FEF 25–75% and FEV 1/FVC, and C-ACT scores in children with bronchial asthma.” (Elnaggara, 2016)

In conclusion, we found that those practising the Buteyko breathing technique (BBT) reduced hyperventilation and their use of beta2-agonists. A trend toward reduced inhaled steroid use and better quality of life was observed in these patients without changes in objective measures of airway calibre.” (Bowler et al, 1998)ss BTS asthma guidelines.

SUMMARY OF TRIALS:

1. BUTEYKO METHOD FOR CHILDREN WITH ASTHMA: A RANDOMIZED CONTROLLED TRIAL

Rationale: Asthma is the most chronic disease among children and became a public health problem due to its high cost in healthcare. The Buteyko Method is a low-cost and non-pharmacological intervention that has been used in the treatment of patients with asthma.

Conclusion: Data from the present showed that the Buteyko Method was effective to improve some lung function and symptoms parameters. Both Buteyko Method and asthma education improved quality of life in the children assessed.

Karla M.P.P. Mendonca, Diana A. Freitas, Thalita M.F. Macedo, Ada C.J.S. Silva, Cleia T. Amaral, Thayla A. Santino, Patrick McKeown. American Journal of Respiratory and Critical Care Medicine 2017;195:A2203

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2. BUTEYKO METHOD FOR CHILDREN WITH ASTHMA AND MOUTH BREATHING: A RANDOMIZED CONTROLLED TRIAL

Rationale: Asthma is one of the most common chronic diseases in childhood with significant morbidity and mortality. Mouth breathing is a breathing disorder with a high prevalence in children. Several non-pharmacological therapies have been widely used in the search for alternative therapies in the treatment of asthma, such as the Buteyko Method. The aim of this study was to evaluate the effects of the Buteyko Method as a complimentary therapy in the treatment of children with asthma and mouth breathing.

Conclusion: The Buteyko Method improved the sleep disorders scores, lung function, and reduced the number of school absences in children with asthma and mouth breathing.

Karla M.P.P. Mendonca , Thalita M.F. Macedo , Diana A. Freitas , Ada C.J.S. Silva , Cleia T. Amaral , Thayla A. Santino , Patrick McKeown. American Journal of Respiratory and Critical Care Medicine 2017;195:A2204

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3. EFFECTIVENESS OF BUTEYKO BREATHING TECHNIQUE ON RESPIRATORY PHYSIOLOGICAL PARAMETERS AMONG PATIENTS WITH BRONCHIAL ASTHMA

Buteyko Breathing Technique was found to be significantly effective in improving the respiratory physiological parameters among patients with bronchial asthma.

Huidrom K. et al, 2016, Effectiveness of Buteyko breathing technique on respiratory physiological parameters among patients with bronchial asthma, International Journal of Recent Scientific Research, Vol. 7, Issue 5, pp. 11328-11331.

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4. EFFICACY OF NON-INVASIVE RESPIRATORY TECHNIQUES IN THE TREATMENT OF CHILDREN WITH BRONCHIAL ASTHMA: A RANDOMIZED CONTROLLED TRIAL. RAGAB K ELNAGGAR, MOHAMMED A SHENDY. BULLETIN OF FACULTY OF PHYSICAL THERAPY. YEAR: 2016, VOLUME: 21, ISSUE: 1, PAGE: 1-10.

This study demonstrated that the Buteyko Breathing Technique and the TLPT can effectively improve the total serum IgE, the ventilatory function in terms of FVC, FEV 1, PEF, FEF 25–75% and FEV 1/FVC, and C-ACT scores in children with bronchial asthma. However, Buteyko breathing was more significantly effective compared with the TLPT.

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5. TO COMPARE THE EFFICACY OF PURSED LIP BREATHING AND BUTEYKO BREATHING TECHNIQUE TO REDUCE THE SYMPTOMS OF EXERCISE INDUCED ASTHMA IN OBESE CHILDREN

The subjects were treated with pursed lip breathing and Buteyko breathing technique along with relaxation technique and chest mobility exercise using bilateral upper limb patterns of PNF for duration on 1 week. Both the group were found to be effective in reducing the symptoms of EIA. We found clinical significance in both the groups But clinically subjects with Buteyko breathing technique showed more improvement than subjects with pursed lip breathing technique.

Chavda MV and Shah HM. (2016) To compare the efficacy of pursed lip breathing and Buteyko breathing technique to reduce the symptoms of exercise induced asthma in obese children, International Journal of Current Research, Vol. 8, Issue 07, pp. 35058-35064.

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6. EFFECT OF BUTEYKO BREATHING EXERCISE IN NEWLY DIAGNOSED ASTHMATIC PATIENTS. PRASANNA K, SOWMIYA K, DHILEEBAN C. INT J MED PUBLIC HEALTH 2015;5:77–81

The results of this study support the effectiveness of Buteyko breathing exercise over the standard treatment in the newly diagnosed asthmatic patients. There was a statistically significant improvement of daily Asthma Control and PEFR in the group who did Buteyko breathing exercise for 2 months over the control group. With an intervention that is safe, equally efficacious and cheap, it is possible to use this Buteyko breathing technique as a primary treatment method in the management of asthmatic patients at the primary health care level itself.

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7. TO STUDY THE EFFECTIVENESS OF BUTEYKO BREATHING TECHNIQUE VERSUS DIAPHRAGMATIC BREATHING IN ASTHMATICS, GAURI MAYANK AFLE, SUMEETA KHAUND GROVER, INT J PHYSIOTHER. VOL 1(3), 116-119, AUGUST (2014)

Background: Asthma is one of the most common chronic diseases in the world. It is estimated that around 300 million people in the world currently have asthma. In asthmatics dysfunctional breathing pattern is common. Breathing pattern is the basis of abnormal patterns in asthma. The purpose of this study was to find out the effectiveness of Buteyko breathing technique versus diaphragmatic breathing in asthmatics.

Conclusion: The Buteyko breathing technique proves to be more effective than diaphragmatic breathing technique in asthmatics.

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8. ROLE OF BUTEYKO BREATHING TECHNIQUE IN ASTHMATICS WITH NASAL SYMPTOMS

In collaboration with the University of Limerick, Patrick McKeown was the instructor in a clinical study investigating the Buteyko Method as a treatment for rhinitis in asthma. Results showed a 70% reduction of nasal symptoms in participants, including snoring, loss of smell, nasal congestion and difficulty breathing through the nose.

Adelola OA. et al. 2013, Role of Buteyko Breathing Technique in asthmatics with nasal symptoms, Clinical Otolaryngology April; 38(2):190-19

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9. COMPARISON OF THE EFFECTS OF BUTEYKO AND PRANAYAMA BREATHING TECHNIQUES ON QUALITY OF LIFE IN PATIENTS WITH ASTHMA – A RANDOMIZED CONTROLLED PREM V1, SAHOO RC, ADHIKARI P. TRIAL. CLIN REHABIL. 2013 FEB;27(2):133-41.

The baseline characteristics were similar in all three groups. Post intervention, the Buteyko group showed better trends of improvement (mean (95% confidence interval), P-value) in total Asthma Quality of Life Questionnaire score than the pranayama (0.47 (-0.008-0.95), P = 0.056) and control groups (0.97 (0.48-1.46), P = 0.0001). In comparison between the pranayama and control groups, pranayama showed significant improvement (0.50 (0.01-0.98), P = 0.042) in total Asthma Quality of Life Questionnaire score. The Buteyko group showed better trends of improvement in quality of life and asthma control than the group performing the pranayama breathing exercise.

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10. EFFECT OF BUTEYKO BREATHING TECHNIQUE ON PATIENTS WITH BRONCHIAL ASTHMA. DEPARTMENT OF PHYSICAL THERAPY, CAIRO UNIVERSITY, EGYPT. CHEST DEPARTMENT, FACULTY OF MEDICINE, AIN SHAMS UNIVERSITY, EGYPT. FACULTY OF PHYSICAL THERAPY, CAIRO UNIVERSITY, EGYPT. HASSAN Z, RIAD N, AHMED F. AVAILABLE ONLINE 31 JANUARY 2013

Taken from the paper: ‘Even though no study has indicated exactly why Buteyko is so effective at controlling asthma, if a drug could show these results, then it is likely that it would be used widely in asthma control. In the present study, the result of Buteyko breathing technique showed a decrease in asthma daily symptoms with 52% and 0.8% in group (A) and (B), respectively. The results of this study support the good effect of Buteyko Breathing Technique on patients with bronchial asthma. It significantly decrease the recurrence and the severity of the main bronchial asthma symptoms (nocturnal waking, morning symptoms activity limitation, shortness of breath, wheezing, PEFR% predicted, and Inhaled Corticosteroids). And it significantly increase PEFR. Buteyko Breathing Therapy will improve patients function level and the capacity for independent living by decreasing the severity of asthma symptoms and recurrence of asthma attacks.’

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11. SYSTEMATIC REVIEW OF THE EFFECTIVENESS OF BREATHING RETRAINING IN ASTHMA MANAGEMENT. EXPERT REVIEW RESPIRATORY MEDICINE.2011;5(6)BURGESS J, EKANAYAKE B, LOWE A, DUNT D, THIEN F C DHARMAGE S.

Discussion
The BBT has been the most widely publicized among the CAM techniques used in asthma management. Individual studies using BBT consistently demonstrated a reduction in asthma medication use, and together with respiratory physiotherapy studies, often showed an improvement in AQOL and the subjective experience of asthma symptoms. However, there was no significant improvement in lung function in any of the BBT studies to account for the positive results. This was supported by the results of meta-analyses, which failed to show an effect of these techniques using pooled estimates. While it is possible that the deep inspiration required for lung function testing might induce bronchoconstriction [56] and override any beneficial effect from BBT, it is also possible that the studies were inadequately powered to detect changes in lung function parameters. Larger studies might reveal an effect. A meta-analysis of the studies that explored the postulated underlying mechanism proposed in BBT showed a significant increase in end-tidal CO2 in the active intervention arm.

Critics of BBT argue that medication reduction could be due to the therapist’s influence and it is difficult to evaluate that possibility. On the other hand, there was no evidence of a detrimental effect on asthma control with reduction in medication usage and to some extent, there might have been an improvement in symptoms. Longer follow-up is needed to show that improvement in asthma control as measured by medication usage is sustained for a duration that is clinically meaningful, and that BBT has no adverse effects. Despite the lack of evidence for physiological change to account for the observed benefits, a decrease in medication use could be useful considering the possible systemic effects of ICS use [57,58].

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12. BUTEYKO BREATHING TECHNIQUE REDUCES HYPERVENTILATION INDUCED HYPOCAPNOEA AND DYSPNOEA AFTER EXERCISE IN ASTHMA. 2009. AUSTIN G, BROWN C, WATSON T, CHAKRAVORTY I, PULMONARY REHABILITATION. PHYSIOTHERAPY SCHOOL, U HERTFORDSHIRE, HATFIELD, HERTS, UNITED KINGDOM.

“Our study demonstrated the hypothesised physiology of BBT, improving hyperventilation induced hypocapnoea and breathlessness, following maximal exercise. By teaching patients to reduce hypernoea of breathing (the rate &depth), BBT may reduce asthma symptoms and improve exercise tolerance and control.”

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13. A RANDOMIZED CONTROLLED TRIAL OF THE BUTEYKO TECHNIQUE AS AN ADJUNCT TO CONVENTIONAL MANAGEMENT OF ASTHMA. RESPIRATORY JOURNAL; 2008 MAY;102(5):726-32. UNIVERSITY OF CALGARY, CANADA. (COWIE RL, ET AL)

At six month follow up the Buteyko group had:

  • Improved asthma control from 40% to 75%
  • 39% of patients decreased inhaled corticosteroids
  • 21% eliminated inhaled corticosteroids

“I’ve been astonished and also very pleased with the excellent result. There is no disruption of their life at all by their disease: normal activities; not waking at night; not needing to use any reliever medications. It’s just great…75% control is about as good as anyone has got in any study of asthma. The neat thing about it is that it has no side effects. It’s very safe. The Buteyko technique certainly has been shown to be an important adjunct to treatment.”

Dr. Robert Cowie, Resident Respirologist of Foothills Hospital in Calgary and head researcher on the Buteyko Breathing Technique Medical Trial. (October 2004 April 2005)

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14. DOUBLE BLIND RANDOMISED CONTROLLED TRIAL OF TWO DIFFERENT BREATHING TECHNIQUES IN THE MANAGEMENT OF ASTHMA THORAX. 2006 AUG;61(8):651-656 (SLADER ET AL, 2006)

At week 28; Buteyko Method Group achieved:

  • Reliever medication decreased by 86%
  • Inhaled Corticosteroids decreased by 50%

15. THE NEW ZEALAND MEDICAL JOURNAL. 2006 MAY 19; 119(1234)
BUTEYKO BREATHING TECHNIQUE AND ASTHMA IN CHILDREN: A CASE SERIES (MCHUGH ET AL, 2006)

At 3 months; Buteyko Group achieved:

  • Reliever medication decreased by 66%
  • Inhaled Corticosteroids decreased by 41%

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16. EFFECT OF TWO BREATHING EXERCISES (BUTEYKO AND PRANAYAMA) IN ASTHMA: A RANDOMISED CONTROLLED TRIAL

The Buteyko breathing technique can improve symptoms and reduce bronchodilator use but does not appear to change bronchial responsiveness or lung function in patients with asthma.

Cooper S. et al (2003) Effect of Two Breathing Exercises (Buteyko and Pranayama) in asthma: A Randomised Controlled Trial. Thorax, Vol. 58, No. 8, pp. 649-659.

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17. THE NEW ZEALAND MEDICAL JOURNAL, 2003 DEC 12;116(1187)

Buteyko Breathing Technique (BBT) for asthma: an effective intervention (McHugh et al, 2003)

At 6 months; Buteyko Group achieved:

  • Reliever medication decreased by 85%
  • Inhaled Corticosteroids decreased by 50%

“Conclusions: BBT is a safe and efficacious asthma management technique. BBT has clinical and potential pharmaco-economic benefits that merit further study”

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18. JOURNAL ASTHMA 2000;37(7):557-64.

A clinical trial of the Buteyko Breathing Technique in asthma as taught by a video. Opat Aj, Cohen MM, Bailey Mj, Abramson Mj.

“Our results demonstrated a significant improvement in quality of life among those assigned to the BBT compared with placebo (p= 0.043), as well as a significant reduction in inhaled bronchodila- tor intake (p = 0.008).”

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19. MEDICAL JOURNAL AUSTRALIA 1998 DEC 7-21; 169 (11-12)575-578

Buteyko breathing techniques in asthma: a blinded randomized controlled trial.
Simon D Bowler, Amanda Green and Charles A Mitchell

At 3 months; Buteyko Group achieved:

  • Reliever medication decreased by 90%
  • Inhaled Corticosteroids decreased by 49%

The above study found that when the breathing volume of asthmatics decreased from 14 litres to 9.6 litres per minute, their symptoms reduced by 70%, the need for rescue medication decreased by 90%, and the need for preventer steroid medication decreased by 49%.

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