Much emphasis is placed upon environmental factors in asthma prevention and treatment, but the profound role of breathing is not sufficiently acknowledged as a therapeutic option. Recent trials of breathing techniques, posture, relaxation and stress reduction confirm their importance in treating asthma and lung diseases.
In a study done in the Netherlands (Cambach et al 1997), researchers compared two 3-month treatment programmes for people with asthma and chronic obstructive pulmonary disease. Baseline measurements were made of their exercise tolerance and quality of life. Patients were randomly assigned to one of the two treatment programme and then after 3 months, crossed over to the other programme. The first programme was only the standard drug treatment.
The second included intensive training by community physiotherapists in exercise, patient education, breathing retraining, mucus evacuation, relaxation techniques and recreational activities as well as drug treatment. After 3 months and after 6 months, the patients in the training programme had significantly improved both their exercise tolerance and their quality of life compared to patients who only had drug treatment. This trial shows the value of a rehabilitation programme which includes breathing and exercise training for people with asthma and chronic obstructive pulmonary disease.
The effectiveness of training in a particular breathing pattern was evaluated by French researchers. They confirmed that there are benefits of the breathing pattern training for patients with chronic obstructive pulmonary disease and for children with asthma. In the study of patients with pulmonary disease, 20 patients were randomly assigned to either a breathing pattern training group or to a control group (Esteve et al 1996). The ones selected for training had more than 30 training sessions over a period of a month where they were taught to adjust each breath to a target breath using visual feedback on a video screen. Improvements were measured by two tests of lung function — the FEV1 (the forced expiratory volume in the first second) and by the FVC (the forced vital capacity). Those who had the breathing pattern training improved both their FEV1 and their FVC by about a fifth. This was a significant improvement compared to the controls but needs further research to see how long the benefit lasts.
In another experiment, 15 asthmatic and 15 healthy children were trained to adjust their breathing pattern to a target pattern displayed on a video screen. The error scores between the two groups were not significantly different. This data showed that voluntary control of respiratory muscles is not impaired in people with asthma and their breathing can be refrained (Blanc-Gras et al 1996).
Breathing techniques are an integral part of yoga and were studied in a small clinical trial in India (Khanam et al 1996). Nine patients with bronchial asthma were sent on a week-long yoga camp. Their autonomic and pulmonary functions were tested both before and after. Certain tests of pulmonary function improved significantly although the FEV1 and FVC did not change. Of the tests measuring the functioning of the autonomic nervous system, there was a significant drop in resting heart rate and sympathetic reactivity caused by relaxation of the voluntary muscles involved in breathing. The results showed clearly that the patients benefited significantly from short term yoga training.
The claim that asthma is caused by over-breathing or hyperventilation is put forward by the Russian scientist, Dr Konstantin Buteyko. Buteyko recommends a course of exercises to main breathing patterns, eliminating the need for drug treatment and resulting in a cure for asthma. He claims that health problems such as asthma, eczema, headaches, allergy, panic attacks and hayfever can result from the body trying to compensate for the lack of carbon dioxide cause by overbreathing. Carbon dioxide is needed to help oxygen get to the cells where it is needed for the proper functioning of every organ and system in the body. When properly trained in the Buteyko technique, people with asthma can prevent an attack from occurring and if followed diligently, can cure their asthma. The book by Alexander Stalmatski explains the theory and practice of this method and includes a list of references to scientific studies about the importance of breathing (Stalmatski 1997).
These studies are part of the body of evidence confirming the role of breathing training in asthma and lung diseases.
Blanc-Gras N et al. Voluntary control of breathing pattern in asthmatic children. Percept Mot Skills 83 (3 Pt 2): 1384-6. Dec 1996.
Cambach W et al, I. Eur Respir J 10(1):104-13. Jan 1997.
Esteve F et al. The effects of breathing pattern training on ventilatory function in patients with COPD. Biofeedback Self Regul 21 (4):311-21. Dec 1996.
Khanam AA et al. Study of pulmonary and autonomic functions of asthma patients after yoga training. Indian J Physiol Pharmacol 40(4):318-24. Oct 1996
Stalmatski, A, Freedom from Asthma – Buteyko’s revolutionary treatment, Kyle Cathie Ltd, London, 1997.