Background

Asthma is a lung disease. Asthma works in two ways. It that causes the airways to become inflamed (the body's response to injury and infection) and it causes the small tubes of the airways to tighten (called airway obstruction). The tightening of the tubes can happen in response to asthma triggers, such as animal fur or feathers, dust or pollen.

Asthma is very common worldwide and is a major public health problem due to the high healthcare costs associated with hospitalisation and medication. Breathing exercises have been used to treat people with asthma as a way of controlling the symptoms of asthma without medication. People use various breathing techniques to change their breathing pattern.

Review question

We wanted to find out how effective breathing exercises are for adults with asthma. We were most interested to know if breathing exercises improved people's quality of life (our primary outcome), and also if they helped improve asthma symptoms, hyperventilation (over-breathing), and lung function (our secondary outcomes).

Key results

We searched for randomised controlled trials. This means people were selected at random to try either breathing exercises or a control. We included education about asthma or usual asthma care as the controls.

We found 22 studies involving 2880 adults with mild to moderate asthma. The studies used different breathing exercises. Fourteen studies used yoga, four studies used breathing retraining, one study used Buteyko method, one study used Buteyko method and pranayama, one study used Papworth method and one study used deep diaphragmatic breathing. Twenty studies compared breathing exercises with normal asthma care and two compared breathing exercises with asthma education. Studies assessed quality of life, asthma symptoms and hyperventilation symptoms, number of acute exacerbations (flare-ups), lung function (breathing tests), and general practitioner (GP) appointments.

Several studies looked at our primary outcome, quality of life. The results showed an improvement in quality of life after three months in the breathing-exercises group. We found that breathing exercises probably did not help to improve asthma symptoms. However, breathing exercises did improve hyperventilation symptoms, when measured from four months after starting the exercises to six months. One lung function test, percentage of predicted FEV1 (the amount of air you can force from your lungs in one second) showed some improvement in the people who did breathing exercises.

Certainty of the evidence

We are moderately certain about the benefits of breathing exercises. However, we found some differences between the studies 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.

Conclusion

Breathing exercises may have positive effects on quality of life, hyperventilation symptoms, and lung function in adults with mild to moderate asthma. Therefore, you can choose to use a breathing exerciser such as OPUMP to help you carry out standardized and effective breathing exercises.