Clinical trial NCT04310696: Comparison of Buteyko Technique and Pursed Lip Breathing in Asthma
Official title: Comparison of Buteyko Breathing Technique and Pursed Lip Breathing to Improve Pulmonary Function in Asthma
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Asthma
Keywords: Asthma
Buteyko
Pursed lip breathing
Spirometer
Lead sponsor: Riphah International University
Sponsor class: OTHER
First posted: 2020-03-17
Enrollment: 60
Sex: ALL
Minimum age (years): 18
Maximum age (years): 40
Standard ages: ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The objective of the study was to compare the effects of Buteyko breathing technique and pursed lip breathing technique in the management of asthma. A randomized controlled trial was conducted on 60 asthmatic patients randomly allocated to Buteyko technique group and pursed lip breathing group. Both the groups received 4 weeks of treatment, 3 times per week. Data was collected at base line, 2nd week and 4th week. Outcome measurements included FVC, FEV, PEFR and Asthma Control Test Questionnaire scores. Data analysis was carried out on Statistical Package for the Social Sciences (SPSS) v.21.0. Confidence interval was kept at 95% and a p-value of less than 0.05 was considered significant.

Detailed description: Asthma is an inflammatory condition in which narrowing and swelling of the airways occur, accompanied with extra mucus production. This results in difficulty in breathing and triggers coughing, wheezing and dyspnea. In some cases asthma is a minor irritation, but on the other end of the spectrum it may interfered with activities of daily living and can even become life threatening in severe asthma attacks. According to a study conducted in Pakistan, the prevalence of asthma in adults was found to be 10.8% in adults, working in tanneries with 5.3% of them reporting their symptoms to be work related.

Non-pharmacological management of asthma includes patient education, guidance and physiotherapy. It is suggested that physical therapy may have positive effects in patients with asthma, as they possess dysfunctional breathing patterns accompanied with poor physical condition. Numerous reviews by Cochrane have been published in the recent years regarding the effects of physical therapy in patients with asthma, focusing on the effects of numerous techniques including Alexander technique, manual therapy, physical training, breathing exercises and inspiratory muscle training. In terms of specific effects of different physical therapy treatment techniques in patients with asthma, in light of the existing literature, breathing exercises have found to improve quality of life, reduce symptoms of anxiety, depression and hyperventilation, and decrease respiratory rate and medication use. Moreover, inspiratory muscle training is found to improve symptoms, decrease medication use and also improve inspiratory pressure.

Buteyko technique is a specialized breathing technique developed to reduce chronic hyperinflation.

A pre and post design quasi experimental study conducted was conducted in 2014 to determine the effects of Buteyko breathing technique on asthma control and QOL in school aged children with asthma where Buteyko breathing technique group showed significant improvements terms of asthma control and quality of life.

Based upon the review of the literature, evidence is inadequate in terms of comparison of Buteyko breathing technique with pursed lip breathing technique in the management of patients with asthma except for a single randomized controlled trial. For this reason the purpose of the current study is to compare the effects of Buteyko technique with pursed lip breathing in the management of patients with asthma.

Eligibility criteria: Inclusion Criteria:

* Patients categorized as mild to moderate persistent asthma category according to the "National Asthma Education and Prevention Program"

Exclusion Criteria:

* Use of oral steroids within the four-week run-in period,
* Change in inhaled steroid dose and type,
* Other significant unstable medical conditions,
* They have undertaken Buteyko breathing technique previously.

Primary outcomes:
measure: Peak expiratory flow rate (PEFR)
timeFrame: After 4 weeks of intervention
measure: Forced vital capacity (FVC)
timeFrame: After 4 weeks of intervention
measure: Forced expiratory volume in 1sec (FEV1)
timeFrame: After 4 weeks of intervention
measure: FVC/FEV1
timeFrame: After 4 weeks of intervention
measure: Asthma Control Questionnaire
timeFrame: After 4 weeks of intervention
Secondary outcomes:
Other outcomes:
Locations:
city: Islamabad
country: Pakistan
facility: Riphah International University
state: Federal
Study officials:
affiliation: Riphah International University
name: Suman Sheraz, PhD*
role: PRINCIPAL_INVESTIGATOR
References:
citation: Davies SJ, Jackson PR, Ramsay LE. Dysfunctional breathing and asthma. Panic disorder needs to be considered. BMJ. 2001 Sep 15;323(7313):631; author reply 631-2. No abstract available.
citation: Stoodley I, Williams L, Thompson C, Scott H, Wood L. Evidence for lifestyle interventions in asthma. Breathe (Sheff). 2019 Jun;15(2):e50-e61. doi: 10.1183/20734735.0019-2019.
citation: Arden-Close EJ, Kirby SE, Yardley L, Bruton A, Ainsworth B, Thomas DM. Evaluation of a breathing retraining intervention to improve quality of life in asthma: quantitative process analysis of the BREATHE randomized controlled trial. Clin Rehabil. 2019 Jul;33(7):1139-1149. doi: 10.1177/0269215519832942. Epub 2019 Feb 27.
citation: Singh V, Wisniewski A, Britton J, Tattersfield A. Effect of yoga breathing exercises (pranayama) on airway reactivity in subjects with asthma. Lancet. 1990 Jun 9;335(8702):1381-3. doi: 10.1016/0140-6736(90)91254-8.
citation: Zampogna E, Centis R, Negri S, Fiore E, Cherubino F, Pignatti P, Heffler E, Canonica GW, Sotgiu G, Saderi L, Migliori GB, Spanevello A, Visca D. Effectiveness of pulmonary rehabilitation in severe asthma: a retrospective data analysis. J Asthma. 2020 Dec;57(12):1365-1371. doi: 10.1080/02770903.2019.1646271. Epub 2019 Aug 13.
citation: Austin G. Buteyko technique use to control asthma symptoms. Nurs Times. 2013 Apr 24-30;109(16):16-7.
citation: Barker NJ, Jones M, O'Connell NE, Everard ML. Breathing exercises for dysfunctional breathing/hyperventilation syndrome in children. Cochrane Database Syst Rev. 2013 Dec 18;2013(12):CD010376. doi: 10.1002/14651858.CD010376.pub2.
citation: Wang Q, Zhang W, Liu L, Yang W, Liu H. Effects of physical therapy on lung function in children with asthma: Study protocol for a systematic review and meta-analysis. Medicine (Baltimore). 2019 Apr;98(15):e15226. doi: 10.1097/MD.0000000000015226.