The Effect of Physiotherapy-Based Breathing Retraining on Asthma Control

Abstract

Background. The mechanism of the breathing retraining effect on asthma control is not adequately based on evidence. Objective. The present study was designed to evaluate the effect of physiotherapy-based breathing retraining on asthma control and on asthma physiological indices across time. Study design. A 6-month controlled study was conducted. Adult patients with stable, mild to moderate asthma (n = 40), under the same specialist’s care, were randomized either to be trained as one group receiving 12 individual breathing retraining sessions (n = 20), or to have usual asthma care (n = 20). The main outcome was the Asthma Control Test score, with secondary outcomes the end-tidal carbon dioxide, respiratory rate, spirometry, and the scores of Nijmegen Hyperventilation Questionnaire, Medical Research Council scale, and SF-36v2 quality-of-life questionnaire. Results. The 2 × 4 ANOVA showed significant interaction between intervention and time in asthma control (F = 9.03, p < .001, η² = 0.19), end-tidal carbon dioxide (p < .001), respiratory rate (p < .001), symptoms of hypocapnia (p = .001), FEV1% predicted (p = .022), and breathlessness disability (p = .023). The 2 × 4 MANOVA showed significant interaction between intervention and time, with respect to the two components of the SF-36v2 (p < .001). Conclusion. Breathing retraining resulted in improvement not only in asthma control but in physiological indices across time as well. Further studies are needed to confirm the benefits of this training in order to help patients with stable asthma achieve the control of their disease.

• asthma control
• breathing retraining
• ETCO₂
• hyperventilation
• physiotherapy

Acknowledgments

The authors wish to thank GlaxoSmithKline and Dr. Folgering for the no charge permission given to use the Greek version of Asthma Control Test and the Nijmegen Questionnaire as well as Aikaterini Haniotou, M.D., Director of the Respiratory Medicine Clinic of “Amalia Fleming” General Hospital in Athens, Greece, and the participants of the study.

Declaration of Interest

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.