Breathing exercises improve quality of life regardless of asthma severity

In patients with uncontrolled moderate to severe asthma, breathing exercises in addition to usual care improved quality of life, despite asthma severity, researchers reported at the European Respiratory Society International Congress.

Breathing exercises, a nonpharmacological treatment for asthma, aim to improve patients’ breathing patterns via diaphragmatic breathing, nose inhalation, normalization of the tidal volume, and relaxation of the jaw and tongue. These exercises can also be conducted in the office and home settings.

Karen Hjerrild Andreasson, PhD, physiotherapist at Naestved Hospital, Denmark, and colleagues conducted a multicenter, randomized controlled trial of 193 participants with uncontrolled moderate to severe asthma (mean age, 52 years; 63.2% women; 37% obese) at seven hospitals and a private clinic in Denmark. Participants were randomly assigned to usual care plus breathing exercises for 12 weeks (n = 94) or usual care alone (n = 99). The intervention group included three sessions of breathing exercises at an official therapist and at home. If needed, participants were instructed on breath-hold techniques and coughing-suppression techniques. Patients were followed for 12 months.

“Breathing exercises have [been] shown to improve quality of life in moderate asthma. However, no trials have reported this intervention in moderate to severe asthma,” Andreasson said.

The primary outcome was mini-Asthma Quality of Life Questionnaire score. Secondary outcomes included 6-minute walk distance, lung function and physical activity level.

At 6 months, participants in the breathing exercise group improved their mini-Asthma Quality of Life Questionnaire score by 0.35 (95% CI, 0.07-0.62) compared with usual care. In addition, the breathing exercise group’s depression score was improved by –0.9 (95% CI, –1.67 to –0.14) compared with usual care.

The incidence rate ratio for asthma-related serious adverse events at 12 months was 1.13 (nine events vs. 10 events; P = .78).

There were no significant differences in other secondary outcome measures between the breathing exercise and usual care groups.

“The message to take home is that breathing exercises improved quality of life despite severity in incompletely controlled asthma, and this effect size is equal to that seen for second controllers,” Andreasson said.