Physiotherapy breathing retaining for asthma: a randomised controlled trial
Anne Bruton, Amanda Lee, Lucy Yardley, et al.
Lancet Respir Med 2018;6:19–28
Many patients express interest in non-pharmacological self-management strategies such as breathing techniques. But although preliminary studies of breathing retraining have shown promising outcomes, such techniques are rarely used in practice. Anne Bruton (University of Southampton) and colleagues developed a self-guided breathing retraining intervention comprising a DVD and accompanying booklet (DVDB). Six hundred and fifty-six patients with asthma were randomised to receive standard care, the DVDB intervention or face-to-face breathing retraining. Benefit was assessed using the Asthma Quality of Life Questionnaire (AQLQ). At 12 months, mean AQLQ scores were significantly higher in the face-to-face and DVDB groups compared with standard care. Patient-reported benefits of the DVDB and face-to-face interventions included increased breathing control, reduced need for medication, increased relaxation, and greater quality of life. Furthermore, an economic assessment found both interventions superior to standard care by providing equivalent clinical benefits at a lower monetary cost. The authors concluded that such a self-help breathing retraining intervention can be delivered conveniently and cost-effectively. However, they warned that it is not disease-modifying, and patients should be counselled on the need to use it to support, not replace, pharmacotherapy.