Physiotherapy Breathing Retraining Improves Quality of Life in Uncontrolled Asthma

Woman using a spirometry
Woman using a spirometry
Nonpharmacological approaches to asthma management may improve patient quality of life.

Self-guided audiovisual breathing retraining programs effectively improve quality of life in patients with incompletely controlled asthma, according to research published in Lancet Respiratory Medicine.

Researchers in the United Kingdom conducted a randomized controlled trial in patients with asthma from 34 medical practices. Eligibility criteria included physician diagnosis of asthma, age 16 to 70 years, therapy with at least 1 anti-asthma medication, and impaired asthma-related quality of life as measured by the Asthma Quality of Life Questionnaire (AQLQ).

More than 600 (n=655) study participants were randomly assigned to receive either researcher-developed self-guided intervention (DVD plus printed booklet [DVDB]), 3 face-to-face breathing retraining sessions with a physiotherapist, or usual care in a 2:1:2 ratio.

At 12 months, AQLQ scores were significantly higher in the DVDB group (mean: 5.40±1.14) vs the usual care and the face-to-face groups (mean: 5.12±1.17 and 5.33±1.06, respectively). Similar AQLQ scores were noted in the DVDB and face-to-face groups (adjusted mean difference: 0.04; 95% CI, –0.16 to 0.24). No significant differences were noted in forced expiratory volume in 1 second or fraction of exhaled nitric oxide in any of the 3 groups.

Adverse events were experienced by 39% of 261 patients in the DVDB group, 42% of 132 patients in the face-to-face group, and 50% of 262 patients in the usual care group.

Although the researchers found minimal effect on lung function and airway inflammation, they note that “breathing retraining programs improve quality of life in patients with incompletely controlled asthma…Such programs can be delivered conveniently and cost-effectively as a self-guided audiovisual program.” 

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Bruton A, Lee A, Yardley L, et al. Physiotherapy breathing retraining for asthma: a randomized controlled trial [published online December 13, 2017]. Lancet Resp Med. doi:10.1016/S2213-2600(17)30474-5