Breaking News
February 19, 2018 - Study sheds light on biology that guides behavior across different stages of life
February 19, 2018 - Morning Break: Transgender Breast Feeding; Brazilian ‘Pro-Vaxxers’; Post-Stroke Exercise
February 19, 2018 - Meningitis vaccination strategy in Africa found to be effective, economical
February 19, 2018 - Researchers uncover how excess calcium may influence development of Parkinson’s disease
February 19, 2018 - Psoriasis drug also effective at reducing aortic inflammation
February 19, 2018 - Excess emissions can make serious contributions to air pollution, study shows
February 19, 2018 - Diabetes Drugs Differ on HF; School-Based Obesity Program Flop; Plaque Type in ACS
February 19, 2018 - Surgical infections linked to drug-resistant bugs, study suggests
February 19, 2018 - Poor awareness may hinder a child’s early dental care
February 19, 2018 - FDA Approves Apalutamide (Erleada) to Help Curb a Tough-to-Treat Prostate Cancer
February 19, 2018 - Educational Tool Boosts Cervical Length Screening
February 19, 2018 - Spider’s web inspires removable implant that may control type 1 diabetes
February 19, 2018 - Scientists develop fluorescent probe to identify cancer stem cells
February 19, 2018 - University Hospital of Santiago de Compostela participates in large pancreatic cancer study
February 19, 2018 - New blood test shows promise to revolutionize diagnosis of tick-borne diseases
February 19, 2018 - Report: Use, Not Price, Drives State Health Costs
February 19, 2018 - Emergency services crews often unprepared for diabetic crises
February 19, 2018 - Scientists in Sweden create DNA nanowires that offer hope for treatment of diseases
February 19, 2018 - ID Break: Clean Hands, Fewer Abx; $11 Million HIV Cure?; MenB Vax for Kids
February 19, 2018 - Patient exposure to X-rays depends on how dentists are paid
February 19, 2018 - Study reveals parents’ views toward children’s tanning bed use
February 19, 2018 - Shot may help reduce risk of shingles
February 19, 2018 - FDA approves first treatment to reduce risk of NSCLC progression
February 19, 2018 - FDA Expands Approval of Imfinzi (durvalumab) to Reduce the Risk of Non-Small Cell Lung Cancer Progressing
February 19, 2018 - D.C. Week: Congress Passes Spending Bill
February 19, 2018 - Heart-muscle patches made with human cells improve heart attack recovery
February 19, 2018 - FDA Approves First Blood Test to Detect Concussions
February 19, 2018 - Survival Bump in Bladder Cancer with Keytruda
February 18, 2018 - Scientists describe the mechanism of heart regeneration in the zebrafish
February 18, 2018 - Scientists uncover the structure of microtubule motor proteins
February 18, 2018 - Light-activated cancer drugs without toxic side effects are closer to becoming reality
February 18, 2018 - Pioneering research could provide novel insight into how genomic information is read
February 18, 2018 - Pearls From: David Putrino, PhD
February 18, 2018 - Researchers uncover how cancer stem cells drive triple-negative breast cancer
February 18, 2018 - Morning Break: Anti-Anti-Vaxxers; Private Piercings Prohibited; A Case for Pelvic Massage
February 18, 2018 - Lower-dose radiation effective, safe for HPV+ head and neck cancer after induction chemo
February 18, 2018 - Specialist residential service for adults with autism opens in Swansea
February 18, 2018 - FDA Moves to Limit Loperamide Doses per Package
February 18, 2018 - Alcohol use disorder – Genetics Home Reference
February 18, 2018 - Autism might be better detected using new two-minute questionnaire
February 18, 2018 - Hand hygiene-intervention practices may reduce risk of infection among nursing home patients
February 18, 2018 - Researchers develop most sophisticated mini-livers to date
February 18, 2018 - Obamacare Helped More Young Women Get Prenatal Care: Study
February 18, 2018 - School-Based Program Fails to Dent Kids’ Obesity
February 18, 2018 - Research compares neural activity in children with and without autism spectrum disorder
February 18, 2018 - Poor fitness levels increase the risk dementia, concludes study
February 18, 2018 - Risk Score May Reveal if Kids are Victims of Ill-Treatment
February 18, 2018 - Adding Folic Acid to Corn Masa Flour May Prevent Birth Defects
February 18, 2018 - Acute treatment suppresses posttraumatic arthritis in ankle injury
February 18, 2018 - A Role for Budesonide in Autoimmune Hepatitis?
February 18, 2018 - Lupus patients exhibit altered cell proteins, a discovery with potential implications for diagnostics
February 18, 2018 - Muscle plays vital role in regulating heat loss from the hands
February 18, 2018 - High-tech brain scans can provide new way to define intelligence
February 18, 2018 - Study reveals the association between ultra-processed foods and cancer
February 18, 2018 - Prescription Opioid Use Tied to Higher Pneumonia Risk
February 18, 2018 - A non-invasive method to detect Alzheimer’s disease
February 18, 2018 - Deletion of specific enzyme leads to improvement in memory and cognitive functions
February 18, 2018 - Amyloid protein may be transmitted through neurosurgical instruments, study suggests
February 18, 2018 - Electric brain signals of males and females show differences
February 18, 2018 - American Heart Association commends McDonald’s for offering healthier menu in kids’ meals
February 18, 2018 - Parents Find Kids’ Weight Report Cards Hard to Swallow
February 18, 2018 - Does a Financial Conflict of Interest Ever Expire?
February 18, 2018 - Exercise can improve Alzheimer’s symptoms
February 18, 2018 - Scientists develop green chemistry method to improve pharmaceutical manufacturing efficiency
February 17, 2018 - ‘A Time Clock to a Tissue Clock’ for Acute Stroke Care
February 17, 2018 - Cancer Care Gets Personal | NIH News in Health
February 17, 2018 - Do more youth use or do youth use more?
February 17, 2018 - Eating faster linked to obesity
February 17, 2018 - Who’s Still Smoking? ACS Report Highlights Most Vulnerable Adults
February 17, 2018 - Study of smoking and genetics illuminates complexities of blood pressure
February 17, 2018 - Study reveals new link between bone cells and blood glucose level
February 17, 2018 - Children with reading challenges may have lower than expected binocular vision test results
February 17, 2018 - Mass Shootings Trigger Change for Emergency Medicine
February 17, 2018 - ECMO helps revive woman thought to be drowned
February 17, 2018 - Learning stress-reducing techniques may benefit people with epilepsy
February 17, 2018 - Shedding Pounds Before Weight-Loss Surgery a Smart Move
February 17, 2018 - FDA Approves New Cystic Fibrosis Drug Combo
February 17, 2018 - Augmented Reality helps surgeons to ‘see through’ tissue and reconnect blood vessels
February 17, 2018 - Emotional state affects operation of the entire brain instead of being restricted to specific regions
February 17, 2018 - Apalutamide Slows Metastasis in Prostate Cancer
At-Home Breath Training Improves Asthma Quality of Life

At-Home Breath Training Improves Asthma Quality of Life

image_pdfDownload PDFimage_print

Action Points

  • Note that this randomized trial found that a web-based video “breathing retraining” intervention was as effective at improving asthma-related quality of life as a face-to-face intervention with a therapist.
  • Be aware that the intervention did not improve less subjective disease measures such as FEV1.

Self-taught breath retraining proved to be an effective, readily available and cost efficient strategy for improving quality of life among patients with asthma in a randomized trial.

The training involved video instruction designed to teach patients breathing exercises such as diaphragmatic breathing, nasal breathing, slow breathing, controlled breath holds, and relaxation techniques.

Quality-of-life improvements among video-trained adult asthma patients were equivalent to those of patients participating in three face-to-face, 30- to 40-minute sessions with a physiotherapist.

Neither breath-training intervention was associated with improvements in lung function or airway inflammation, but both were associated with measurable improvements in quality-of-life, wrote Anne Bruton, PhD, of Southampton University in England, and colleagues in Lancet Respiratory Medicine.

“To our knowledge we report the largest trial of breathing retraining in asthma to date,” Bruton and colleagues wrote. “We confirmed improvements in quality-of-life scores over usual care previously reported in smaller studies for face-to-face physiotherapist-taught programs, and additionally showed that the (video) program results in equivalent clinically relevant benefits more conveniently and less expensively.”

More than 650 patients from 34 general practices in Great Britain were enrolled. All were age 16-70, had been prescribed at least one asthma medication during the previous year, and had Asthma Quality-of-Life Questionnaire (AQLQ) scores less than 5.5.

The researchers developed a self-guided intervention, which was delivered as a DVD plus a printed booklet. Participants were randomized 2:1:2 to the self-training, therapist-delivered training, or standard care for 12 months.

The main study outcome was AQLQ score in the intention-to-treat population at 12 month: participants completed quality-of-life questionnaires at the start of the trial and after 3, 6, and 12 months. The trial was also powered to show equivalence between the two active intervention groups, and superiority of both intervention groups over usual care.

Secondary outcomes included patient-reported and physiological measures of asthma control, patient acceptability, and health-care costs.

Among the main findings for AQLQ scores at 12 months:

  • Significantly higher in the self-training group (mean 5.40, SD 1.14) compared to usual care (5.12, SD 1.17; adjusted mean difference 0.28, 95% CI 0.11 to 0.44)
  • Higher in the face-to-face group (5.33, SD 1.06) than usual care (adjusted mean difference 0.24, 95% CI 0.04 to 0.44)
  • Similar in the self-training and face-to-face groups (adjusted mean difference 0.04, 95% CI -0.16 to 0.24)

No differences were seen between the randomization groups in FEV1 or fraction of exhaled nitric oxide.

Adverse event rates were similar in all three study arms, suggesting that breath retraining was not associated with additional side effects.

Bruton and colleagues have made the content of the DVD and supporting booklet freely available online through their Breathestudy website.

They noted that the low cost and easy access for an internet-based intervention, along with the absence of adverse effects, “indicate that this evidence-based non-pharmacological intervention can now be offered to people with asthma with persisting quality-of-life impairment despite current asthma medications.”

But they added that it is important to stress to patients that the intervention is to be used along with, and not instead of, their currently prescribed medications.

In an accompanying editorial, John D. Balkey, PhD, of Royal Liverpool Hospital in England, highlighted the number needed to treat — eight patients — to achieve a clinically important difference in AQLQ. This is superior to that reported for medications commonly added to inhaled corticosteroids.

“Unlike add-on therapies, however, breathing retraining was not associated with any change in other symptom measures, such as airflow obstruction or inflammation. As the authors point out, breathing retraining is an adjunct to appropriate pharmacotherapy and not a replacement,” Balkey wrote.

The editorial writer added that further research is needed to confirm the generalizability of the findings.

The research was funded by the U.K. National Institute of Health Research.

  • Reviewed by
    F. Perry Wilson, MD, MSCE Assistant Professor, Section of Nephrology, Yale School of Medicine and Dorothy Caputo, MA, BSN, RN, Nurse Planner

2017-12-13T14:00:00-0500

Tagged with:

About author

Related Articles