Breaking News
August 15, 2018 - Cardiac Profiles Up With Exercise, Less Sitting in Early Old Age
August 15, 2018 - Precision medicine offers a glimmer of hope for Alzheimer’s disease
August 15, 2018 - Immunovia’s new blood-based testing platform accurately detects non-small cell lung cancer
August 15, 2018 - New method provides a ‘big picture’ of genetic influences on traits and diseases
August 15, 2018 - Early Onset Type 1 Diabetes Linked to Heart Disease, Shorter Life
August 14, 2018 - SMURF1 provides targeted approach to preventing cocaine addiction relapse
August 14, 2018 - Genetic testing pushed for hereditary high cholesterol disease
August 14, 2018 - Researchers discover new genes involved in Alzheimer’s Disease
August 14, 2018 - Medicare to overhaul ACOs but critics fear fewer participants
August 14, 2018 - Adolescent health projects receive meager percentage of global funding, study finds
August 14, 2018 - University Hospitals Seidman Cancer Center launches new CAR-T therapy trial
August 14, 2018 - In the addiction battle, is forced rehab the solution?
August 14, 2018 - Busting myths about milk – Scope
August 14, 2018 - Platelet-rich plasma does not enhance cartilage formation capabilities of stem cells
August 14, 2018 - Wearable devices and ‘mhealth’ technology emerge as promising tools for better health
August 14, 2018 - Clinical study suggests new treatment direction for head and neck cancer in heavy smokers
August 14, 2018 - Phase 2 Clinical Data Published Showing Summit’s Ridinilazole Preserved Gut Microbiome of Patients with CDI
August 14, 2018 - Cardiac progenitor cells undergo a cell fate switch to build coronary arteries
August 14, 2018 - Study identifies potential guidance to treat gastric cancer patients
August 14, 2018 - Revealed: The molecular mechanism underlying hypertrophic cardiomyopathy, or “workaholic heart”
August 14, 2018 - Diabetes epidemic in Guatemala driven by aging, not obesity
August 14, 2018 - New technology shows potential to streamline the analysis of proteins
August 14, 2018 - Rethinking the stroke rule ‘time is brain’
August 14, 2018 - Incidence of coronary artery compression in children may be more common than previously thought
August 14, 2018 - Study helps to better understand disease caused by Alpha-1 antitrypsin deficiency
August 14, 2018 - AI platform identifies acute neurological illnesses faster than human diagnosis
August 14, 2018 - American College of Rheumatology receives grants to support development of lupus clinical trials
August 14, 2018 - New study explains why women get more migraines than men
August 14, 2018 - American Heart Association Urges Screen Time Limits for Youth
August 14, 2018 - Brief interventions during routine care reduce alcohol use among men with HIV
August 14, 2018 - New genome analysis could identify people at higher risk of common deadly diseases
August 14, 2018 - NIH grant for Mount Sinai to study use of inhaled corticosteroids for treatment of sickle cell disease
August 14, 2018 - Daicel supplies free nanodiamond samples to international researchers
August 14, 2018 - Switching anti-psychotic drugs in first-episode schizophrenia patients does not improve clinical outcomes
August 14, 2018 - Study to examine whether modulating gut bacteria can improve cardiac function in heart failure patients
August 14, 2018 - AI technology could hold key to improving health services
August 14, 2018 - One out of two children not getting enough nutrients needed for their health
August 14, 2018 - Mono-antiplatelet therapy after aortic heart valve replacements may work as well as two drugs
August 14, 2018 - Aid-in-dying patient chooses his last day
August 14, 2018 - Exercise Really Can Chase Away the Blues, to a Point
August 14, 2018 - Surgical mesh implants may cause autoimmune disorders
August 14, 2018 - Researchers develop revolutionary zebrafish model to gain more insight into bone diseases
August 14, 2018 - Researchers discover secret communication hotline between breast cancers and normal cells
August 14, 2018 - Study examines how a person adapts to visual field loss after stroke
August 14, 2018 - Researchers show how specialized nucleic acid-based nanostructures could help target cancer cells
August 14, 2018 - Reducing opioid prescriptions for one operation can also spill over to other procedures
August 14, 2018 - E-cigarettes not so safe but still better than cigarettes
August 14, 2018 - Researchers find link between common ‘harmless’ virus and cardiovascular damage
August 14, 2018 - Initiation of PIMs associated with higher risk of fracture-specific hospitalizations and mortality
August 14, 2018 - Genetically modified mosquitoes and special bed nets help tackle deadly diseases
August 14, 2018 - Advances in treating hep C lead to new option for transplant patients
August 14, 2018 - Study finds quality of doctor-patient discussions about lung cancer screening to be ‘poor’
August 14, 2018 - MSU researchers uncover the effects of aging on regenerative ability of kidneys
August 14, 2018 - Better conditioning, throwing mechanics can help reduce elbow injuries in young baseball pitchers
August 14, 2018 - Brain game doesn’t offer brain gain
August 14, 2018 - Reproductive choices facing women with disabilities require careful consideration
August 14, 2018 - Scientists pinpoint the cause of a rare childhood seizure disorder
August 14, 2018 - Lumpectomy plus radiation associated with reduced risk of breast cancer death, study finds
August 14, 2018 - UAB study shows how ion channel differentiates newborn and mature neurons in the brain
August 14, 2018 - Experts highlight key knowledge gaps that need to be addressed in Ebola vaccine research
August 14, 2018 - Discovery could lead to new drugs against infection and inflammation
August 14, 2018 - Infection Prevention Differs Between Small, Large Hospitals
August 14, 2018 - Mom still matters—In study, young adults tended to prioritize parents over friends
August 14, 2018 - Deep brain stimulation might benefit those with severe alcoholism, preliminary studies show
August 14, 2018 - Study finds increased rate of repeat pregnancies in women with intellectual and developmental disabilities
August 14, 2018 - Lighter sedation fails to reduce risk of postoperative delirium in older patients
August 13, 2018 - Asking better questions about person’s memory could improve doctors’ understanding of patients
August 13, 2018 - U.S. Trauma Doctors Push for Stricter Gun Controls
August 13, 2018 - Asthma and flu: a double whammy
August 13, 2018 - 5 Questions: Donna Zulman on engaging high-need patients in intensive outpatient programs | News Center
August 13, 2018 - Behavioral Nudges Lead to Drop in Prescriptions of Potent Antipsychotic
August 13, 2018 - Potential New Class of Drugs May Reduce Cardiovascular Risk by Targeting Gut Microbes
August 13, 2018 - How to get your kids to eat better
August 13, 2018 - The importance of hearing your patients
August 13, 2018 - Transmission of F. tularensis unlikely to happen through the food chain
August 13, 2018 - Researchers discover epigenetic mechanism underlying ischemic cardiomyopathy
August 13, 2018 - Adolescent health programs receive only a tiny share of international aid, finds research
August 13, 2018 - Fracture risk increases by 30% after gastric bypass, study shows
August 13, 2018 - Quality-improvement project to standardize feeding practices helps micro preemies gain weight
August 13, 2018 - Long-term cannabinoid exposure impairs memory, study shows
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