ASTHMA Effect of two breathing exercises (Buteyko and pranayama) in asthma: a randomised controlled trial

Background: Patients with asthma are interested in the use of breathing exercises but their role is uncertain. The effects of the Buteyko breathing technique, a device which mimics pranayama (a yoga breathing technique), and a dummy pranayama device on bronchial responsiveness and symptoms were compared over 6 months in a parallel group study. Methods: Ninety patients with asthma taking an inhaled corticosteroid were randomised after a 2 week run in period to Eucapnic Buteyko breathing, use of a Pink City Lung Exerciser (PCLE) to mimic pranayama, or a PCLE placebo device. Subjects practised the techniques at home twice daily for 6 months followed by an optional steroid reduction phase. Primary outcome measures were symptom scores and change in the dose of methacholine provoking a 20 % fall in FEV1 (PD20) during the first 6 months. Results: Sixty nine patients (78%) completed the study. There was no significant difference in PD20 between the three groups at 3 or 6 months. Symptoms remained relatively stable in the PCLE and pla-cebo groups but were reduced in the Buteyko group. Median change in symptom scores at 6 months was 0 (interquartile range –1 to 1) in the placebo group, –1 (–2 to 0.75) in the PCLE group, and –3 (–4 to 0) in the Buteyko group (p=0.003 for difference between groups). Bronchodilator use was reduced in the Buteyko group by two puffs/day at 6 months; there was no change in the other tw