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Buteyko Therapy HOL-emblem1-web.GIF (3556 bytes)

Breathing Exercises for Asthma
By Andrew Web

In the light of a recent Cochrane review (1) coming out in favour of some aspects of physical therapy in asthma, the spotlight is once again turning towards treatments such as the Buteyko method. This is the message of Health Scientist Janet Brindley and Cornish GP, Dr James Oliver who have both been teaching the method privately and within the NHS for the last three years. .

World wide there has now developed a wealth of anecdotal evidence of the effectiveness of the Buteyko method. Take Andrew for example. For several years he suffered from very brittle 'crash asthma' which required so many admissions to hospital that his mother stopped counting when they reached 65 visits. His consultant even supplied him with a yellow card recommending immediate assessment at any casualty unit in the country.

From the start he was keen to learn the Buteyko techniques and as a result of diligent practice he soon learned how to abort attacks in their early stages. Within eight weeks his condition had improved to the point where he was once again able to join his friends at school in a game of football.

In the last 18 months he has only been admitted once for his asthma. His parents say that they now feel much more confident about assessing his condition and taking appropriate action. He has missed much less time off school and is optimistic that he won't have to go into hospital again.

Buteyko is certainly not the first or only method of breathing retraining to be used in asthma, but nevertheless it is gradually developing considerable popularity in Australia and New Zealand where experience with the technique now goes back over 10 years.

The basis of the method centres around five key elements:-

bullet Encouraging constant nose breathing
bullet Redirecting breathing to the lower chest
bullet Exercises in voluntary hypoventilation
bullet Reduction in muscle tone and improvement in posture through relaxation
bullet Up to date advice regarding asthma management and prevention of symptoms

More scientific evidence for the effectiveness technique came from a randomised, blinded controlled trial that was published in the Medical Journal of Australia in 1998 (3). This compared the progress of two groups of asthmatic patients who were both given classes in asthma management by physiotherapists. One used 'conventional' chest physio, the other used the Buteyko method. After 12 weeks there was an average 90% reduction in bronchodilator use among the Buteyko group compared to only 5% among the controls. Measures of lung function and quality of life showed that this dramatic reduction in the need for medication had not produced any deterioration in well-being.

A later study showed that to a lesser extent the same sorts of results but could be achieved in only four weeks by simply issuing asthma sufferers with a video about the Buteyko technique (2).

Janet Brindley, an asthmatic herself who benefited enormously from the method, remains enthusiastic. "Limited published and anecdotal evidence indicates that breathing exercises can be helpful in asthma. Our experience is that the Buteyko method is a safe, effective treatment. It is such a simple, self-help intervention that if it were only used more widely in the NHS there would inevitably be savings in both drug expenditure and hospital admissions."

1. Breathing exercises for asthma (Cochrane review). Holloway E, Ram FSF, The Cochrane Library Issue 1 2001.

2. A clinical trial of the Buteyko Breathing Technique in asthma as taught by video. Opat AJ., Cohen MM., Bailey MJ and Abramson MJ. J Asthma 2000: 37 (7), 557 - 64.

3. Buteyko breathing techniques in asthma: a blinded randomised controlled trial. Bowler SD., Green A and Mitchell CA. Medical Journal of Australia 1998: 169, 575 - 578.

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