Key Takeaway
Cochrane review of 22 RCTs found breathing exercises (including Buteyko) may improve quality of life and reduce hyperventilation symptoms in adults with asthma, though evidence certainty remains low to moderate.
Summary
This Cochrane systematic review is the most comprehensive assessment of breathing exercises for adults with asthma, including an updated search through 2019. It included 22 randomized controlled trials with 2,880 participants across various breathing techniques, including the Buteyko method, yoga breathing, and physiotherapist-led programs.
The review found that breathing exercises may improve quality of life (measured by AQLQ) with a mean difference of 0.42 points, approaching the minimal clinically important difference of 0.5. Hyperventilation symptoms showed significant improvement. However, effects on lung function (FEV1, peak flow) were inconsistent across trials.
Importantly, the review noted that evidence certainty was low to moderate due to small sample sizes, heterogeneity in interventions, and risk of bias. No serious adverse events were reported, confirming the safety profile of breathing exercises as adjunctive therapy.
For the Buteyko method specifically, the included studies showed trends toward reduced bronchodilator use and improved asthma control, consistent with earlier individual trial findings. The review supports breathing exercises as a safe add-on to standard asthma treatment, while calling for larger, higher-quality trials with standardized protocols.
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