Alternative Medicine

Objective: To evaluate the effect of Buteyko breathing techniques (BBT) in the management of asthma. Design: Prospective, blinded, randomised study comparing the effect of BBT with control classes in 39 subjects with asthma. The study was conducted from January 1995 to April 1995. Participants and setting: Subjects recruited from the community, aged 12 to 70 years, with asthma and substantial medication use. Main outcome measures: Medication use; morning peak expiratory flow (PEF); forced expiratory volume in one second (FEV1); end-tidal (ET) CO2; resting minute volume (MV); and quality of life (QOL) score, measured at three months. Results: No change in daily PEF or FEV1 was noted in either group. At three months, the BBT group had a median reduction in daily beta2agonist dose of 904 μg (range, 29 μg to 3129 μg), whereas the control group had a median reduction of 57 μg (range, 2343 μg to 1143 μg) (P = 0.002). Daily inhaled steroid dose fell 49% (range, 100% to 150%) for the BBT group and 0 (range, 82% to +100%) for the control group (P = 0.06). A trend towards greater improvement in QOL score was noted for BBT subjects (P = 0.09). Initial MV was high and similar in both groups; by three months, MV was lower in the BBT group than in the control group (P = 0.004). ET CO2 was low in both groups and did not change with treatment. Conclusion: Those practising BBT reduced hyperventilation and their use of beta2-agonists. A trend toward reduced inhaled steroid use and better quality of life was observed in these patients without objective changes in measures of airway calibre. Introduction Proponents of Buteyko breathing techniques (BBT) suggest that hyperventilation resulting in alveolar and airway hypocapnia is a major contributor to the pathophysiology of asthma. Advocates claim that exercises designed to reduce minute volume lead to improvements in asthma control and allow reduction of medication. To our knowledge, no formal study of the techniques has been reported in accessible publications. Aside from considerations of hyperventilation, a variety of breathing http://www.mja.com.au/public/issues/xmas98/bowler/bowler.html 1 and relaxation techniques have been advocated for the complementary control of asthma. These include yoga, diaphragmatic breathing and progressive muscle relaxation. Although varying claims of efficacy have been made, no technique has been adopted by mainstream medical