A clinical trial of the Buteyko breathing technique

A clinical trial of the Buteyko breathing technique

Opat, A. Cohen M., Bailey, M., and Abramson, M. A clinical trial of the Buteyko breathing technique Journal of Asthma, Vol 37 Issue VIII, 2000.

Abstract

 

The Buteyko Breathing Technique (BBT) is promoted as a drug-free asthma therapy. It is based on the premise that raising blood PaCO2 through hypoventilation can treat asthma. Our study was designed to examine whether the Buteyko Breathing Technique, as taught by a video, is an efficacious asthma therapy. Thirty-six adult subjects with mild to moderate asthma were randomized to receive either a BBT or placebo video to watch at home twice per day for 4 weeks. Asthma-related quality of life, peak expiratory flow (PEF), symptoms, and asthma medication intake were assessed both before and after intervention. Our results demonstrated a significant improvement in quality of life among those assigned to the BBT compared with placebo (p = 0.043), as well as a significant reduction in inhaled bronchodilator intake (p = 0.008). We conclude that the BBT may be effective in improving the quality of life and reducing the intake of inhaled reliever medication in patients with asthma. These results warrant further investigation.

Mind-body medicine

Mind-body medicine

Cohen, M. Mind-Body Medicine, Journal of Complementary Medicine, 2004, 3(6): 46-47 

Abstract

 

While the importance of a good ‘bedside manner’ has long been recognised, the development of a therapeutic relationship and subsequent clinical exchange has recently begun to attract scientific interest through studies on the ‘placebo effect’. In the past the placebo effect was considered a scientific distraction and the refuge of charlatans and the purveyors of snake oil. It is now recognised, however, that all therapies have a nonspecific therapeutic action in addition to any purported specific activity and that, in clinical practice, the placebo effect is continually being evoked regardless of the modality used. The power of the placebo effect is evidenced by its ability to produce positive therapeutic outcomes in virtually every medical condition, and researchers must go to enormous efforts to counter it with the double-blinding of clinical trials and the recruiting of large numbers of patients into clinical trials in order to detect ‘effect beyond placebo’. 

Investigating the claims of Konstantin Buteyko, MD, PhD: The relationship of breath holding time to end tidal CO2 and other proposed measures of dysfunctional breathing.

Investigating the claims of Konstantin Buteyko, MD, PhD: The relationship of breath holding time to end tidal CO2 and other proposed measures of dysfunctional breathing.

Courtney, R., Cohen, M. Investigating the claims of Konstantin Buteyko, MD., PhD: The relationship of breath holding time to end tidal CO2 and other proposed measures of dysfunctional breathing. Journal of Alternative and Complementary Medicine, 2008, 14(2):115 -123

Abstract

 

OBJECTIVES:
Konstantin Buteyko, M.D., Ph.D., claimed that breath holding time (BHT) can be used to detect chronic hyperventilation and that BHT predicts alveolar CO(2) (Pa(CO(2))) according to his patented mathematical formula. The Buteyko Breathing Technique (BBT) is believed to correct chronic hyperventilation as evidenced by increased BHT. In this study, we test Buteyko’s claims and explore the relationship between BHT and end-tidal carbon dioxide (ETCO(2)) as well as measures of dysfunctional breathing (DB) including the Nijmegen questionnaire, the Self Evaluation of Breathing Questionnaire, and thoracic dominant breathing pattern.
SUBJECTS:
Eighty-three (83) adults healthy or suspected of having dysfunctional breathing, 29 with abnormal spirometry readings, 54 with normal spirometry.
OUTCOME MEASURES:
BHT, performed according to BBT protocols, was measured along with ETCO(2) and other measures of DB including the Nijmegen questionnaire, and manual assessment of respiratory motion, a palpatory technique for measuring thoraco-abdominal balance during breathing. Correlations between measures of DB were made in the whole sample and also in subgroups with normal or abnormal spirometry. DB measures were compared in normal and abnormal spirometry groups.
RESULTS:
The results revealed a negative correlation between BHT and ETCO(2) (r= -0.241, p<0.05), directly opposite to Buteyko’s claims. BHT was significantly shorter in people with abnormal spirometry (FEV(1) or FVC<15% below predicted), with no difference in ETCO(2) levels between the abnormal and normal spirometry groups. In the abnormal spirometry group, lower BHT was found to correlate with a thoracic dominant breathing pattern. (r= -0.408, p<0.028).
CONCLUSIONS:
Although BHT does not predict resting ETCO(2), it does correlate with breathing pattern in subjects with abnormal spirometry. It is proposed that altered breathing pattern could contribute to breathing symptoms such as dyspnea and that breathing therapies such as BBT might influence symptoms by improving the efficiency of the biomechanics of breathing.

Evaluation of breathing pattern: comparison of a manual assessment of respiratory motion  (MARM) and respiratory induction plethysmography

Evaluation of breathing pattern: comparison of a manual assessment of respiratory motion  (MARM) and respiratory induction plethysmography

Courtney, R., van Dixhoorn, J., Cohen, M. Evaluation of Breathing Pattern: Comparison of a Manual Assessment of Respiratory Motion (MARM) and Respiratory Induction Plethysmography, Applied Psychophysiology and Biofeedback 5 March 2008 available at: www.springerlink.com/content/w6n12ujr8768204v/

Abstract

 

Altered breathing pattern is an aspect of dysfunctional breathing but few standardised techniques exist to evaluate it. This study investigates a technique for evaluating and quantifying breathing pattern, called the Manual Assessment of Respiratory Motion (MARM) and compares it to measures performed with Respiratory Induction Plethysmography (RIP). About 12 subjects altered their breathing and posture while 2 examiners assessed their breathing using the MARM. Simultaneous measurements with RIP were taken. Inter-examiner agreement and agreement between MARM and RIP were assessed. The ability of the measurement methods to differentiate between diverse breathing and postural patterns was compared. High levels of agreement between examiners were found with the MARM for measures of the upper rib cage relative to lower rib cage/abdomen motion during breathing but not for measures of volume. The measures of upper rib cage dominance during breathing correlated with similar measures obtained from RIP. Both RIP and MARM measures methods were able to differentiate between abdominal and thoracic breathing patterns, but only MARM was able to differentiate between breathing changes occurring as result of slumped versus erect sitting posture. This study suggests that the MARM is a reliable clinical tool for assessing breathing pattern.