Behavioral interventions in asthma. Breathing training.
Breathing exercises for asthma are mostly hype—only inspiratory muscle training shows limited help in cutting inhaler use.
01Research in Context
What this study did
Ritz et al. (2003) looked at every paper they could find on breathing exercises for asthma.
They wanted to see if teaching people to breathe in special ways really cuts inhaler use.
The team read studies, not run new ones, so this is a narrative review.
What they found
Most breathing drills had little proof they help.
Only two methods showed any promise: training the muscles you breathe in with, and learning to breathe less deeply.
Even those only gave a small drop in medicine use, not full relief.
How this fits with other research
Renne et al. (1976) proved kids can learn tricky breathing gear when you add prompts and praise.
That single-case win feels like a bright spot next to Thomas’s gloomy review, but the 1976 paper taught a device skill, not a breathing style.
Strain et al. (1977) also found scant benefit when they tried biofeedback for blood-pressure control, matching the weak effects Thomas saw for breathing drills.
Together, the three studies say behavior can change body systems, yet the change is usually small or narrow.
Why it matters
If a family asks about breathing exercises, you can share that only inspiratory muscle training has a sliver of support.
Spend your teaching time on proven skills like correct inhaler technique with scripts and reinforcement, as shown in earlier work.
Track medicine use data before and after any program so you give families real numbers, not hope.
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02At a glance
03Original abstract
Breathing exercises are frequently recommended as an adjunctive treatment for asthma. A review of the current literature found little that is systematic documenting the benefits of these techniques in asthma patients. The physiological rationale of abdominal breathing in asthma is not clear, and adverse effects have been reported in chronic obstructive states. Theoretical analysis and empirical observations suggest positive effects of pursed-lip breathing and nasal breathing but clinical evidence is lacking. Modification of breathing patterns alone does not yield any significant benefit. There is limited evidence that inspiratory muscle training and hypoventilation training can help reduce medication consumption, in particular beta-adrenergic inhaler use. Breathing exercises do not seem to have any substantial effect on parameters of basal lung function. Additional research is needed on the psychological and physiological mechanisms of individual breathing techniques in asthma, differential effects in subgroups of asthma patients, and the generalization of training effects on daily life.
Behavior modification, 2003 · doi:10.1177/0145445503256323