Breathing and relaxation training added to usual asthma treatment improved patients' respiratory symptoms, dysfunctional breathing, and mood better than did usual asthma care alone, according to a British randomized controlled trial.
The researchers studied the effect of exercises collectively known as the Papworth method on asthma patients in a general practice in the town of Welwyn in Hertfordshire, England.
The Papworth method has five components: breathing training (including development of proper breathing patterns and elimination of hyperventilation and “mouth-breathing” habits); education; general and specific relaxation training; integration of breathing and relaxation techniques into daily living activities, including speech; and home exercises with reminders of the techniques, the researchers wrote.
A total of 85 patients aged 16-70–most of whom had mild asthma or symptoms that were well controlled by medication–were randomized into a control group or an intervention group that received five sessions of treatment using the Papworth method (Thorax 2007 June 28 [Epub doi:10.1136/thx.2006.076430]). Both groups continued to receive routine asthma medication and education during the study.
At 6 months, mean scores on a per-protocol basis on the St. George's Respiratory Questionnaire symptoms scale dropped from 42.9 to 21.8 in the intervention group, compared with a change from 35.1 to 32.8 for the control group. At 12 months, the scores were 24.9 for the intervention group and 33.5 for controls, researchers found. The changes were significantly greater in the intervention than in the control group.
The researchers also found significant improvements in intervention group versus control group scores on the Hospital Anxiety and Depression Scale anxiety and depression components, as well as in scores for hypocapnic symptoms on the Nijmegen questionnaire.
“These results support the hypothesis that the Papworth method ameliorates respiratory symptoms and improves quality of life in a general practice population of patients diagnosed with asthma,” wrote the researchers, Elizabeth Holloway and Robert West of University College London's department of epidemiology and public health. “To our knowledge, this is the first evidence from a controlled trial to demonstrate the effectiveness of the Papworth method.”
Papworth method patients significantly improved their relaxed breathing rate over 10 minutes compared with the usual care group. The researchers did not find any significant improvement in spirometric parameters for the intervention patients, however.
“The fact that no significant change was observed in objective measures of lung function suggests that the Papworth method does not improve the chronic underlying physiological causes of asthma, but rather their manifestation,” they wrote.
The researchers acknowledged that their study did not track medication use or changes in medication use, nor does it compare the Papworth method with other treatment options that exceed usual care. In addition, the researchers said they could draw no conclusions about the Papworth method's effectiveness for those with severe asthma, because such patients were not included in the study.