Breathing retraining for dysfunctional breathing in asthma: a randomised controlled trial
Open accessAbstract
Background Functional breathing disorders may complicate asthma and impair quality of life. This study aimed to determine the effectiveness of physiotherapy based breathing retraining for patients treated for asthma in the community who have symptoms suggestive of dysfunctional breathing. Methods 33 adult patients aged 17-65 with diagnosed and currently treated asthma and Nijmegen questionnaire scores > or =23 were recruited to a randomised controlled trial comparing short physiotherapy breathing retraining and an asthma nurse education control. The main outcome measures were asthma specific health status (Asthma Quality of Life questionnaire) and Nijmegen questionnaire scores Results Of the 33 who entered the study, data were available on 31 after 1 month and 28 at 6 months. The median (interquartile range) changes in overall asthma quality of life score at 1 month were 0.6 (0.05-1.12) and 0.09 (-0.25-0.26) for the breathing retraining and education groups, respectively (p=0.018), 0.42 (0.11-1.17) and 0.09 (-0.58-0.5) for the symptoms domain (p=0.042), 0.52 (0.09-1.25) and 0 (-0.45-0.45) for the activities domain (p=0.007), and 0.50 (0-1.50) and -0.25 (-0.75-0.75) for the environment domain (p=0.018). Only the change in the activities domain remained significant at 6 months (0.83 (-0.10-1.71) and -0.05 (-0.74-0.34), p=0.018), although trends to improvement were seen in the overall score (p=0.065), the symptoms domain (p=0.059), and the environment domain (p=0.065). There was…
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One study found that most people with high Nijmegen questionnaire scores had evidence of asthma at follow-up.
“One study assessing the prevalence of dysfunctional breathing in people with asthma found that most with high Nijmegen questionnaire scores had evidence of asthma at follow-up [14].”
From Dysfunctional breathing: a review of the literature and proposal for classification (2016) · cites this paper as [14]
The Papworth method has resulted in some symptom relief and increasing carbon dioxide tension using small sample sizes of moderate asthmatics, but data on long-term follow-up are lacking.
“The Papworth method (where patients are taught diaphragmatic breathing with an emphasis on controlled, slow nasal breathing) has resulted in some symptom relief and increasing carbon dioxide tension using small sample sizes of moderate asthmatics, but data on long-term follow-up are lacking [14, 37].”
From Dysfunctional breathing: a review of the literature and proposal for classification (2016) · cites this paper as [14]
Thomas et al. conducted an RCT in asthmatic patients with probable HVS; after 1 month there was no significant difference for HVS symptoms, but at 6 months the difference became significant; the decrease in the Nijmegen score in the treated group was −2.5 points.
“After 1 month, the authors did not find a significant difference for HVS symptoms, but this difference became significant at 6 months. The decrease in the Nijmegen score in the treated group was relatively small (−2.5 points) compared to our results (−11.6 points).”
From Physiotherapy Education and Breathing Retraining for Patients With Hyperventilation Syndrome: An Observational Study (2026) · cites this paper as [29]
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Self-citationBreathing retraining: A rational placebo?
Garssen, B., de Ruiter, C., & van Dyck, R. (1992) · Clinical Psychology Review · doi:10.1016/0272-7358(92)90111-k · Cited by 76 · see citing works
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Dysfunctional breathing: a review of the literature and proposal for classification
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Self-citationLe syndrome d’hyperventilation
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Beaumont, M., Selleron, B., Passard, G., Karsandi, K., Proffit, M., Valentin, R., & Poncin, W. (2026) · Physiotherapy Canada · doi:10.3138/ptc-2024-0066
- Authors
- Thomas, M.
- Affiliations
- University of Aberdeen (GB)
- Corresponding author
- Thomas, M
- ORCID
- Thomas, M
- Venue
- Thorax
- Publisher
- BMJ
- Published
- 2003-02-01
- Volume
- 58
- Issue
- 2
- Pages
- 110-115
- ISSN
- 0040-6376 (ISSN-L)
- PMC
- PMC1746567
- OpenAlex
- W2141006215
- Cited by
- 230
- References
- 3
- Citations by year
- 2026: 13 · 2025: 4 · 2024: 8 · 2023: 9 · 2022: 13 · 2021: 7 · 2020: 6 · 2019: 9 · 2018: 3 · 2017: 11 · 2016: 17 · 2015: 8 · 2014: 14 · 2013: 14 · 2012: 12
- FWCI
- 5.94
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Thorax (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory and Cough-Related Research
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Keywords
- dysfunctional breathing, asthma, breathing retraining, physiotherapy, Nijmegen questionnaire, asthma quality of life, number needed to treat, asthma self-management education, asthma action plan, asthma exacerbation prevention, asthma-related emergency department visits
- MeSH terms
- Administration, Inhalation, Adolescent, Adult, Aged, Algorithms, Asthma, Female, Humans, Male, Middle Aged, Patient Education as Topic, Peak Expiratory Flow Rate, Quality of Life, Surveys and Questionnaires, Respiration Disorders, Anti-Asthmatic Agents, Physical Therapy Modalities
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