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Cited by 170Asthma and respiratory diseasesChronic Obstructive Pulmonary Disease (COPD) ResearchRespiratory and Cough-Related Research

Integrated breathing and relaxation training (the Papworth method) for adults with asthma in primary care: a randomised controlled trial

Open access
Holloway, E. A, West, R. J·2007·Thorax
DOI 10.1136/thx.2006.076430PMC PMC2094294
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Abstract

BACKGROUND: An integrated breathing and relaxation technique known as the Papworth method has been implemented by physiotherapists since the 1960s for patients with asthma and dysfunctional breathing, but no controlled trials have been reported. This study evaluated the effectiveness of the Papworth method in a randomised controlled trial. METHODS: Eighty-five patients (36 men) were individually randomised to the control group (n = 46) or to the intervention group receiving five sessions of treatment by the Papworth method (n = 39). Both groups received usual medical care. Assessments were undertaken at baseline, post-treatment (6 months after baseline) and at 12 months. The primary outcome measure was the St George's Respiratory Symptoms Questionnaire (SGRQ). Secondary outcome measures included the Hospital Anxiety and Depression Scale (HADS), the Nijmegen dysfunctional breathing questionnaire and objective measures of respiratory function. RESULTS: Post-treatment and 12 month data were available for 78 and 72 patients, respectively. At the post-treatment assessment the mean (SD) score on the SGRQ Symptom subscale was 21.8 (18.1) in the intervention group and 32.8 (20.1) in the control group (p = 0.001 for the difference). At the 12 month follow-up the corresponding figures were 24.9 (17.9) and 33.5 (15.9) (p = 0.007 for the difference). SGRQ Total scores and HADS and Nijmegen scores were similarly significantly lower in the intervention group than in the control group. The groups did not differ significantly following the treatment on objective measures of respiratory function except for relaxed breathing rate. CONCLUSIONS: The Papworth method appears to ameliorate respiratory symptoms, dysfunctional breathing and adverse mood compared with usual care. Further controlled trials are warranted to confirm this finding, assess the effect in other patient groups and determine whether there is some effect on objective measures of respiratory function.

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  • Many participants found the relaxation techniques as being particularly helpful in preventing panic-related episodes and breathlessness easing.

    “In support of previous research, many participants found the relaxation techniques as being particularly helpful in preventing panic-related episodes and breathlessness easing [32].”

    From A randomised controlled feasibility trial of Group Cognitive Behavioural Therapy for people with severe asthma (2017) · cites this paper as [32]

    The treatment summary describes relaxation training, and the Results report improved respiratory-symptom and mood scores for the combined Papworth method. The paper does not report that many participants singled out relaxation as particularly helpful, or that it prevented panic-related episodes; it does not isolate relaxation’s effect from the other components. (LLM, conf=0.85)

    Experimental — accuracy not yet measured

  • In those studies, quality of life improved between the beginning and the end of treatment; quality of life was assessed using specific questionnaires.

    “However, in the latter studies, quality of life improved between the beginning and the end of treatment; quality of life was assessed using specific questionnaires (Saint George questionnaire or asthma quality of life questionnaire).”

    From Physiotherapy Education and Breathing Retraining for Patients With Hyperventilation Syndrome: An Observational Study (2026) · cites this paper as [62]

  • Holloway and West did not report a significant difference between groups for quality of life improvement at 6 months.

    “Similarly, Holloway and West62 did not report a significant difference between the groups for quality of life improvement at 6 months.”

    From Physiotherapy Education and Breathing Retraining for Patients With Hyperventilation Syndrome: An Observational Study (2026) · cites this paper as [62]

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Cites

Flagged first, then by citations

2 of the 23 references couldn’t be matched to a known paper.

Research works printed but not linked: 3

  1. Turner-Warwick M. Profile. Asthma J 1999;4:84-6.
  2. Jones PW. Measurement of health in asthma and chronic obstructive airways disease. Pharm Med 1992;6:13-22.
  3. Lum LC. Breathing exercises in the treatment of hyperventilation and chronic anxiety states. Chest, Heart Stroke J 1977;2:6-11.

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Authors
Holloway, E. A., & West, R. J.
Affiliations
University College London (GB)
Corresponding author
Holloway, E. A
ORCID
West, R. J
Venue
Thorax
Publisher
BMJ
Published
2007-12-01
Volume
62
Issue
12
Pages
1039-1042
ISSN
0040-6376 (ISSN-L)
DOI
10.1136/thx.2006.076430
PMC
PMC2094294
OpenAlex
W2155620354
Cited by
170
References
23
Citations by year
2026: 5 · 2025: 6 · 2024: 11 · 2023: 6 · 2022: 9 · 2021: 8 · 2020: 8 · 2019: 10 · 2018: 5 · 2017: 14 · 2016: 12 · 2015: 8 · 2014: 16 · 2013: 11 · 2012: 9
FWCI
4.67
Type
journal article
Language
en
Open access
Locations
  • Thorax (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • UCL Discovery (University College London) (submittedVersion)
  • HighWire Press Open Archive (submittedVersion)
Topics
  • Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory and Cough-Related Research
Keywords
asthma, dysfunctional breathing, physiotherapy, respiratory symptoms, anxiety and depression, primary care
MeSH terms
Adolescent, Adult, Aged, Asthma, Breathing Exercises, Female, Forced Expiratory Volume, Humans, Male, Middle Aged, Prognosis, Vital Capacity

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