Breathing Exercises for Asthma Patients in Specialist Care: A Multicenter Randomized Trial

• Published in: Annals of the American Thoracic Society
• Main Authors: Andreasson, Karen H, Skou, Søren T, Ulrik, Charlotte S, Madsen, Hanne, Sidenius, Kirsten, Assing, Karin D, Porsbjerg, Celeste, Bloch-Nielsen, Jannie, Thomas, Mike, Bodtger, Uffe
• Format: Journal Article
• Language: English
• Published: United States 19.05.2022
• ISSN: 2325-6621

Moderate-to-severe asthma is associated with impaired asthma control and quality of life (QoL) despite access to specialist care and modern pharmacotherapy. Breathing exercises (BrEX) improve QoL in incompletely controlled mild asthma, but impact in moderate-to-severe asthma is unknown. To investigate the effectiveness of breathing exercises (BrEX) as adjuvant treatment on QoL in patients with uncontrolled moderate-to-severe asthma. Adult patients with incompletely controlled asthma attending respiratory specialist clinics were randomized to usual specialist care (UC), or UC and BrEX (UC+BrEX) with three individual physiotherapists-delivered sessions and home exercises. Primary outcome was asthma-related QoL (Mini-Asthma Quality of Life Questionnaire (Mini-AQLQ)) at 6-month based on intention-to-treat analysis. Mini-AQLQ at 12-month, lung function, 6-minute Walk Test, physical activity level, Nijmegen Questionnaire, Hospital Anxiety and Depression Scale (HADS), and adverse events (AE). Repeated measures mixed effects models were used to analyze data. Poisson regression models were used to analyze AE incidence rate ratio. 193 participants were allocated to UC+BrEX (n=94) or UC (n=99). UC+BrEX was superior in the primary outcome (adjusted mean change difference 0.35, 95% CI 0.07 to 0.62). Superiority in Mini-AQLQ was sustained at 12-month (0.38, 95% CI 0.12 to 0.65). A minor improvement in HADS-depression at 6-month favoring UC+BrEX (-0.90, 95% CI -1.67 to -0.14) was observed. Asthma-related adverse events occurred similarly in UC+BrEX and UC participants: 14.9% versus 18.1% (p=0.38). Breathing exercises as add-on to usual care improve asthma-related QoL in incompletely controlled asthma regardless of severity and with no evidence of harm. Clinical trial registered with ClinicalTrials.gov (NCT03127059).