Skip to main content
Bulletin of Faculty of Physical Therapy
Download PDF

Efficacy of noninvasive respiratory techniques in the treatment of children with bronchial asthma: a randomized controlled trial

Bulletin of Faculty of Physical Therapy volume 21, pages 1–10 (2016)Cite this article

Abstract

Background and purpose

Although the effects of the respiratory techniques are appreciated, it is yet in need to be defined for the treatment of children with bronchial asthma. Thus, this study aimed to compare the effects of the active cycle of breathing technique (ACBT), Buteyko breathing technique (BBT), and thoracic lymphatic pump technique (TLPT) on the total serum immunoglobulin (Ig) E, ventilatory function, and asthma perception in children with bronchial asthma.

Materials and methods

In a randomized controlled trial, 54 children with bronchial asthma randomly allocated to three equal groups. The groups were then randomly assigned to the following interventions: the ACBT group, the BBT group, or the TLPT group. Total serum IgE, ventilatory function, and perception of asthma were evaluated before treatment and after 3 consecutive months of treatment.

Results

No significant differences were found between groups at entry (P>0.05). There were nonsignificant differences as regards all outcome measures within the ACBT group (P>0.05) and significant differences within the BBT group and the TLPT group (P<0.05). Significant difference in total serum IgE in favor of the BBT group was recorded when compared with ACBT group (P=0.046) and the TLPT group (P=0.036). Moreover, significant differences in ventilatory function measures favoring the BBT group in comparison with the ACBT group and the BBT group (P<0.05) were recorded. Finally, asthma control was significantly higher in the BBT group than ACBT group (P=0.017) but not BBT group (P=0.081).

Conclusion

The BBT and TLPT are more advantageous compared with the ACBT in the treatment of children with bronchial asthma, and Buteyko breathing is potentially more valuable.

References

  1. Lugogo N, Que G, Fertel D, Kraft M, Mason J, Broaddus C, Martin R. Asthma in adults and children. Respir Med 2010;38:115–139.

    Google Scholar 

  2. Aligne CA, Auinger P, Byrd RS, Weitzman M. Risk factors for pediatric asthma. Contributions of poverty, race, and urban residence. Am J Respir Crit Care Med 2000;162:873–877.

    CAS  Google Scholar 

  3. Niven AS, Argyros G. Alternate treatments in asthma. Chest 2003;123:1254–1265.

    PubMed  Google Scholar 

  4. Rosenbaum E. Racial/ethnic differences in asthma prevalence: the role of housing and neighborhood environments. J Health Soc Behav 2008;49:131–145.

    PubMed  Google Scholar 

  5. Zedan M, Settin A, Farag M, Ezz-Elregal M, Osman E, Fouda A. Prevalence of bronchial asthma among Egyptian school children. Egypt J Bronchol 2009;3:124–130.

    Google Scholar 

  6. Marcatili P, Rosi A, Tramontano A. PIGS: automatic prediction of antibody structures. Bioinformatics 2008;24:1953–1954.

    CAS  PubMed  Google Scholar 

  7. Erb KJ. Helminths, allergic disorders and IgE-mediated immune responses: where do we stand? Eur J Immunol 2007;37:1170–1173.

    CAS  PubMed  Google Scholar 

  8. Opat AJ, Cohen MM, Bailey MJ, Abramson MJ. A clinical trial of the Buteyko breathing technique in asthma as taught by a video. J Asthma 2000;37:557–564.

    CAS  PubMed  Google Scholar 

  9. Prem V, Sahoo RC, Adhikari P. Comparison of the effects of Buteyko and pranayama breathing techniques on quality of life in patients with asthma –a randomized controlled trial. Clin Rehabil 2013;27:133–141.

    PubMed  Google Scholar 

  10. Bowler SD, Green A, Mitchell CA. Buteyko breathing techniques in asthma: a blinded randomised controlled trial. Med J Aust 1998;169:575–578.

    CAS  PubMed  Google Scholar 

  11. Berlowitz D, Denehy L, Johns DP, Bish RM, Walters EH. The Buteyko asthma breathing technique. Med J Aust 1995;162:53.

    CAS  PubMed  Google Scholar 

  12. Cooper S, Oborne J, Newton S, Harrison V, Thompson Coon J, Lewis S, Tattersfield A. Effect of two breathing exercises (Buteyko and pranayama) in asthma: a randomised controlled trial. Thorax 2003;58:674–679.

    CAS  PubMed  PubMed Central  Google Scholar 

  13. McHugh P, Aitcheson F, Duncan B, Houghton F. Buteyko breathing technique for asthma: an effective intervention. N Z Med J 2003;116:U710.

    PubMed  Google Scholar 

  14. Hassan ZM, Riad NM, Ahmed FH. Effect of Buteyko breathing technique on patients with bronchial asthma. Egypt J Chest Dis Tuberc 2012;61:235–241.

    Google Scholar 

  15. Cooper S, Oborne J, Harrison T, Tattersfield A. Effect of mouth taping at night on asthma control –a randomised single-blind crossover study. Respir Med 2009;103:813–819.

    PubMed  Google Scholar 

  16. Courtney R, Cohen M. Investigating the claims of Konstantin Buteyko, MD, PhD: the relationship of breath holding time to end tidal CO2 and other proposed measures of dysfunctional breathing. J Altern Complement Med 2008;14:115–123.

    PubMed  Google Scholar 

  17. Lewis LK, Williams MT, Olds TS. The active cycle of breathing technique: a systematic review and meta-analysis. Respir Med 2012;106:155–172.

    PubMed  Google Scholar 

  18. Pryor JA, Webber BA, Bethune D. Physiotherapy techniques. In: Pryor JA, Prassad SA, eds. Physiotherapy for respiratory and cardiac problems. 3rd ed. Edinburgh, UK: Churchill Livingstone; 1993. 161–242.

    Google Scholar 

  19. Savci S, Ince DI, Arikan H. A comparison of autogenic drainage and the active cycle of breathing techniques in patients with chronic obstructive pulmonary diseases. J Cardiopulm Rehabil 2000;20:37–43.

    CAS  PubMed  Google Scholar 

  20. Wilson G, Baldwin A, Walshaw M. A comparison of traditional chest physiotherapy with the active cycle of breathing in patients with chronic suppurative lung disease. Eur J Respir Dis 1995;8:171s.

    Google Scholar 

  21. Tiep BL. Disease management of COPD with pulmonary rehabilitation. Chest 1997;112:1630–1656.

    CAS  PubMed  Google Scholar 

  22. Allen TW, D’Alonzo GE. Investigating the role of osteopathic manipulation in the treatment of asthma. J Am Osteopath Assoc 1993;93:654–656.

    CAS  PubMed  Google Scholar 

  23. Sleszynski SL, Kelso AF. Comparison of thoracic manipulation with incentive spirometry in preventing postoperative atelectasis. J Am Osteopath Assoc 1993;93:834–838.

    CAS  PubMed  Google Scholar 

  24. Rowane WA, Rowane MP. An osteopathic approach to asthma. J Am Osteopath Assoc 1999;99:259–264.

    CAS  PubMed  Google Scholar 

  25. Neder JA, Nery LE, Silva AC, Cabral AL, Fernandes AL. Short-term effects of aerobic training in the clinical management of moderate to severe asthma in children. Thorax 1999;54:202–206.

    CAS  PubMed  PubMed Central  Google Scholar 

  26. Liu AH, Zeiger R, Sorkness C, Mahr T, Ostrom N, Burgess S et al. Development and cross-sectional validation of the Childhood Asthma Control Test. J Allergy Clin Immunol 2007;119:817–825.

    PubMed  Google Scholar 

  27. Koolen BB, Pijnenburg MW, Brackel HJ, Landstra AM, van den Berg NJ, Merkus PJ et al. Comparing Global Initiative for Asthma (GINA) criteria with the Childhood Asthma Control Test (C-ACT) and Asthma Control Test (ACT). Eur Respir J 2011;38:561–566.

    CAS  PubMed  Google Scholar 

  28. Inal-Ince D, Savci S, Topeli A, Arikan H. Active cycle of breathing techniques in non-invasive ventilation for acute hypercapnic respiratory failure. Aust J Physiother 2004;50:67–73.

    PubMed  Google Scholar 

  29. Mckeown P. Close your mouth: Buteyko breathing clinic self-help Buteyko books. Moycullen, County Galway, Ireland: Buteyko Books Loughwell; 2009. www.ButeykoClinic.com

    Google Scholar 

  30. Courtney R. Strengths, weaknesses, and possibilities of the Buteyko breathing method. Biofeedback 2008;36:59–63.

    Google Scholar 

  31. Lundberg JO, Weitzberg E. Nasal nitric oxide in man. Thorax 1999;54:947–952.

    CAS  PubMed  PubMed Central  Google Scholar 

  32. Koetzler R, Saifeddine M, Yu Z, Schürch FS, Hollenberg MD, Green FH. Surfactant as an airway smooth muscle relaxant. Am J Respir Cell Mol Biol 2006;34:609–615.

    CAS  PubMed  Google Scholar 

  33. Finucane KE, Panizza JA, Singh B. Efficiency of the normal human diaphragm with hyperinflation. J Appl Physiol (1985) 2005;99:1402–1411.

    Google Scholar 

  34. Casaburi R, Porszasz J. Reduction of hyperinflation by pharmacologic and other interventions. Proc Am Thorac Soc 2006;3:185–189.

    PubMed  Google Scholar 

  35. O’Donnell DE. Hyperinflation, dyspnea, and exercise intolerance in chronic obstructive pulmonary disease. Proc Am Thorac Soc 2006;3:180–184.

    PubMed  Google Scholar 

  36. Muller N, Bryan AC, Zamel N. Tonic inspiratory muscle activity as a cause of hyperinflation in asthma. J Appl Physiol Respir Environ Exerc Physiol 1981;50:279–282.

    CAS  PubMed  Google Scholar 

  37. Cowie RL, Conley DP, Underwood MF, Reader PG. A randomised controlled trial of the Buteyko technique as an adjunct to conventional management of asthma. Respir Med 2008;102:726–732.

    PubMed  Google Scholar 

  38. Prasanna K, Sowmiya K, Dhileeban C. Effect of Buteyko breathing exercise in newly diagnosed asthmatic patients. Int J Med Public Health 2015;5:77–81.

    Google Scholar 

  39. Al-Delaimy WK, Hay SM, Gain KR, Jones DT, Crane J. The effects of carbon dioxide on exercise-induced asthma: an unlikely explanation for the effects of Buteyko breathing training. Med J Aust 2001;174:72–74.

    CAS  PubMed  Google Scholar 

  40. Guiney PA, Chou R, Vianna A, Lovenheim J. Effects of osteopathic manipulative treatment on pediatric patients with asthma: a randomized controlled trial. J Am Osteopath Assoc 2005;105:7–12.

    PubMed  Google Scholar 

  41. Wallace E, McPartland JM, Jones JM III, Kuchera WA, Buser BR. Lymphatic system: lymphatic manipulative techniques. In: Ward RC, ed. Foundations for osteopathic medicine. 2nd ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2003. 1056–1077.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Physical Therapy for Disturbances of Growth and Development in Children and its Surgery, Faculty of Physical Therapy, Cairo University, 12613, Cairo, Giza, Egypt

    Ragab K. Elnaggar PhD

  2. Physical Therapy for Cardiovascular, Respiratory Disorders and Geriatrics, Cairo University, Cairo, Egypt

    Mohammed A. Shendy

Authors
  1. Ragab K. Elnaggar PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mohammed A. Shendy
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ragab K. Elnaggar PhD.

Additional information

This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work noncommercially, as long as the author is credited and the new creations are licensed under the identical terms.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Elnaggar, R.K., Shendy, M.A. Efficacy of noninvasive respiratory techniques in the treatment of children with bronchial asthma: a randomized controlled trial. Bull Fac Phys Ther 21, 1–10 (2016). https://doi.org/10.4103/1110-6611.188025

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.4103/1110-6611.188025

Keywords