Breathing techniques to reduce symptoms in people with serious respiratory illness: a systematic review.


Journal

European respiratory review : an official journal of the European Respiratory Society
ISSN: 1600-0617
Titre abrégé: Eur Respir Rev
Pays: England
ID NLM: 9111391

Informations de publication

Date de publication:
Oct 2024
Historique:
received: 23 01 2024
accepted: 24 06 2024
medline: 31 10 2024
pubmed: 31 10 2024
entrez: 30 10 2024
Statut: epublish

Résumé

In adults with serious respiratory illness, breathlessness is prevalent and associated with reduced health-related quality of life. The aim of this review was to assess the impact of breathing techniques on breathlessness in adults with serious respiratory illness. Electronic databases were searched to identify randomised controlled trials testing breathing techniques (techniques that aim to alter the respiratory pattern, excluding respiratory muscle training) in people with serious respiratory illness. The primary outcome was breathlessness and secondary outcomes were health-related quality of life and adverse events. Two authors independently screened for inclusion, evaluated risk of bias and extracted data. 73 randomised controlled trials were included with 5479 participants, most with COPD or asthma. Breathing exercises (pursed lip and/or diaphragmatic breathing) reduced breathlessness measured by the modified Medical Research Council scale compared to usual care (mean difference (MD) -0.40 points, 95% CI -0.70- -0.11, eight studies, n=323), although the effect did not exceed the minimal important difference. Yoga breathing also improved modified Medical Research Council score compared to usual care (MD -1.05 points, 95% CI -2.45-0.35, three studies, n=175). Breathing techniques consistently improved health-related quality of life in people with COPD and asthma on multiple health-related quality of life measures in comparison to usual care, with effects that generally exceeded the minimal important difference. No adverse events related to breathing techniques were reported. Breathing techniques may improve breathlessness, and consistently improve health-related quality of life, in people with serious respiratory illness. These findings support the use of breathing exercises in the care of people with serious respiratory illness.

Sections du résumé

BACKGROUND BACKGROUND
In adults with serious respiratory illness, breathlessness is prevalent and associated with reduced health-related quality of life. The aim of this review was to assess the impact of breathing techniques on breathlessness in adults with serious respiratory illness.
METHODS METHODS
Electronic databases were searched to identify randomised controlled trials testing breathing techniques (techniques that aim to alter the respiratory pattern, excluding respiratory muscle training) in people with serious respiratory illness. The primary outcome was breathlessness and secondary outcomes were health-related quality of life and adverse events. Two authors independently screened for inclusion, evaluated risk of bias and extracted data.
RESULTS RESULTS
73 randomised controlled trials were included with 5479 participants, most with COPD or asthma. Breathing exercises (pursed lip and/or diaphragmatic breathing) reduced breathlessness measured by the modified Medical Research Council scale compared to usual care (mean difference (MD) -0.40 points, 95% CI -0.70- -0.11, eight studies, n=323), although the effect did not exceed the minimal important difference. Yoga breathing also improved modified Medical Research Council score compared to usual care (MD -1.05 points, 95% CI -2.45-0.35, three studies, n=175). Breathing techniques consistently improved health-related quality of life in people with COPD and asthma on multiple health-related quality of life measures in comparison to usual care, with effects that generally exceeded the minimal important difference. No adverse events related to breathing techniques were reported.
CONCLUSION CONCLUSIONS
Breathing techniques may improve breathlessness, and consistently improve health-related quality of life, in people with serious respiratory illness. These findings support the use of breathing exercises in the care of people with serious respiratory illness.

Identifiants

pubmed: 39477355
pii: 33/174/240012
doi: 10.1183/16000617.0012-2024
pii:
doi:

Types de publication

Systematic Review Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright ©The authors 2024.

Déclaration de conflit d'intérêts

Conflicts of interest: L. Romero declares funding from the European Respiratory Society to design search strategies for this review. A.E. Holland declares authorship on one of the systematic reviews included in this study but no other conflicts of interest. All other authors declare no conflicts of interest.

Auteurs

Angela T Burge (AT)

Department of Physiotherapy, Alfred Health, Melbourne, Australia.
School of Translational Medicine, Monash University, Melbourne, Australia.

Adelle M Gadowski (AM)

School of Translational Medicine, Monash University, Melbourne, Australia.

Alice Jones (A)

School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.

Lorena Romero (L)

The Ian Potter Library, Alfred Health, Melbourne, Australia.

Natasha E Smallwood (NE)

School of Translational Medicine, Monash University, Melbourne, Australia.
Department of Respiratory Medicine, Alfred Health, Melbourne, Australia.

Magnus Ekström (M)

Respiratory Medicine, Allergology and Palliative Medicine, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.

Lynn F Reinke (LF)

College of Nursing, University of Utah, Salt Lake City, UT, USA.

Ravijyot Saggu (R)

Pharmacy Medicines Management Team, Central London Community Healthcare Trust, London, UK.

Marlies Wijsenbeek (M)

Centre for Interstitial Lung Diseases and Sarcoidosis, Department of Respiratory Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands.

Anne E Holland (AE)

Department of Physiotherapy, Alfred Health, Melbourne, Australia anne.holland@monash.edu.
School of Translational Medicine, Monash University, Melbourne, Australia.
Department of Respiratory Medicine, Alfred Health, Melbourne, Australia.
Institute for Breathing and Sleep, Melbourne, Australia.

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