Breathing exercises for children with asthma. 2016

Thalita M F Macêdo, and Diana A Freitas, and Gabriela S S Chaves, and Elizabeth A Holloway, and Karla M P P Mendonça
Department of Physical Therapy, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.

BACKGROUND Asthma is the most common chronic disease in childhood. Breathing exercise techniques have been widely used by researchers and professionals in the search for complementary therapies for the treatment of asthma. OBJECTIVE To assess the effects of breathing exercises in children with asthma. METHODS We searched for trials in the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, PsycINFO, CINAHL and AMED and handsearched respiratory journals and meeting abstracts. We also consulted trial registers and reference lists of included articles.The literature search was run up to September 2015. METHODS We included randomised controlled trials of breathing exercises alone versus control or breathing exercises as part of a more complex intervention versus control in children with asthma. METHODS Two review authors independently assessed trial quality and extracted data. The primary outcomes were quality of life, asthma symptoms and serious adverse events. The secondary outcomes were reduction in medication usage, number of acute exacerbations, physiological measures (lung function (especially low flow rates) and functional capacity), days off school and adverse events. RESULTS The review included three studies involving 112 participants. All the included studies performed the comparison breathing exercises as part of a more complex intervention versus control. There were no trials comparing breathing exercises alone with control. Asthma severity of participants from the included studies varied. The studies measured: quality of life, asthma symptoms, reduction in medication usage, number of acute exacerbations and lung function. Breathing exercise techniques used by the included studies consisted of lateral costal breathing, diaphragmatic breathing, inspiratory patterns and pursed lips. One study included in the review did not specify the type of breathing exercise used. The control groups received different interventions: one received placebo treatment, one an educational programme and doctor appointments, and one was not described. There were no reported between-group comparisons for any of the primary outcomes. We judged the included studies as having an unclear risk of bias. CONCLUSIONS We could draw no reliable conclusions concerning the use of breathing exercises for children with asthma in clinical practice. The breathing exercises were part of a more comprehensive package of care, and could not be assessed on their own. Moreover, there were methodological differences among the three small included studies and poor reporting of methodological aspects and results in most of the included studies.

UI MeSH Term Description Entries
D008168 Lung Either of the pair of organs occupying the cavity of the thorax that effect the aeration of the blood. Lungs
D011788 Quality of Life A generic concept reflecting concern with the modification and enhancement of life attributes, e.g., physical, political, moral, social environment as well as health and disease. HRQOL,Health-Related Quality Of Life,Life Quality,Health Related Quality Of Life
D001945 Breathing Exercises Therapeutic exercises aimed to deepen inspiration or expiration or even to alter the rate and rhythm of respiration. Respiratory Muscle Training,Exercise, Breathing,Muscle Training, Respiratory,Training, Respiratory Muscle
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001249 Asthma A form of bronchial disorder with three distinct components: airway hyper-responsiveness (RESPIRATORY HYPERSENSITIVITY), airway INFLAMMATION, and intermittent AIRWAY OBSTRUCTION. It is characterized by spasmodic contraction of airway smooth muscle, WHEEZING, and dyspnea (DYSPNEA, PAROXYSMAL). Asthma, Bronchial,Bronchial Asthma,Asthmas
D016032 Randomized Controlled Trials as Topic Works about clinical trials that involve at least one test treatment and one control treatment, concurrent enrollment and follow-up of the test- and control-treated groups, and in which the treatments to be administered are selected by a random process, such as the use of a random-numbers table. Clinical Trials, Randomized,Controlled Clinical Trials, Randomized,Trials, Randomized Clinical
D018927 Anti-Asthmatic Agents Drugs that are used to treat asthma. Anti-Asthmatic,Anti-Asthmatic Agent,Anti-Asthmatic Drug,Antiasthmatic,Antiasthmatic Agent,Antiasthmatic Drug,Anti-Asthmatic Drugs,Anti-Asthmatics,Antiasthmatic Agents,Antiasthmatic Drugs,Antiasthmatics,Agent, Anti-Asthmatic,Agent, Antiasthmatic,Agents, Anti-Asthmatic,Agents, Antiasthmatic,Anti Asthmatic,Anti Asthmatic Agent,Anti Asthmatic Agents,Anti Asthmatic Drug,Anti Asthmatic Drugs,Anti Asthmatics,Drug, Anti-Asthmatic,Drug, Antiasthmatic,Drugs, Anti-Asthmatic,Drugs, Antiasthmatic

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