Mater Hospital, Brisbane 1995
A clinical trial funded by Australian Association of Asthma Foundations was conducted in December 1994- January 1995 through the Mater Hospital (Brisbane). It was conducted by Professor Charles Mitchell and Doctor Simon Bowler. The results were released at the conference for Thoracic physicians Society in Hobart in March 1995.
To compare the efficacy of the Buteyko Method with the conventional asthma treatment 39 asthmatics were recruited following a publicity campaign. All individuals gave a convincing history of asthma and were taking significant doses of asthma medication. They were randomly divided into two groups which were stratified by daily bronchodilators use. Before division medication intake was optimised for one month to minimise usage of bronchodilators. The control group was trained by a physiotherapist in conventional techniques including relaxation, coughing and abdominal breathing techniques. In the Buteyko group Buteyko method was taught by an experienced Buteyko Practitioner. The trial was 'blind' which means, that neither group was aware of which group they were in.
During the trial asthmatics in both groups were asked to use bronchodilating medication only to overcome asthma symptoms, attempting to minimise bronchodilator usage. Subjects were also required not to change their steroid medication intake during the initial six weeks of the trial. Medication usage, symptoms levels and respiratory parameters were recorded in diary cards for every patient.
|Buteyko group||Control group|
|Bronchodilator use at 3 months||90% decrease||9% increase|
|Inhaled steroids use at 3 months||49% decrease||no change|
|Symptoms score at 3 months||71% improvement||14% improvement|
|Quality of life at 6 weeks||54% improvement||24% worsening|
At the end of 4 weeks run-in period, at 6 weeks and at 3 months patients from both groups answered a self-administrated quality of life questionnaire. Quality of life was estimated accordingly to the impact of asthma on breathing, mood, social activity and concern for the future.
Sechenov's Medical Institute, Moscow 1981
This is a translation of original report by doctors K.Buteyko and V.Genina. Note that the Buteyko method here is referred as "Balanced Volume Breathing method".
K. P. BUTEYKO V. A. GENINA
* BVB Balanced Volume Breathing
The BVB method was tested and approved by the E.M.Sechenov's Medical Institute between 27.2.81 and 21.5.81
The method is based on a conscious decrease in depth of breathing and specifically designed for patients suffering from bronchial asthma. It is based on the fact that clinical results show improvement proportional to the decrease in lung ventilation.
The trial involved patients suffering from regular asthma attacks (once a day or more) during the previous month. Some of the patients had severe asthmatic conditions leading to asphyxia. The purpose of the experiment was to demonstrate the relationship between the major symptoms of the disease (bronchospasm, cough, blockage of nose, etc.) and hyperventilation. The patients were asked to undergo a three stage hyperventilation test (developed by Professor Buteyko in 1968).
- The test was conducted in a sitting position. The patients were asked to use the BVB method. In 1 to 5 minutes of using the method asthma symptoms decreased or disappeared and the patients experienced relief from tightness, wheezing, cough or rhinitis.
- On the second stage patients were asked to do the opposite: to breathe deeply for 15 to 60 seconds to provoke symptoms of asthma.
- The patients were asked to return to the BVB and thus prevent the onset of the attack independently.
|male||female||3-5 y.o.||6-10 y.o.||11-15 y.o.|
If the patients did not understand the relationship between the hyperventilation and the disease, the test was repeated. The test was not conducted if the patients took a bronchodilator 1.5 to 2 hours prior to the test. Fifty two patients between the ages of 3 and 15 were treated according to the BVB method: 36 boys (69%) and 16 girls (31%). 16 from 52 children (65%) were hospitalised, 18 or (35%) were outpatients Twenty-four or (46%) had atopic bronchial asthma, 22 or (42%) had mixed bronchial asthma and 6 or (12%) had bacterial allergy bronchial asthma. The majority of the patients (36) had been suffering from this condition for up to 5 years, 12 for between 6 to 10 years and 4 from 11 to 15 years. The patients were divided into three categories: mild, severe and very severe (see Table II).
|Indoor patients||34||0||24 (70.6%)||10 (29.4%)|
|Outdoor patients||18||1 (5.5%)||13 (72.2%)||4 (22%)|
|Total||52||1 (1.9%)||37 (71.1%)||14 (26.9%)|
According to patients' histories, 41 cases (79%) had pneumonia 1 to 7 times. Four (8%) were taking corticosteroids (prednisone tablets) prior to the BVB treatment. Six (11%) were physically handicapped, 9 (17%) were obese; all the children had bad posture, 11(21.2%) had chest deformity. Most of the children (33 or 64%) had allergic reactions to medication, 34 (65%) allergic reactions to food and 25 (48%) allergic reactions to dust. Twenty-seven (52%) suffered from rhinitis, 18 (34.6%) had Quinke's oedema. 47 (90%) had a predisposition to colds and flu. All had problems with breathing through the nose, 36 (69%) chronic tonsillitis, 11(21%) sinus problems. 23 (44%) had frequent headaches, all had palpitations and 13 (25%) had unstable body temperature.
Acute periods of their condition were accompanied by the following symptoms: 31(59%) had sleeping problems, 16 (31%) had loss of appetite and 13 (25%) constipation. Of the 52 children 47 (90%) were regular hospital patients and only 5 (10%) did not require hospitalisation.
Prior to the BVB treatment, all children had antibiotics treatment. all had to use bronchodilators, 37 (71.2%) were using Intal over prolonged periods, 15 (29%) were taking anti histamines. All these treatments were having little effect.
The course of the BVB treatment consisted of a daily training of 40 to 90 minutes exercise in the mornings under the supervision of the specialist: self training included 3 to 5 hours under the supervision of the instructor or the parents. The majority of the children mastered the method in 5 to 10 minutes; they were eager, disciplined and enthusiastic.
After 1 to 5 days of the BVB treatment, the patients were able to stop their asthma attacks, coughs, blocked noses and wheezing. The patients were encouraged to use the BVB method rather than their medication to overcome their attacks. Thirty-eight (73%) discontinued their medication as soon as they commenced the BVB method. Eight (15%) cut down on their medication after 3 to 4 days. Steroid medications however were an exception. They had to be reduced gradually. The patients were allowed to take their medication in conjunction with the treatment. only if they were unable to stop the attack after 10 to 15 minutes with the BVB method. For these cases, medication dosage was reduced by a factor of 2 to 3 and remained sufficient to stop the attack.
Fifty two children were observed for between 29 and 84 days. The results were based on the following criteria:
- no improvement;
- some improvement (the degree of attacks is lessened together with a considerable reduction in medication);
- considerable improvement (cessation of the heavy attacks, slight traces of the disease or a total disappearance of the symptoms).
The results are listed in Table III.
|Group||Number||Considerable improvement||Some improvement||No improvement||Worsening|
|Indoor patients||34||28 (82.4%)||6 (17.6%)||0||0|
|Outdoor patients||18||15 (83.3%)||3 (16.7%)||0||0|
|Total||52||43 (82.7%)||9 (17.3%)||0||0|
Forty-three (83%) of the patients showed considerable improvement and nine (17%) showed some improvement. There were no cases showing no improvement. The average period of hospitalisation was 16 days. MI the patients with bronchial asthma (52) improved in the first four days. They could breath freely through the nose and their coughs and wheezing disappeared. Fifteen experienced self-cleansing reactions, manifesting themselves through nervous excitement, chills, raised temperatures (up to 390), headaches, muscular pains, intestinal pains. chest pains, weakness and hyper secretion of, mucus. Some experienced appetite loss, nausea. vomiting, thirst, excessive salivation (smelling of their medication) and increased urination and defecation. These reactions lasted from a few hours to two days and happened 2 to 3 times. The tie in the condition of the patient was relative to the length of the control pause (A measure of the concentration of carbon dioxide in the alveoli. Clinically defined as the length of time (or which a patient is comfortable after a normal exhalation though the nose.).
The clinical observations of the dynamics and the functions of the bronchi were researched simultaneously (using Tiffno tests and Rait scale). All the patients showed the following results during the first fourteen days of the BVB treatment.
|Severity||Number||Run in||40 min||7 days||14 days||30 days|
|Mild and moderate||26||+76±8%||+121±8%||+161±18%||+173±10%||+139±9%|
As the control pause increased from 10 to 40 seconds, so did the concentrations of IgA, IgM, IgG and IgE. Forced expiratory volume (Rait's measuring scale) was raised front 36.7 to 173.2 (Table IV). The acid-alkali balance of the blood normalised (it became less basic), the pCO2 of the arterial blood increased from 24.6 to 36.3 mm Hg. Control pause increased from 3.9 ± 0.3 seconds to 31.4 ± 4.7 seconds (Table V).
|Severity||Number||Run in||40 min||7 days||14 days||30 days|
|Mild and moderate||26||+5.4±0.7%||+12.5±1.8%||+24.0±3.9%||+28.3±6.4%||+31.4±4.7%|
Patients with severe cases of asthma increased their lung capacities by 27%; the allergic resistance increased by 33%:
|Severity||Number||Lung volume||Allergic resistance||Expiratory flow|
|Mild and moderate||Run in||15||+55.3%||+48.0%||+51.0%|
- The BVB method as suggested by Professor Buteyko helps to decrease the number and severity of attacks as well as the dosage of medication.
- As a result of this therapy, the indicators of acid-alkali balance and lung ventilation improved.
- The method may be taught to children from 3 years of age up either in hospital or as outpatients.
- This method is endured by children of any age over 3.
- This method is most effective in acute periods of bronchial asthma in very ill patients.