Breathing Retraining: From Sick/Victims to Superhumans

All Clinical Trials of the Buteyko Method

There were 6 randomized controlled trials of the Buteyko method (follow these links in order to read abstracts). You can click on a link to read the abstract of the trial of scroll down (they are all on this page):
• 1995, Mater Hospital, Brisbane, Australia (asthma)
• 1999, Alfred Hospital, Prahan, Australia (asthma)
• 2003, Gisborne Hospital, Gisborne, New Zealand (asthma)
• 2003, Division of Respiratory Medicine, City Hospital, Nottingham, United Kingdom (asthma)
• 2006, Royal Prince Alfred Hospital, Camperdown, Australia (asthma)
• 2008 Calgary COPD and Asthma Program, University of Calgary, Alberta, Canada (asthma)

Soviet medical approbations and trials of the Buteyko method

Apart from asthma, there were Soviet medical approbations or trials on heart disease, cancer, liver cirrhosis and hepatitis B, radiation disease, and HIV-AIDS. The Soviet health care system, for political and social reasons, had always been more centralized than Western ones. Innovations in medicine were usually introduced by the Soviet authorities and health care bureaucracy. New ideas and drugs were often tested in hospitals and research Institutes, which provided higher authorities with reports about the results. In the West, as we know, results of scientific studies or trials are usually published in journals. While the Soviet approach was different, the reliability of their information was comparable. Directors, managers and project leaders of corresponding organizations and departments put their signatures to official reports about such Soviet trials and their approbations. These people were personally responsible for the trustworthiness of the results and their names and copies of the relevant documents, related to the Buteyko trials as well, are still archived in Russia and Ukraine.

Soviet medical approbations and trials of the Buteyko method and health conditions addressed:
• 1981, Sechenov's Med Inst, Moscow, USSR (asthma, with pneumonia, rhinitis, chronic tonsillitis)
• 1990, Shevchenko's Central Hospital, Kiev, Ukraine (radiation disease)
• 1991, Kiev Scientific and Research Instit of Epidemiol and Infect Diseases, Ukraine (HIV-AIDS)
• 1991, Kiev Scient and Res Inst of Epidemiol and Infect Diseases, Ukraine (hepatitis B and liver cirrhosis)
• 2001 Zaporozhsky State Institute of Further Medical Education, Zaporozhie, Ukraine (cancer)

The Buteyko method is applied only for patients with alveolar hyperventilation, since the goal of the technique is to breathe less. This Table with 34 medical research studies (minute ventilation in heart disease, diabetes, cancer, asthma, COPD, ...) suggests which diseases can be addressed with the Buteyko method.


All clinical trials and approbations of the Buteyko breathing method

(in chronological order, with summary and references)

• 1968, Institute of Pulmonology, Leningrad, USSR (bronchial asthma, hypertension and angina pectoris)

50 patients with severe bronchial asthma, hypertension and angina pectoris, all of them with many years of heavy medication, most with steroid deficiencies and organic complications; success rate 95% (Khoroscho, 1982).

Khoroscho A, Interview with Buteyko [in Russian] 1982, in Buteyko method. Its application in medical practice, ed. by K.P. Buteyko, 2nd ed., 1991, Titul, Odessa, p.168-180.


• 1981, Sechenov's Med Inst, Moscow, USSR (asthma, with pneumonia, rhinitis, chronic tonsillitis)

52 children (34 in-patients and 18 out-patients; 3-15 years old) with regular asthma attacks (once per day or more); 41 of them had pneumonia, 27 rhinitis, 36 chronic tonsillitis. All had problems with breathing through the nose, palpitations, and were bronchodilator users. In 1-5 days the patients were able to stop the attacks, cough, blocked nose, and wheezing, using the method. Observations in 1-3 months showed considerable improvements (cessation of heavy attacks or a total disappearance of the symptoms) in 83%, some improvement (less heavy attacks and considerable reduction in medication) in remaining 17%. Their average CP increased from 4 to 30 s, aCO2 from 25 to 36 mm Hg. Higher blood concentrations of IgA, IgM, IgG, and IgE were found, according to laboratory reports. Blood pressure normalised, forced expiratory volume raised over 5 times. Significant increases in lung volume, expiratory speed, and other parameters were found. Average breath holding time (CP) increased from about 3-6 s to over 30 s. For more information on this trial, visit http://www.buteyko.com/research/trials/index_trials.html.


• Reports from two conferences in Moscow and Krasnojarsk in 1988 (large variety of health problems)

In addition to these trials, there were about 30 published reports (Buteyko method, 1992) of about 40 Russian medical doctors and health professionals, who met during two conferences in Moscow and Krasnojarsk in 1988 in order to share their practical experience of application of the Buteyko method in over 20 medical hospitals and clinics in Russia. The total reported number of treated people, according to the published conference proceedings (Buteyko, 1991), was over 3,000. Although most of them had respiratory (asthma, bronchitis, rhinitis, etc.) and cardiovascular (hypertension, angina pectoris, ischemia, etc.) problems, hundreds were treated or relieved from arthritis, osteoporosis, epilepsy, ulcers, gastritis, kidney stone problems, hepatitis, different infertility conditions, skin diseases (e.g., dermatitis, psoriasis, eczema), etc. Typical reported results were either some or essential improvement for over 90% patients, while remaining patients were not able to normalise their breathing parameters due to absence of desire or motivation and quitting the method during its initial stages. Thus, those patients who achieved large CPs significantly improved their health state. Normalization of breathing always leads to dissapperance of symptoms and no need for medication.

Buteyko method. Its application in medical practice, ed. by K.P. Buteyko, 1991, 2nd edition, Titul, Odessa.


• 1990, Shevchenko's Central Hospital, Kiev, Ukraine (radiation disease)

50 patients with radiation sickness due to Chernobyl's nuclear plant disaster. 82% patients had considerable improvement in blood analysis, cardiovascular parameters (blood pressure, pulse, etc.), work of the digestive system, and reduction in medication. No cases of side effects or complications due to the breathing exercises were reported (Bebeshko et al, 1990; p.221, Zimchenko & Romanenko, 1991).

Bebeshko VG, Denisyuk AB, Act regarding the clinical trial of VEDB (Volitional Elimination of Deep Breathing) method or the Buteyko method in accordance with the Cooperation Agreement of January 3, 1990 between the USSR AMS (Academy of Medical Sciences) NRMRC (National Radiation Medical Research Centre) and the therapeutic center "Buteyko Breathing" during 1990, Kiev, 1990.

Zimchenko VN & Romanenko NF, Conclusions on practical trial of Buteyko method, conducted in Department of Radiation Pathology of Central Republican Hospital of Shevchenko region (Ukraine) during 06.03.1990-07.04.1990 [in Russian], in Buteyko method. Its application in medical practice, ed. by K.P. Buteyko, 2nd ed., 1991, Titul, Odessa, p.222-227.


• 1991, Kiev Scientific and Res Inst of Epidemiol and Infect Diseases, Ukraine (HIV-AIDS)

This trial involved 7 young patients with AIDS, two of them had HIV-infection in the lympho-adenopathic stage (Frolov et al, 1991a). Progression of this disease is usually accompanied by a variety of symptoms and complaints in the digestive, immune, cardiovascular, respiratory, hormonal and other systems. The official documents of the Institute provided information about improvements in clinical symptoms and the patients’ quality of life such as emotional stability, irritability, panic attacks, chronic fatigue, insomnia, digestive complaints and some other factors. All symptoms were relieved with no side effects due to breathing retraining. More about this HIV-AIDS trial...


• 1991, Kiev Scient and Res Inst of Epidemiol and Infect Diseases, Ukraine (hepatitis B and liver cirrhosis)

30 patients, mostly 20-40 years old, diagnosed with acute (6 patients) and chronic (18 patients) hepatitis and cirrhosis of the liver (6 patients) applied the Buteyko method, while continuing to use traditional medication (Frolov et al, 1991b). 28 patients had remissions of their symptoms while 25 showed improvements in their blood test results. The official documents report 93% success rate.

Frolov AF, Buteyko KP, Vovk AD, Novosel’tsev VA, Degtyareva RM, Report about approbation of the VEDB (voluntary elimination of deep breathing) method or the Buteyko method in the Clinic of the KSRIEID (Kiev Scientific and Research Institute of Epidemiology and Infectious Diseases) on patients with acute and chronic hepatitis, and liver cirrhosis during 10 January-30 April 1991, Kiev, 1991b.


• 1995, Mater Hospital, Brisbane, Australia (asthma)

20 patients with a long history of asthma and significant medication. In 3 months, they decreased use of relievers (bronchodilators) by 96%, preventers (inhaled steroids) by 49%. Minute volume decreased from 14 l/min to 9.6 l/min. The symptoms' score was improved by 71% (Bowler et al, 1998).

Bowler SD, Green A, Mitchell CA, Buteyko breathing techniques in asthma: a blinded randomized controlled trial, Med J of Australia 1998; 169: 575-578.
Mater Adult Hospital, South Brisbane, QLD. sbowler@mater.org.au
Abstract
OBJECTIVE: To evaluate the effect of Buteyko breathing techniques (BBT) in the management of asthma. DESIGN: Prospective, blinded, randomized study comparing the effect of BBT with control classes in 39 subjects with asthma. The study was conducted from January 1995 to April 1995. PARTICIPANTS AND SETTING: Subjects recruited from the community, aged 12 to 70 years, with asthma and substantial medication use. MAIN OUTCOME MEASURES: Medication use; morning peak expiratory flow (PEF); forced expiratory volume in one second (FEV1); end-tidal (ET) CO2; resting minute volume (MV); and quality of life (QOL) score, measured at three months. RESULTS: No change in daily PEF or FEV1 was noted in either group. At three months, the BBT group had a median reduction in daily beta 2-agonist dose of 904 micrograms (range, 29 micrograms to 3129 micrograms), whereas the control group had a median reduction of 57 micrograms (range, -2343 micrograms to 1143 micrograms) (P = 0.002). Daily inhaled steroid dose fell 49% (range, -100% to 150%) for the BBT group and 0 (range, -82% to +100%) for the control group (P = 0.06). A trend towards greater improvement in QOL score was noted for BBT subjects (P = 0.09). Initial MV was high and similar in both groups; by three months, MV was lower in the BBT group than in the control group (P = 0.004). ET CO2 was low in both groups and did not change with treatment. CONCLUSION: Those practising BBT reduced hyperventilation and their use of beta 2-agonists. A trend toward reduced inhaled steroid use and better quality of life was observed in these patients without objective changes in measures of airway calibre.


• 1997, Perth Academy of Natural Therapies, Australia (chronic fatigue syndrome)

A study by Shellie Gaskin, as a partial fulfillment for a Diploma of Naturopathy, was conducted on 15 people diagnosed with CFS. There were following improvements: fatigue 87%, night sweats 75%, depression 70%, allergies 66%, anxiety 66%, muscular aches 60%, difficulty sleeping 54%, and headaches 50%. After 10-12 weeks all those who continued their breathing exercise regimes reported a 100% reduction in fatigue.


• 1999, Alfred Hospital, Prahan, Australia (asthma)

18 patients with mild to moderate asthma were taught the Buteyko method by a video and compared with 18 control subjects (Opat et al, 2000). The study found a significant improvement in quality of life and significant reduction in inhaled steroid use.

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(7): 557-564.
Department of Epidemiology and Preventive Medicine, Monash Medical School, Alfred Hospital, Prahan, Vic, Australia.
Abstract
The Buteyko Breathing Technique (BBT) is promoted as a drug-free asthma therapy. It is based on the premise that raising blood PaCO2 through hypoventilation can treat asthma. Our study was designed to examine whether the Buteyko Breathing Technique, as taught by a video, is an efficacious asthma therapy. Thirty-six adult subjects with mild to moderate asthma were randomized to receive either a BBT or placebo video to watch at home twice per day for 4 weeks. Asthma-related quality of life, peak expiratory flow (PEF), symptoms, and asthma medication intake were assessed both before and after intervention. Our results demonstrated a significant improvement in quality of life among those assigned to the BBT compared with placebo (p = 0.043), as well as a significant reduction in inhaled bronchodilator intake (p = 0.008). We conclude that the BBT may be effective in improving the quality of life and reducing the intake of inhaled reliever medication in patients with asthma. These results warrant further investigation.


• 2001 Zaporozhsky State Institute of Further Medical Education, Zaporozhie, Ukraine (cancer)

One hundred twenty patients with metastasized breast cancer participated in this controlled study published in Oncology Journal (Kiev). It could be the most successful clinical trial in medical history in relation to metastasized breast cancer: fivefold (!) reduction in 3-year mortality for breathing normalization group. You can read the translated full text of this breast cancer trial, as well as my analysis and the PDF file, of the this trial.

S. N. Paschenko, STUDY OF APPLICATION OF THE REDUCED BREATHING METHOD IN A COMBINED TREATMENT OF BREAST CANCER
Zaporozhsky State Institute of Further Medical Education, Zaporozhie, Ukraine
Oncology (Kiev, Ukraine), 2001, v. 3, No.1, p. 77-78


• 2003, Gisborne Hospital, Gisborne, New Zealand (asthma)

In this blinded randomized controlled trial conducted in 38 people with asthma Buteyko Breathing Technique group was compared with control (McHugh et al, 2003). The Buteyko group was taught by a Buteyko practirtioner Russell Stark. As in the previous western trials, the Buteyko group reduced inhaled steroid use by 50% and 2-agonist use by 85% at six months from baseline. In the conclusions, the medical professionals wrote, “Conclusions BBT is a safe and efficacious asthma management technique. BBT has clinical and potential pharmaco-economic benefits that merit further study.” The instructions for the Buteyko group were provided by Russell Stark.

McHugh P, Aitcheson F, Duncan B, Houghton F, Buteyko breathing technique for asthma: an effective intervention, New Zealand Medical Journal 2003; 116: 1187.
Emergency Department, Gisborne Hospital, Gisborne, New Zealand. mchugh@tdh.org.nz
Abstract
AIM: To assess the impact of the Buteyko Breathing Technique (BBT) on medication use in asthma. METHODS: A blinded randomized controlled trial comparing BBT with control was conducted in 38 people with asthma aged between 18 and 70. Participants were followed for six months following the intervention. Medication use and indices of ventilatory function were recorded. RESULTS: No significant change in FEV1 (forced expiratory volume in one second) was recorded in either group. The BBT group exhibited a reduction in inhaled steroid use of 50% and beta2-agonist use of 85% at six months from baseline. In the control group inhaled steroid use was unchanged and beta2-agonist use was reduced by 37% from baseline. Investigator contact between the two groups was equal. There were no adverse events recorded in either group. CONCLUSIONS: BBT is a safe and efficacious asthma management technique. BBT has clinical and potential pharmaco-economic benefits that merit further study.


• 2003, Division of Respiratory Medicine, City Hospital, Nottingham, United Kingdom (asthma)

90 patients with asthma taking an inhaled corticosteroid participated in a randomized controlled trial. The groups were followed in 3 and 6 month periods (Cooper et al, 2003). “Symptoms remained relatively stable in the PCLE and placebo groups but were reduced in the Buteyko group…The Buteyko breathing technique can improve symptoms and reduce bronchodilator use…”

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 randomized controlled trial, Thorax 2003; 58: 674-679.
Division of Respiratory Medicine, City Hospital, Nottingham NG5 1PB, UK. sue.cooper@nottingham.ac.uk
Abstract
BACKGROUND: Patients with asthma are interested in the use of breathing exercises but their role is uncertain. The effects of the Buteyko breathing technique, a device which mimics pranayama (a yoga breathing technique), and a dummy pranayama device on bronchial responsiveness and symptoms were compared over 6 months in a parallel group study. METHODS: Ninety patients with asthma taking an inhaled corticosteroid were randomized after a 2 week run in period to Eucapnic Buteyko breathing, use of a Pink City Lung Exerciser (PCLE) to mimic pranayama, or a PCLE placebo device. Subjects practised the techniques at home twice daily for 6 months followed by an optional steroid reduction phase. Primary outcome measures were symptom scores and change in the dose of methacholine provoking a 20% fall in FEV(1) (PD(20)) during the first 6 months. RESULTS: Sixty nine patients (78%) completed the study. There was no significant difference in PD(20) between the three groups at 3 or 6 months. Symptoms remained relatively stable in the PCLE and placebo groups but were reduced in the Buteyko group. Median change in symptom scores at 6 months was 0 (interquartile range -1 to 1) in the placebo group, -1 (-2 to 0.75) in the PCLE group, and -3 (-4 to 0) in the Buteyko group (p=0.003 for difference between groups). Bronchodilator use was reduced in the Buteyko group by two puffs/day at 6 months; there was no change in the other two groups (p=0.005). No difference was seen between the groups in FEV(1), exacerbations, or ability to reduce inhaled corticosteroids. CONCLUSION: The Buteyko breathing technique can improve symptoms and reduce bronchodilator use but does not appear to change bronchial responsiveness or lung function in patients with asthma. No benefit was shown for the Pink City Lung Exerciser.


• 2003, Glasgow, United Kingdom (asthma)

According to the recent press release (4 December, 2003) of the British Thoracic Society (the UK’s professional body of respiratory specialists),

“Nurse, Jill McGowan, led the world’s largest clinical trial to measure the effects of the Buteyko method (breathing retraining exercises in conjunction with conventional asthma management). 384 of the initial 600 participants (64%) completed the trial…

Those patients who were taught the Buteyko Institute Method all experienced significant improvement in asthma, with reduced symptoms, reduced medication and improvement in quality of life:

- asthma symptoms decreased by an average of 98%;

- use of reliever inhalers decreased by an average of 98%;

-  use of preventor inhalers decreased by an average of 92%.”

These results were found after 6 months (McGowan, 2003). This self-funded trial was possible due to heroic and sacrificial, in financial terms, efforts of the Buteyko practitioner Jill McGowan.

McGowan J, Health Education: Does the Buteyko Institute Method make a difference? Thorax, 58, Suppl. III, p. 28 December 2003.


• 2005, Foothills Hospital, Calgary, Canada
64 patients, all of whom were using inhaled corticosteroids, after 6 months improved their asthma control from 41% to 75% (Proceedings, 2006). Decrease in inhaled corticosteroids was found in 39% patients, elimination of steroids in 21%.

Proceedings of the American Thoracic Society, 2006; 3: A530.


• 2006, Royal Prince Alfred Hospital, Camperdown, Australia
The Buteyko method was applied for 12 weeks. Median reduction in usage of relievers was 86%, preventers 50% (Slader et al, 2006).

Slader CA, Reddel HK, Spencer LM, Belousova EG, Thien FC, ArmourCL, Bosnic-Anticevich SZ, Jenkins CR, Impact of breathing exercises on asthma symptoms and control, Thorax Journal 2006, 000: 1-7.

Faculty of Pharmacy, University of Sydney, New South Wales, Australia 2006.
BACKGROUND: Previous studies have shown that breathing techniques reduce short acting beta(2) agonist use and improve quality of life (QoL) in asthma. The primary aim of this double blind study was to compare the effects of breathing exercises focusing on shallow nasal breathing with those of non-specific upper body exercises on asthma symptoms, QoL, other measures of disease control, and inhaled corticosteroid (ICS) dose. This study also assessed the effect of peak flow monitoring on outcomes in patients using breathing techniques. METHODS: After a 2 week run in period, 57 subjects were randomized to one of two breathing techniques learned from instructional videos. During the following 30 weeks subjects practised their exercises twice daily and as needed for relief of symptoms. After week 16, two successive ICS downtitration steps were attempted. The primary outcome variables were QoL score and daily symptom score at week 12. RESULTS: Overall there were no clinically important differences between the groups in primary or secondary outcomes at weeks 12 or 28. The QoL score remained unchanged (0.7 at baseline v 0.5 at week 28, p = 0.11 both groups combined), as did lung function and airway responsiveness. However, across both groups, reliever use decreased by 86% (p<0.0001) and ICS dose was reduced by 50% (p<0.0001; p>0.10 between groups). Peak flow monitoring did not have a detrimental effect on asthma outcomes. CONCLUSION: Breathing techniques may be useful in the management of patients with mild asthma symptoms who use a reliever frequently, but there is no evidence to favour shallow nasal breathing over non-specific upper body exercises.


• 2006, Gisborne Hospital, Gisborne, New Zealand
8 children, from 8 to 14 years old, in 12 weeks reduced their average b2-agonist use (salbutamol) by 66%. Inhaled steroid (fluticasone) use reduced by 41% McHugh et al, 2006). While 11 courses of prednisone were given 3 months before the trial, only 1 course of prednisone was given three months after the trial.

McHugh P, Bruce Duncan P, Houghton F, Buteyko breathing technique and asthma in children: a case series, New Zealand Medical Journal Vol 119 No 1234 May 2006.


• 2008 Calgary COPD and Asthma Program, University of Calgary, Alberta, Canada
Cowie RL, Conley DP, Underwood MF, Reader PG, A randomized controlled trial of the Buteyko technique as an adjunct to conventional management of asthma, Respir Med. 2008 May; 102(5): 726-732. Epub 2008 Jan 31.
Calgary COPD and Asthma Program, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta, Canada T2N 4N1. cowie@ucalgary.ca
Abstract
OBJECTIVE: To assess the effectiveness of a non-pharmacological intervention in patients with asthma on conventional therapy including inhaled corticosteroid. DESIGN: A randomized controlled trial of the Buteyko technique in a group of adults with asthma. The control group was trained by a physiotherapist in breathing and relaxation techniques. SETTING: A single centre associated with a University-based asthma programme. MAIN OUTCOME MEASURE: Asthma control, defined by a composite score based on the Canadian asthma consensus report 6 months after completion of the intervention. RESULTS: Both groups showed substantial and similar improvement and a high proportion with asthma control 6 months after completion of the intervention. In the Buteyko group the proportion with asthma control increased from 40% to 79% and in the control group from 44% to 72%. In addition the Buteyko group had significantly reduced their inhaled corticosteroid therapy compared with the control group (p=0.02). None of the other differences between the groups at 6 months were significant. CONCLUSIONS: Six months after completion of the interventions, a large majority of subjects in each group displayed control of their asthma with the additional benefit of reduction in inhaled corticosteroid use in the Buteyko group. The Buteyko technique, an established and widely recognised intervention, or an intensive programme delivered by a chest physiotherapist appear to provide additional benefit for adult patients with asthma who are being treated with inhaled corticosteroid.


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