Speech-guided breathing retraining in asthma: a randomised controlled crossover trial in real-life outpatient settings

Dietrich von Bonin, Sabine D Klein, Jana Würker, Eva Streit, Oliver Avianus, Christian Grah, Jörg Salomon, Ursula Wolf, Dietrich von Bonin, Sabine D Klein, Jana Würker, Eva Streit, Oliver Avianus, Christian Grah, Jörg Salomon, Ursula Wolf

Abstract

Background: Breathing retraining techniques have received increased attention in the management of asthma, because there is growing evidence of the usefulness of such methods in improving quality of life, reducing symptoms and reducing bronchodilator use. Our study investigated the effect of anthroposophic therapeutic speech (ATS), which uses sounds and syllabic rhythm to improve articulation, breathing and cardiorespiratory interaction, in patients with asthma in a real-life outpatient setting.

Methods: In a randomised controlled crossover trial, patients with asthma in three centres in Switzerland and Germany were randomised to either receive 11 ATS sessions or to wait. Subsequently, patients changed either to wait or to receive ATS. Primary outcomes were changes from the beginning to the end of each phase in the Asthma Quality of Life Questionnaire (AQLQ) and spirometry parameters. Secondary outcomes were changes in inhaled glucocorticoids, the Asthma Control Test (ACT), peak flow and asthma exacerbations.

Results: Altogether, 63 patients were randomised, of which 56 were enrolled and 49 completed the study. Statistically significant differences between the ATS groups and waiting control groups were found for the overall AQLQ score (d = 0.86, p = 0.001) and the domain scores for symptoms, activity limitation and emotional function as well as ACT score (d = 0.53, p = 0.048). No significant differences were observed in spirometry parameters, inhaled glucocorticoids, peak flow and days without asthma exacerbation per week. No serious adverse events occurred during ATS sessions.

Conclusions: ATS significantly improves asthma control and quality of life in patients with asthma. Whether ATS may improve lung function remains to be shown.

Trial registration: ClinicalTrials.gov NCT02501824 . Retrospectively registered on 8 July 2015.

Keywords: Anthroposophic therapeutic speech; Asthma; Breathing; Lung function; Quality of life.

Conflict of interest statement

Ethics approval and consent to participate

The trial was approved by the ethical committees (Bern KEK 115/10, Basel EKBB 35/11 and Berlin KEK 115/10). All participants consented to participate and signed an informed consent form prior to the beginning of the interventions.

Consent for publication

Not applicable

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Flow of participants in the study. ATS anthroposophic therapeutic speech
Fig. 2
Fig. 2
Box plots of overall AQLQ and ACT scores. Data at baseline, after waiting phase and after ATS, subdivided into the two groups are shown. Circles represent outliers. Spirometry parameters are not displayed, since no significant changes were observed. ACT Asthma Control Test, AQLQ Asthma Quality of Life Questionnaire, ATS anthroposophic therapeutic speech

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Source: PubMed

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