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Background: The Buteyko Breathing Method is a unique breathing therapy that uses breath control and breath-holding exercises to treat a wide range of health conditions believed to be connected to hyperventilation and low carbon dioxide. The therapy involves instructing patients in controlled shallow breathing through the nose only, with breath-holding at the end of the exhalation and resuming normal breathing calmly and gently. Aim: To Study the immediate effect of Buteyko breathing technique on cardio-respiratory parameters in young Adults Methodology: 80 subjects recruited for the study were explained the entire procedure and subject were taught how to perform Buteyko Breathing Technique (BBT). Baseline HR, BP, RPE and PFT were noted as pre-test evaluation. Post-BBT for 12 min, evaluation was done for outcome measures like HR, RPE, BP and PFT (PEFR, FEV1 and FEF 25-75). Results: When subject performed five minute Buteyko at rest it was seen that HR increased and SBP decreased, the RPE also increased significantly for both males and females and an increase in FEF 25-75 was also observed after five minute of BBT at rest, but it was significant only in females. Conclusion: Buteyko Breathing technique used at rest has significant effect on certain cardio-respiratory parameters in young adults like HR, SBP and RPE.
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International Journal of Health Sciences & Research (www.ijhsr.org) 166
Vol.8; Issue: 7; July 2018
International Journal of Health Sciences and Research
www.ijhsr.org ISSN: 2249-9571
Original Research Article
A Study on Immediate Effect of Buteyko Breathing Technique on Cardio-
Respiratory Parameters in Young Adults
Richa H Rai1, Rashmi Kumari Hembrom2, Priyanka Sharma1, JyotiKataria3
1Assistant Professor, Banarsidas Chandiwala Institute of Physiotherapy, New Delhi
2Student MPT Cardiopulmonary-Banarsidas Chandiwala Institute of Physiotherapy, New Delhi (Assistant Prof,
Dept of Physiotherapy, Assam Downtown University)
3Assistant Professor, School of Physiotherapy, Delhi Pharmaceutical Sciences and Research University,
DPSRU, New Delhi
Corresponding Author: Richa H Rai
ABSTRACT
Background: The Buteyko Breathing Method is a unique breathing therapy that uses breath control
and breath-holding exercises to treat a wide range of health conditions believed to be connected to
hyperventilation and low carbon dioxide. The therapy involves instructing patients in controlled
shallow breathing through the nose only, with breath-holding at the end of the exhalation and
resuming normal breathing calmly and gently.
Aim: To Study the immediate effect of Buteyko breathing technique on cardio-respiratory parameters
in young Adults
Methodology: 80 subjects recruited for the study were explained the entire procedure and subject
were taught how to perform Buteyko Breathing Technique (BBT). Baseline HR, BP, RPE and PFT
were noted as pre-test evaluation. Post-BBT for 12 min, evaluation was done for outcome measures
like HR, RPE, BP and PFT (PEFR, FEV1 and FEF25-75).
Results: When subject performed five minute Buteyko at rest it was seen that HR increased and SBP
decreased, the RPE also increased significantly for both males and females and an increase in FEF25-75
was also observed after five minute of BBT at rest, but it was significant only in females.
Conclusion: Buteyko Breathing technique used at rest has significant effect on certain cardio-
respiratory parameters in young adults like HR, SBP and RPE.
Keywords: Buteyko breathing technique, immediate effect, at rest, Sedentary
INTRODUCTION
Life is absolutely dependent upon
the act of breathing. Breathing is considered
the most important of all the functions of the
body as all other functions depend upon it.
[1] In this modern era we eat more processed
foods, overeat, do less physical exercise and
experience more stresses. Jobs in the
modern economy tend to be service-based.
As a result they entail very little physical
activity and many hours of talking which
entails a lot of over breathing i.e. breathing
a volume of air greater than which we
require. [2]
The Buteyko Breathing Method is a
unique breathing therapy that uses breath
control and breath-holding exercises to treat
a wide range of health conditions believed
to be connected to hyperventilation and low
carbon dioxide. A number of clinical trials
indicate that it is a successful treatment for
asthma; however, there is little support for
the carbon dioxide theory that underpins the
Buteyko Method. There are, however, many
other possible reasons that the breathing
techniques used by the Buteyko Method
Richa H Rai et al. A Study on Immediate Effect of Buteyko Breathing Technique on Cardio-Respiratory
Parameters in Young Adults
International Journal of Health Sciences & Research (www.ijhsr.org) 167
Vol.8; Issue: 7; July 2018
work. These reasons include change in
symptom perception and improved sense of
control, improved biomechanics of
breathing, beneficial effects of low-volume
breathing, altered nitric oxide levels, and
resetting of respiratory rhythm generation
by breath-holding techniques. [3] Thus the
study was taken up to evaluate the
immediate effect of Buteyko Breathing
Technique on cardio-respiratory parameters
in young adults
METHODOLOGY
This was an Observational Study
with a sample size of 80 subjects of the age
group 18-30 years, both sexes, by
convenient sampling, from a reputed
institute, New Delhi.
The subjects who consented to
participate, with Normal BMI, Sedentary
lifestyle and who understand written and
verbal English language were included
whereas those with any history of medical,
surgical, musculoskeletal or systematic
condition which can affect the outcome of
the study, with negative comment on
PARQ, smokers and alcoholic and on
regular medications were excluded.
Instruments used were: Motorized treadmill,
Stop watch, Aneroid BP Apparatus, An RPE
worksheet, Pulse oximeter and Spirometer.
The subjects were monitored for
their Heart Rate(HR)- bpm, Blood
Pressure(BP)- mmHg, Rate of Perceived
Exertion(RPE)-Scores, Peak Expiratory
Flow Rate(PEFR) -L/sec, Forced expiratory
volume in one second(FEV1)-L/sec and
Forced Expiratory Flow(25-75)-L/sec
Trial and Familiarization session
was given and entire procedure was
explained. Subject was demonstrated how to
perform Buteyko Breathing Technique
(BBT) and he was then asked to perform
BBT (Illustration 1). Baseline HR, BP, RPE
and PFT were noted on the Data Collection
Form (DCF) as the readings for BBT at rest.
[2-4] The Control Pause time was noted on
the DCF for the particular individual and it
was minimum 10 to 40 seconds for the
subject to be included in the study. [1,3]
He/she was then asked to practice the
controlled breathing with the amount of
Control Pause noted for each breath cycle,
for 12 min and after this he/she was
evaluated for outcome measures.
The subject was observed for vitals for 30
min and was thanked for his efforts.
Quite inspiration
Quite expiration
Breath hold by using nose clip (As per subject convenience) i.e. Control Pause Period(a)
Followed by Quite inspiration
Quite expiration
Illustration 1: Buteyko Breathing Technique
Richa H Rai et al. A Study on Immediate Effect of Buteyko Breathing Technique on Cardio-Respiratory
Parameters in Young Adults
International Journal of Health Sciences & Research (www.ijhsr.org) 168
Vol.8; Issue: 7; July 2018
RESULT
A total of 80 subjects both males and
females with a mean age of 20.92 ± 1.98
and 20.74±1.71years respectively and a
BMI of 22.81±1.66 and 20.75± 1.59kg/m2
respectively were recruited for the study,
amongst which- 15 (18.8%) were males and
65(81.3%) were females. Paired t Test was
used for data analysis by SPSS software and
a p value of < 0.05 was considered to be
significant. The Cardiac parameters were
analyzed for both the genders at rest. The
mean value for heart rate at rest for males
was found to be 73.60 ± 5.19 bpm and for
females was 73.91 ±4.70 bpm which did not
differ statistically (p =0.14). The mean value
of SBP for males and females were 119.00
± 8.90 mmHg and 115.00 ± 8.66 mmHg
respectively, which differed and were
statistically significant (p=0.000).The
respiratory parameters were also analysed -
The PEFR at rest for males was 4.67± 1.42
and that for females was 3.94± 1.42 L/sec,
which differed statistically (p=0.034). The
other Cardio-respiratory parameters
analyzed did not differ significantly.
For „Subject Performing BBT on
Rest‟ for five minutes, pre and post BBT
session, cardio respiratory parameters were
compared for males and females separately
as we saw there was a significant difference
at rest between certain cardio respiratory
parameters. The result is as seen in Table 1
and Table 2
Table 1: ‘Subject Performing BBT at Rest’: Cardiac Respiratory parameters for Females
Table 2:‘Subject Performing BBT at Rest’: Cardiac Respiratory parameters for males
DISCUSSION
A. Dhawarkar did a comparative study of
Breath holding time (BHT) as index of
Central Ventilatory Response in young
healthy adults of both sexes & suggested
that Progesterone, Estrogen and
Testosterone can influence respiratory
function in humans. [3] Thus in our study we
analyzed our data for males and females
separately.
According to Buteyko breathing
manual, overbreathing is just a habit. The
part of the brain (central chemoreceptor)
that regulates the amount of air one breathes
becomes accustomed to breathing too much.
In a paper entitled Hyperventilation
Syndrome and Asthma, Dr Stephen Demeter
states “prolonged hyperventilation (for more
than 24 hours) seems to sensitize the brain,
leading to a more prolonged
hyperventilation.”[5] Hyperventilation
becomes habitual or long term, so even
when the primary cause is removed, the
behavior is maintained and leads to
hypocapnea. There are different theories as
to why over breathing and loss of CO2
causes airways to narrow. One is that
airways cool and/or dehydrate from having
exposed to condition such a large volume of
air. A paper by Davis and Freed published
in the European Respiratory Journal
concluded that repeated dry air challenge in
dogs in vivo causes persistent airway
obstruction and inflammation similar to that
found in human asthma. [6] Professor
Buteyko and others point to the loss of
Carbon Dioxide (CO2), there is clear
evidence that low CO2 plays a role in
Mean ±SD of Variables
PRE±SD
POST±SD
Difference of mean (Post-Pre)
p-VALUE
HR(BPM)
73.91± 4.70
75.38± 6.57
1.47
0.021*
SBP(mmHg)
115.00± 8.66
110.07± 11.68
(-4.93)
0.000**
DBP(mmHg)
78.77± 4.5
78.31± 4.53
(-0.46)
0.410
RPE
0
1.06± 0.496
1.06
0.000**
PEFR(lit/sec)
3.93±1.42
3.87± 1.34
(-0.06)
0.154
FEF(25-75) (lit/sec)
3.34± 0.86
3.39± 0.85
0.05
0.009**
FEV1(lit/sec)
2.99± 0.66
3.03± 0.67
0.04
0.068
Mean ±SD of Variables
PRE±SD
POST±SD
Difference of mean (Post-Pre)
p-VALUE
HR(BPM)
73.60± 5.19
77.20± 7.83
3.6
0.049
SBP(mmHg)
119.00± 8.90
121.00± 9.67
2
0.164
DBP(mmHg)
79.33± 4.58
80.6± 4.58
1.34
0.433
RPE
0
1.13± 0.63
1.13
0.000**
PEFR(lit/sec)
4.67± 1.66
4.62± 1.42
(-0.05)
0.740
FEF(25-75) (lit/sec)
3.27± 0.86
3.39± 0.84
0.12
0.079
FEV1(lit/sec)
3.12± 0.69
3.18± 0.71
0.06
0.258
Richa H Rai et al. A Study on Immediate Effect of Buteyko Breathing Technique on Cardio-Respiratory
Parameters in Young Adults
International Journal of Health Sciences & Research (www.ijhsr.org) 169
Vol.8; Issue: 7; July 2018
bronchoconstriction and many other types
of physiological dysfunction. [7] During
normal conditions 75% of the intake of
Oxygen is exhaled, while breathing a
healthy volume of 4 - 6 litres per minute.
Even during exercise, it is estimated that
25% of our intake of Oxygen is exhaled.
Breathing a volume greater than normal
does not improve the amount of Oxygen in
the blood, as it is already 97-98% saturated.
Instead it lowers CO2 levels, firstly in the
lungs, then in the blood, tissues and cells
and this reduces the delivery of Oxygen
from the hemoglobin within the red blood
cells. Studies have proved that Carbon
Dioxide relaxes smooth muscle which
surrounds airways, arteries and capillaries.
The heavier one breathes- the more he feeds
hyperventilation-related problems by
increasing histamine levels of the body.
When subject performed five minute
Buteyko at rest it was seen that HR
increased and SBP decreased significantly,
which is a normal physiological response
after a breathing technique. [8-11] The RPE
also increased significantly for both males
and females (Table 1 & 2 ) and an increase
in FEF25-75 was also observed after five
minute of BBT at rest, but it was significant
only in females as seen in Table(1).
Brutona, G.T. Lewith‟s study provides the
background for BBT, reviews the available
evidence for its use and examines the
physiological hypothesis claimed to
underpin it. Their study results indicated
that higher CO2 may exert some
bronchoprotective effect as seen in our
study indicated by FEF25-75
Further study is thus recommended
to evaluate the immediate effect of Buteyko
Breathing Technique during sub-maximal
exercise on cardio-respiratory parameters in
young Adults.
Thus, a normal physiological
response was observed as an immediate
effect of Buteyko Breathing Technique on
cardio-respiratory parameters in young
adults.
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******
How to cite this article: Rai RH, Hembrom RK, Sharma P et al. A study on immediate effect of
buteyko breathing technique on cardio-respiratory parameters in young adults. Int J Health Sci
Res. 2018; 8(7):166-169.
... The subjects who consented to participate, with Normal BMI, Sedentary lifestyle and who understand written and verbal English language were included whereas those with any history of medical, surgical, musculoskeletal or systematic condition which can affect the outcome of the study, with negative comment on PARQ, smokers and alcoholic and on regular medications were excluded. [3] Instruments used were: Motorized treadmill, [4] Stop watch, Aneroid BP Apparatus, An RPE worksheet, Pulse oximeter and Spirometer. ...
... Other demographic variables are shown in Table 1.The study done by Rai R et al showed that there was a significant decrease in SBP at rest in females and after BBT at rest and FEF (25-75) for females increased significantly post BBT. [3] We studied further the same subjects in the present study for the outcome variables for the instance 'Subject Performing Sub Maximal Exercise on Treadmill without BBT' & 'Subject Performing Sub Maximal Exercise on Treadmill with BBT', for males and females separately, as we saw there was a significant difference at rest between certain cardio respiratory parameters. ...
... A. Dhawarkar did a comparative study of Breath holding time (BHT) as index of Central Ventilatory Response in young healthy adults of both sexes & suggested that Progesterone, Estrogens and Testosterone can influence respiratory function in humans. [5] Thus in our studies we analyzed our data for males and females separately When subject performed five minute Buteyko at rest in our prior study it was seen that HR increased and SBP decreased significantly, which is a normal physiological response [3] It was also seen that RPE increased significantly for both males and females and an increase in FEF 25-75 was also observed after five minute of BBT at rest, but it was significant only in females. [3] Brutona, G.T. Lewith's study provides the background for BBT, reviews the available evidence for its use and examines the physiological hypothesis claimed to underpin it. ...
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Background: The Buteyko breathing technique, or Buteyko method, is a physical therapy that is used mainly in the management of respiratory conditions. The therapy involves instructing patients in controlled shallow breathing through the nose only, with breath-holding at the end of the exhalation and resuming normal breathing calmly and gently. Aim: To Study the immediate effect of Buteyko breathing technique during sub-maximal exercise, on cardio-respiratory parameters in young Adults Methodology: 80 subjects recruited for the study were explained the entire procedure and subjects were taught how to perform Buteyko Breathing Technique (BBT). Baseline HR, BP, RPE and PFT were noted as pre-test evaluation and then they were subjected to brisk walking on treadmill with and without BBT randomly. Post-Sub maximal exercise evaluation was done for outcome measures like HR, RPE, BP and PFT (PEFR, FEV1 and FEF (25-75) after both the instances. Results: On comparing the results of instances sub maximal exercise on treadmill with and without BBT, significant change in RPE was found in both Males and Females. Conclusion: Buteyko Breathing technique used during sub-maximal exercise does not have any significant immediate effect on cardio-respiratory parameters in young adults
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Hyperventilation syndrome is a common and often disabling condition. Traditional treatment consists of reassurance and anxiolytic drugs. Hyperventilation is known to precipitate an asthmatic reaction. A retrospective review of patients with hyperventilation syndrome was performed to ascertain the frequency of asthma as well as the response to bronchodilator medication. Forty-seven patients were seen. Thirty-eight were tested, and asthma was proved in 36. Two additional patients had positive clinical responses with bronchodilators. Thus, asthma was identified in 38 of 47 consecutive patients seen for hyperventilation syndrome (80 percent), and asthma was proved in 36 of 38 of patients tested (95 percent). Hyperventilation syndrome was eliminated in 29 of 35 patients (90 percent) treated with a combination of explanation and bronchodilator treatment.
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A Comparative Study of breath holding time as an Index of Central Ventilatory Response in young Healthy Adults of both Sexes
  • A A Dharwadkar
  • B B Chenmarathy
  • A R Dharwadkar
Dharwadkar A A, Chenmarathy B B, Dharwadkar A R. A Comparative Study of breath holding time as an Index of Central Ventilatory Response in young Healthy Adults of both Sexes. J Pharm Biomed Sci 2014;04(09):806-812
Buteyko Breathing Technique Versus Incentive Spirometer on Breath Holding Time after Coronary Artery Bypass Graft
  • El Sayed
  • H A Mohamed
El Sayed H.A. Mohamed, et al. Buteyko Breathing Technique Versus Incentive Spirometer on Breath Holding Time after Coronary Artery Bypass Graft. Med. J. Cairo Univ 2014;82(1):651-656.
Strength, Weakness, and Possibilities of the Buteyko Breathing Method
  • Rosalba Courtneyr
Rosalba CourtneyR. Strength, Weakness, and Possibilities of the Buteyko Breathing Method. Biofeedback 2008;36(2):59-63.
ACSM's Guidelines for Exercise Testing and Prescription
  • D A Mahler
  • V F Froelicher
  • N H Miller
  • T York
Mahler DA, Froelicher VF, Miller NH, York T, eds. ACSM's Guidelines for Exercise Testing and Prescription. 5th ed. Baltimore: Williams & Wilkins; 2006