Biofeedback Effective for Asthma Control

Ninety-four adult, outpatient, paid volunteers with asthma were randomly assigned to one of four conditions: (1) a full protocol, consisting of HRV biofeedback and abdominal breathing through pursed lips and prolonged exhalation); (2) HRV biofeedback alone; (3) placebo EEG biofeedback; and (4) a wait list control. Subjects were first pre-stabilized, using controller medication, and then medication was titrated biweekly by blinded asthma specialists, according to a protocol based on National Heart, Lung, and Blood Institute guidelines which responds to symptoms, spirometry, and home peak flows.

Subjects recorded daily asthma symptoms and twice-daily peak expiratory flows. Spirometry was performed before and after each weekly treatment session under the HRV and placebo biofeedback conditions, and at tri-weekly assessment sessions under the wait list condition. In addition, oscillation resistance was measured tri-weekly.

Compared with the two control groups, subjects in both of the two HRV biofeedback groups were prescribed less medication, with minimal differences between the two active treatments. Improvements averaged one full level of asthma severity. Measures from forced oscillation pneumography similarly showed improvement in pulmonary function. A placebo effect influenced an improvement in asthma symptoms, but not in pulmonary function. Groups did not differ in the occurrence of severe asthma flares.

These results suggest that HRV biofeedback may prove to be a useful adjunct to asthma treatment and may help to reduce dependence on steroid medications. Further evaluation of this method is warranted.

Citation: Lehrer PM, Vaschillo E, Vaschillo B, Lu SE, Scardella A, Siddique M, Habib RH. Biofeedback treatment for asthma. Chest. 2004 Aug; 126 (2): pages 352-61. lehrer@umdnj.edu .