Overview & Efficacy: A relatively large, controlled study by Lehrer et al (2004) showed that biofeedback can have a highly significant impact on the severity of asthma related symptoms. Small clinical studies have also shown positive effects of biofeedback.

This therapy is rated as probably efficacious (level 3 on a scale of 1 - 5 with 5 being the best).

Why biofeedback would help this problem: Many people with asthma have an unusual breathing pattern in which they take a deep breath and then breathe in and out with very shallow, rapid breaths rather than exhaling all the way. This prevents their being able to take reasonably deep breaths and leaves them chronically short of breath. Many workers consider it essential to train asthmatics not to barrel breathe. Pneumographic biofeedback is perfect for detecting and retraining this pattern. Asthmatics can be taught to recognize and correct abnormal interactions between heart rate variability and breathing. Correcting this abnormal relationship has been shown to reduce the symptoms of asthma.

Brief summary of evidence supporting the efficacy of biofeedback for asthma

Lehrer et al (2004) recently performed a controlled study in which 94 asthmatics were trained (or not if they were in the control group) using heart rate variability biofeedback with excellent results. Other studies have found signs of reduced inflammation of the lungs and reduced respiratory impedance coincident with reduced symptoms (Kern-Buell, Lehrer et al., 1997; Lehrer, McGrady, Conran, & Nelson, 2000, Lehrer, Smetankin, & Potapova, 2000)

* Much of the information provided here is from Carolyn Yucha and Christopher Gilbert's 2004 book "Evidence Based Practice in Biofeedback & Neurofeedback" AAPB, Wheat Ridge, CO.

Detailed information on biofeedback augmented treatment of asthma

A. Citations to the papers summarized in the "brief summary":

Kern-Buell, C.L., McGrady, A.V., Conran, P.B., & Nelson, L.A. (2000). Asthma severity, psychophysiological indicators of arousal, and immune function in asthma patients undergoing biofeedback-assisted relaxation. Applied Psychophysiology and Biofeedback, 25(2), 79-91.

Lehrer, P., Carr, R.E., Smetankine, A., Vaschillo, E., Peper, E., Porges, S., et al. (1997). Respiratory sinus arrhythmia versus neck/trapezius EMG and incentive inspirometry biofeedback for asthma: A pilot study. Applied Psychophysiology and Biofeedback, 22(2), 95-109.

Lehrer, P., Smetankin, A., & Potapova, T. (2000). Respiratory sinus arrhythmia biofeedback therapy for asthma: A report of 20 unmedicated pediatric cases using the Smetankin method Applied Psychophysiology and Biofeedback, 25(3), 193-200.

Lehrer et al 2004 ____________________________________________