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Approach to the Buteyko Method

Find out what the Buteyko method is and how it can help you if you have a chronic respiratory condition

 

Historic context

El Buteyko method It was originally developed by the Ukrainian physiologist Kostantin Pavlovich Buteyko (1923-2003), in the 50s, in Russia (1). Dr. Buteyko noted that many medical conditions, including asthma, cause or exacerbate respiratory failure and hyperventilation. Faced with this situation, the following question was raised: is the underlying disease what leads people to adopt a non-physiological respiratory pattern and, therefore, to hyperventilation?, or is this altered respiratory pattern what negatively influences the underlying disease and leads to hyperventilation? Thus, he developed his method based on the theory that if he re-educated his patients' respiratory pattern, it would have a positive effect on their general state of health and reverse hyperventilation.

The first official study on the effectiveness of the Buteyko method in patients with asthma was conducted in 1968 at the Leningrad Institute of Pulmonology. Twelve years later, in 1980, a second study was carried out at the Institute of Pediatric Diseases in Moscow, which led to the inclusion of the Buteyko method in the state guidelines for the treatment of bronchial asthma, to the appointment of the doctor as an honorary son of the hospital. Moscow and the practice of his method spread throughout the country(2).

Subsequently, the Buteyko method was introduced in Australia by Professor Alexander Stalmatski, in the UK by Patrick Mckeown, in the USA by Susan Neves and in New Zealand by Russell Stark.

Currently there are official instructors of the Buteyko method throughout the world, about 20 books whose main theme is to explain what the method consists of and how it can be applied in different pathologies, and about 50 clinical trials that study its efficacy in different aspects related to health of children and adults.

Basic theoretical notions

Having a respiratory affectation can alter the pattern of our breathing and this can lead to unwanted biomechanical, biochemical, physiological and psychological consequences.

At a biomechanical level, we can observe how people with respiratory problems can have faster, irregular breathing, an increase in minute volume, a movement pattern with upper chest predominance and even mouth breathing.

This non-physiological respiratory pattern would fit with what we know up to now as dysfunctional breathing. In addition, this pattern is influenced by the sensation of lack of air or dyspnea, as if no breath of air was enough to "fill the lungs". However, breathing like this not only does not resolve this sensation of dyspnea, but also feeds it back further and can lead to hyperventilation and even respiratory alkalosis(3).

La hyperventilation It does not appear exclusively in respiratory conditions, it is the ventilatory pattern adopted by people who are experiencing states of anxiety or panic attacks. This respiratory pattern is an alert response to a threat or danger, activates the sympathetic nervous system, feeds back states of anxiety, a feeling of lack of air, and can alter the ratio between oxygen and CO2 in the lungs and blood.

This dysfunctional breathing is not the origin of the respiratory or anxiety problem, but it certainly contributes to making them worse(4).

Also, the way we breathe during the day influences the way we breathe at night and this can interfere with our quality of sleep. In children it can even determine the orofacial development of the skull structure and increases the predisposition to suffer certain dental and respiratory problems and even behavioral and/or concentration problems(5).

The way we breathe influences our quality of life, as simple and radical as that. Therefore, restoring a natural respiratory pattern helps to have better control of the symptoms that we may have, for example, as a result of a respiratory disease.

What is the Buteyko method?

The intervention or treatment through the Buteyko method consists of the practice and integration of low volume and low inspiratory flow breathing exercises, with the introduction of progressively longer expiratory pauses, exercises to decongest the upper airway, reduction of minute volume, re-education of the pattern biomechanics, respiratory control and habituation to the sensation of lack of air. Most exercises are practiced statically and dynamically.

The introduction of the different exercises is guided by the evolution of a series of measures such as the respiratory pause, the steps and the maximum pause, as well as the symptoms and tolerance to them. The regulation of intensity, repetitions, duration and ultimately workload will be borne by the trained and certified professional who directs the sessions. If the practitioner has an underlying disease of respiratory origin, it is important that they seek an instructor with health training.

The Buteyko method is not intended to replace the use of medication or other interventions such as respiratory physiotherapy; in fact, it is in combination with these therapeutic approaches that the maximum benefits of this treatment can be obtained(6).

How can the Buteyko method help you if you have a chronic respiratory disease?

Scientific evidence has already shown that professional intervention with the Buteyko method can reduce symptoms and the use of rescue medication in pathologies such as asthma, chronic obstructive pulmonary disease (COPD) and chronic hyperventilation(7).

In the 2003 British asthma management guidelines(8), the use of the Buteyko method is recommended as a non-pharmacological intervention to improve control of this disease.

Below we will review some of the studies that have demonstrated the efficacy of the Buteyko method, especially in the treatment of asthma in both the pediatric and adult populations:

In 2021, a controlled study was carried out by Vagedes et al.(9) The authors investigated the effect of the Buteyko method added to basic medical and physiotherapy treatment in children aged 6 to 15 years with moderate and mild asthma. The results of this study revealed that the children who received training with the Buteyko method in addition to their usual treatment improved certain spirometric parameters as well as the emotional management of the family.

In 2009, another clinical study(10) was published that studied the efficacy of the Buteyko method in the adult population with moderate asthma. The results showed a significant improvement in the quality of life of the subjects treated with the Buteyko method as well as a significant reduction in the use of inhaled rescue medication.

In 2008, a clinical study carried out in Canada by Robert L. Cowie and his team(6) studied the effects, 6 months later, of adding the Buteyko method to medical treatment and regular respiratory physiotherapy in adults with asthma. The intervention had positive effects on disease management and reduced use of inhaled corticosteroids; deducing that the addition of the Buteyko method in the range of respiratory physiotherapy interventions can be beneficial for patients.

This study published in New Zealand in 2006 in adults diagnosed with asthma(11) concluded that Buteyko method intervention in the adult population with asthma is safe and effective and may have pharmacoeconomic benefits.

These are just some of the studies that support the Buteyko method as a safe and effective intervention that can help people achieve better management of their symptoms and therefore increase their quality of life. In the future, it would be interesting to study the benefits that its integration into the current treatment of certain pathologies may entail in terms of reducing health economic costs in pathologies with a high worldwide incidence such as bronchial asthma.

Don't miss the interview with Patrick McKeown about the Buteyko Method and how it can help you improve your health!

 

 

The interview was conducted by Ester Gálvez Martinez, respiratory physiotherapist, HappyAir Coach and founder of RespiFit, within the framework of the face-to-face Certification Course in the Buteyko Method (CERTBBM) held in Barcelona, ​​Spain, on May 4-7, 2023.

 

Bibliography

1. The Buteyko breathing technique for asthma: a review. Bruton A. et al. Complement Ther Med 13 (1): 41-46. PMID 15907677. doi:10.1016/j.ctim.(2005).01.003.

2. A Study to Assess the Knowledge Regarding Buteyko Breathing Technique among Asthma Patients Miss. Gunjan Singh et al. International Journal of Trend in Scientific Research and Development (IJTSRD) Volume 5 Issue 6, September-October (2021). Unique Paper ID – IJTSRD47629 | Volume-5.

3. Ineffective breathing pattern: care for COPD patients. Chen HW. et al. 2011 Oct;58(5):95-100. Chinese. PMID: 22024810.

4. Syndrome of hyperventilation and dysfunctional respiration: mise à day. Du Pasquier D. et al. Rev Med Suisse. 2020 Jun 17;16(698):1243-1249. French. PMID: 32558453.

5. Association between oral habits, mouth breathing and malocclusion. Grippaudo C. et al. Acta Otorhinolaryngol Ital. 2016 Oct;36(5):386-394. doi:10.14639/0392-100X-770. PMID: 27958599; PMCID: PMC5225794.

6. A randomized controlled trial of the Buteyko technique as an adjunct to conventional management of asthma. Robert L. Cowie. Respiratory Medicine (2008) 102, 726–732.

7. A Study to Assess the Knowledge Regarding Buteyko Breathing Technique among Asthma Patients Miss. Gunjan Singh1Mr. Raghavendra M.2 2022.

8. British Guideline on the Management of Asthma. 2003.

9. The Buteyko breathing technique in children with asthma: a randomized controlled pilot study Jan Vagedes et al. 2021.

10.A Clinical Trial of the Buteyko Breathing Technique in Asthma as Taught by a Video AJ Opat et al. 2009

11. Buteyko Breathing Technique for asthma: an effective intervention Patrick McHugh. Nzjournal/116-1187/710/ (1 of 6) [1/15/2006 3:22:43 PM.

Author: Ester Gálvez Martínez. Physiotherapist Col. No.: 15982. Certified Instructor of the Buteyko Method by Buteyko Clinic International.