Biofeedback helps reduce steroid use by asthmatics

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Biofeedback training aimed at increasing heart rate variability appears to allow asthma patients to reduce the amount inhaled steroid drugs they need to control their symptoms, researchers report.

“Heart rate variability (HRV) tends to be reduced in patients with asthma and various diseases affecting the cardiovascular and/or central nervous system,” the investigators report in the journal Chest.

There is evidence that increasing HRV improves lung function in asthmatics, lead author Dr. Paul M. Lehrer of the University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, Piscataway and colleagues note.

To investigate, the researchers randomly assigned 94 patients with a wide range of asthma severity to HRV biofeedback and training in abdominal breathing, HRV biofeedback alone, “placebo” biofeedback or no treatment.

The intervention groups underwent 10 weekly biofeedback sessions and practiced at home twice daily.

During this period, asthma medication level was determined biweekly by a specialist who was not aware of which group the patient was in. Treatment was guided by lung test results and symptom reports.

Those in the HRV biofeedback groups were prescribed less medication than patients in the placebo biofeedback and the control group. Both active treatment groups achieved similar reductions.

“Improvements averaged one full level of asthma severity,” the investigators report. Measures of lung function also showed improvement in the HRV biofeedback groups.

Patients in the placebo group achieved a reduction in asthma symptoms comparable to those seen in the active treatment groups. However, they did not have a reduction in medication use or an improvement on lung function tests.

There was no difference in the incidence of asthma exacerbations across groups.

“Biofeedback...allows patients with asthma to maintain their health while taking less inhaled steroid medication,” Lehrer told Reuters Health.

“People can get more information about biofeedback from the Association for Applied Psychophysiology and Biofeedback, the national organization of biofeedback scientists and practitioners, located in Wheat Ridge, Colorado (http://www.aapb.org)," he added.

SOURCE: Chest, August 2004.

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