Buteyko method

From Wikipedia, the free encyclopedia

You have new messages (last change).
There are very few or no other articles that link to this one.
Please help introduce links in articles on related topics. After links have been created, remove this message.
This article has been tagged since December 2006.

The Buteyko Method, or Buteyko Breathing Technique (BBT) is part of a holistic health philosophy that includes a set of breathing exercises developed by the Ukrainian born, Russian doctor, Konstantin Pavlovich Buteyko (Russian: Бутейко).

The Buteyko method is a complementary and safe technique for treating asthma. Several clinical trials have shown a reduction in asthma symptoms and the need for reliever medication as well as an improvement in quality of life scores. However, there have been no significant improvements in lung function (peak-flow), which is the conventional measurement of asthma severity.

The exercises work by retraining, or correcting, breathing patterns. At present it is mainly used for asthma, sleep apnea, anxiety and panic attacks. Given the long list of symptoms attributed to poor breathing patterns by BBT's proponents,[1][2][3][4][5][6][7][8][9] its application is growing world-wide, despite scepticism from the mainstream medical community. Some of this scepticism stems from the lack of an effective physiological mechanism to explain why Buteyko exercises work. Buteyko's own physiological mechanism, the "CO2 theory", is popular but has more opposing than supporting clinical evidence.

Chronic hyperventilation has been discussed in medical literature for most of the last century.[1][10][4][5][7][8] Theories, such as the balancing of nitric oxide and the production of ANP, have been proposed, and studies continue. Buteyko has developed breathing exercises to influence breathing patterns, akin to certain forms of Yoga.

Advocates of the technique claim that asthmatics can eliminate the need for inhalers and live a medication-free life. Sceptics claim that the causal relationship is flawed, and that there is little evidence of anything other than a placebo effect. Controlled clinical trials have sometimes shown higher effectiveness than a placebo, though these trials are often confounded by including few patients, or by interference from Buteyko teachers.[10]

Contents

[edit] Theory

Central to the method is the theory that respiratory illnesses are a subset of illnesses caused by habitually breathing excessive volumes of air - what Buteyko calls "hidden hyperventilation". In particular, Buteyko claimed that the lungs of asthmatics contained too little carbon dioxide. One of the effects of low CO2 is a tightening of the Oxy-hemoglobin bond, which prevents proper oxygenation of the tissues. This well established physiological principle is known as the Bohr effect.[2][3][5][7][9] Buteyko also supported the view of others that chronic hyperventilation was attributable largely to the sedentary modern life style.[11]

[edit] Practice

The technique centers upon reduced breathing exercises, designed to increase the 'control pause' - the amount of time the individual can survive comfortably between exhaling and having to inhale. (Note that this isn't a matter of 'holding your breath'—the technique involves pausing after a typical breath has been exhaled and then breathing in again when it starts to become uncomfortable).

Typically, asthmatics are said to be measured to have control pauses of less than 15 seconds. Using reduced breathing exercises, people are able to increase their control pause up to several minutes. As a person's control pause increases, so, it is argued, their symptoms decrease.

Buteyko also stressed the importance of breathing through the nose, rather than the mouth. Apart from protecting the airways by humidifying, warming, cleaning and sterilizing air entering the lungs, breathing through the nose also reduces the tendency to hyperventilate.

[edit] Asthma attack

Under the Buteyko model, the first feeling of an asthma attack results in a short period of over-breathing. By controlling this initial over-breathing phase, it is said that the asthmatic can prevent a vicious circle of over-breathing developing.

If true, this means that asthma attacks may be averted, simply by breathing less.

Many asthmatics chronically overbreathe,[12][13] causing (or providing a catalyst for) various physiological symptoms, asthma attacks among them.[12][6][7] There is also the fact that, by practice of reduced volume breathing, the control pause can be lengthened significantly so something on a physiological level is clearly being changed or retrained. It has been demonstrated that blood CO2 levels do increase during the practice of reduced volume breathing.

Note that the method isn't designed to be primarily a treatment for an asthma attack. It's effectively a change in lifestyle which is designed to minimise or stop attacks occurring in the first place.

The technique is very popular in Australia and is starting to get a foothold in the UK. It is normally learned via short courses from teachers trained in the technique. It is possible to self-learn Buteyko but this is not recommended as unofficial or inappropriate guidelines could worsen, rather than improve, asthma symptoms.

By the end of Buteyko treatment, most asthma and even emphysema sufferers are able to reduce their medication.[10]

[edit] What critics say

[edit] Critical analysis

Clinical studies (see below) have shown that the Buteyko method makes no differences to the quality of airways or lungs of asthma sufferers initially until the exercises have been practiced for considerable time, and that it makes no difference to the amount of carbon dioxide in the bloodstream. Though studies show decreased drug usage, all major studies have involved outside interference from Buteyko groups, so changes in the patient's decisions (such as deciding when to use inhalers, or how to describe their quality of life) could easily have been down to a psychological influence rather than a change in the illness.

Buteyko courses are considered by some to be expensive and attendees are discouraged from teaching the technique to others. Additionally, many both inside and outside the medical community consider it to be another example of quack medicine. This situation isn't helped by the great many medical conditions, many unrelated to respiratory complaints, which the technique claims to alleviate.

Advocates say the profound impact of low carbon dioxide on the biochemistry of the body is well established.[3][14][4][5][6][7][9] Such biochemical disturbances could disrupt any of the normal body functions and systems, such as the immune system, one of the major problems in asthma.

Furthermore the claimed success against asthma is supposed to be the increased CO2 concentration, yet asthma sufferers are noted for increased levels of CO2 during attacks. This is a side effect of the inability to exhale fully. Critics suggest that making the CO2 problem even worse one is unlikely to improve the condition.

On the other hand, the Buteyko argument holds that since high blood CO2 is only seen in severe asthma attacks, when there is already significant damage to the lungs, the functioning parts of the lungs are over-ventilated to compensate and will therefore have low CO2.[12][13] Studies have, in fact shown, that during mild asthma attacks, before there is significant damage to the lungs, the blood CO2 is extremely low with oxygen still in the normal range.[12][13] This is considered an important pointer to the cause of asthma.

Others suggest that asthma is greatly affected by general mental state, and relaxation of any form is known to be fairly effective, which is readily explained by Buteyko's hyperventilation theory.

[edit] Clinical studies

In 1995 a randomized double blind placebo controlled study on the technique was run in Brisbane, Australia.[10]

People in the test were taught either the Buteyko method or a placebo breathing method involving standard physiotherapy relaxation and breathing, and changes in behavior noted. The results of the test showed no improvement in lung function, such as forced expiratory volume in one second or peak flow, in either the Buteyko method group or the placebo group.

Additionally, the tests showed no statistically significant increase in actual CO2 along with no statistically significant reduction in minute volume: "Despite a trend ..., there was no significant difference".[10]

However, the study detected significant changes in drug use, with the Buteyko group showing a decrease in steroid inhaler use of 49%. To quote the summary of the trial: "Those practising [the Buteyko technique] reduced hyperventilation and their use of beta2-agonists. A trend toward reduced inhaled steroid use and better quality of life was observed in these patients without objective changes in measures of airway calibre." "Quality of life" was measured by a self-administered questionnaire that asked patients about breathing, mood, social interaction and concerns for the future. As the questonnaire relied on subjective information and was not carried out by an independent source, it is possible that it was merely people's perceptions of their own health that was changed.

From the data given the reduction in beta2-agonists (e.g. Ventolin) was 96% and the reduction in steroid inhalers was 49%.

The results were also clouded because it was later learned that the Buteyko group was being telephoned by the Buteyko teacher during the trial. This was unknown to the people carrying out the trial and though it was claimed to be a normal part of the Buteyko process it was not disclosed as such. This leaves open the possibility that people were talked into having their perceptions of their illness changed, which would explain why the Buteyko group showed a change in their drug usage and in their own descriptions of their quality of life, but no changes in physically measurable areas such as airway or lung function. There has been no repeat of the trial to measure the possible influence from outside sources.

Other interesting findings from the Brisbane trial were:

  1. Neither the Buteyko nor the placebo group experienced a change in carbon dioxide levels after the treatment.
  2. Neither group experienced a difference in airway function.
  3. There was no significant change in the quality of life at any stage of the treatment, though there was a slight trend towards the Buteyko group measuring theirs as better in the long term. The changes in life quality were evenly spread across all areas that were measured.
  4. There was no significant difference in tidal volume at the end of the trial
  5. Those who used the Buteyko method used beta2-agonist inhalers less often.

The trial quite clearly shows that the Buteyko method makes no physical changes to asthma sufferers, though it does change the actions and perceptions to a significant level. The trial also shows that lower drug usage did not increase illness in the Buteyko group -

The report states "BBT might also have altered subjects' perceptions of asthma severity without affecting the underlying disease. This could account for the reduction in medication use and trends toward improvements in quality of life and is consistent with the absence of any change in objective measures of airway calibre. On the other hand, the reduction in medication use in the BBT group did not lead to a decline in lung function, and rates of oral steroid use and hospital admission were similar in each group."

In 2003 another trial took place in New Zealand, the aim of which was to measure safety rather than effectiveness.[15] It recorded no change in forced expiratory volume, an 85% reduction in beta2-agonists and a 49% reduction in steroid use amongst people who had used the Buteyko method. The trial recorded no adverse effects. Patients were contacted confidentially from outside the trial which leaves open the same possibility as with the Australian trial, that psychological influence may have lead to drug use being discouraged and perceptions of the illness changing. The contents of the conversations were unknown to anyone but the Buteyko group, and although the placebo group were also given phone calls to hide the fact that they were the placebo group, the exact effects of the conversations with the Buteyko group could not be replicated and would still show up in results. Patients were also asked to measure their health in the form of a subjective, unsupervised questionnaire. The term "Buteyko" was allowed in the trial, despite contradicting the guidelines for clinical trials set out by Bowler et al. No measurements of any physical difference took place, the trial simply the parts of the Australian trial that supported Buteyko, and replicated the same problems (outside interference). The same explanation of perceptions being changed rather than health applies. The only new finding is that Buteyko seems to be safe.

[edit] Literature

[edit] Bibliography of Russian texts

from the paper by Kazarinov VA[14]

  1. Buteyko K.P. Oscillogtaphs and Hypertonia. Is "Enhanced" Breathing Beneficial? Izobretatell I Ratsionalizator. 1962. No.5.
  2. Buteyko K.P. Shurgaya Sh. I.Functional Diagnosis of Coronary Disease. Thesis from Symposium on Surgical Treatment of Coronary Disease, Moscow, 1962.
  3. Buteyko K.P., Demin D.V. Cross-correlational Analysis of Physiological Functions. Izv. Sib.Otd. AN SSSR. 1963, No.6. Ser.biol.med.nauk.Vypusk Issue) 2.
  4. Buteyko K.P., Odintsova M.P., Demin D.V. The Influence of Hyper and Hypoxaemia on the Tonus of Peripheral Vessels. Proceeding of the Second Siberia Scientific Conference of Therapists, Irkutsk, 1964.
  5. Buteyko K.P., Demin D.V., Odintsova M.P. The Application of Regressive Analysis for Differentiation of the Influence of Gaseous Components of the Arterial Blood on the Functional State of Fine Peripheral Arteries. Materialy Vtoroy sib. Nauchnoy Konf. Terapevtov. Irkutsk, 1964.
  6. Buteyko K.P., Demin D.V.,, Odintsova M.P. The Mathematical Analysis of Interreaction of Physiological tigation Factors. Physics-Mathematical Methods for Inves in Biology and Medicine. Materialy Pervoy Novosib- Conf., Novosibirsk/, 1965.
  7. Buteyko K.P., Demin Dove,, Odintsova M.P. The Relationship between the Ventilation of the Lungs and the Tone of Arterial Vessels in Patients with Hypertonic Disease and Stenocardia. Fiziologichni Zhurnal, 1965. Vol. II, No.5 (in Ukrrainian).
  8. Buteyko K.P., Demin D.V., Odintsova M.P. The Relationship between the Carbon Dioxide in Alveoles, Arterial Pressure and Cholesterol in Blood in Patients with Hypertonic Disease and Stenocardia. Materialy Tretley Sib. Nauchn. Conf. Terapevtov. irkutsk, 1965. (Proceedings of the Third Siberian Sci. Conference of Therapists).
  9. Buteyko K.P. The Cross-Correlational Technique of Analysis of Physiological Regulations. Materialy VII Vsesoyuzn. Conf. po Avtomat. Kontrolyu i Metodam Elektr. Izmereniy. Novosibirsk, 1965, (Proc. of the VII-Union Conference on Automatic Control and Methods for Electrical Measurements).
  10. Buteyko K.P. The Complex Investigations into Functional Systems in Biology and Medicine. (Reports of the Medical Electronics Section of the 9th Regional Sci.-Tech. Conference Dedicated to the Day of. Radio). Dokl. Sektsii Med. Elektroniki 9-oy Obl. Nauchn.-Tekhn. Conf. Posvyashchennoy Dnyu Radio, Novosibirsk, 1966.
  11. Buteyko K.P., Demin D.V., Odintsova M.P. The Relationship between the Partial Pressure in Alveolar Air and the Tone of Peripheral Arteries in Patients with Hypertonic Disease and Stenocardia. Zdravookhranenie Turkmenistana. 1966. No.2 (Public Health of Turkmenistan. 1966, No.2).
  12. Buteyko K.P., Demin D.V., Odintsova M.P. The Effect of Carbon Dioxide on the Coronary Efferent Arteries in Patients with Hypertonic Disease and Atherocardiosclerosis. Zdravookhranenie Kazakhranenie Kazakhstana. 1966. No. 6 (The Kazakhstan Public Health, 1966, No.6).
  13. Buteyko K.P., Demin D.V., Odintsova M.P. A Linear Model for Regulation of Vascular Tone by Gaseous Components of Arterial Blood. Dokl. 9-oy Obl. Nauchn.-Tekhn. Conf., Posvyashchennoy Dnyu Radio. Novosibirsk, 1966.
  14. Buteyko K.P. et al. The Influence of Intentional Regulation of Respiration on Some Physiological Functions at Altitude. Voprosy Aviatsionnoy Meditsiny (Problems of Aviation Medicine). Moscow, 1966.
  15. Buteyko K.P., Chasovskikh S.F.,, Demin D.V. An Indirect Determination of the Degree of Hypertension of Pulmonary Circulation According to the Data of Calibrated Phonocardiography. Materialy 4-oy Povolzhskoy Conf. Fiziologov, Biokhimikov i Farmakologov- Saratov, 1966. T.l. (Proceedings of the 4th Volga River Conference of Physiologists, Biochemists and Pharmacologists. Saratov, 1966, Vol.1).
  16. Buteyko K.P., Odintsova M.P., Demin D.V. The Influence of Hyper- and Hypoxaemia on the Tone of Arterial Vessels. Sovetskaya Meditsina. 1967. No.3 (Soviet Medicine, 1967. No3) -
  17. Murakhtanova Z.M., Buteyko K.P. et al. Concerning Characteristic of External Respiration in Patients with Scoliosis. Sbornik Rabot Novosib. Instituta Travmatologii i Ortopedii. Novosibirsk, 1967. (Collection of Reports of the Novosibirsk Institute of Traumatology and Orthopedics. Novosibirsk, 1967).
  18. Buteyko K.P. et al. The Use of Correlation Methods for Investigation of Cardiovascular System. Mat. Metody v Aviatsionnoy i Kosmicheskoy Meditsine. - Moscow, 1967 (Mathematical Methods in Aviation and Cosmic Medicine).
  19. Buteyko K.P., Demin D.V., Odintsova M.P. The Mutual Information of Heartrhythm and Other Physiological Human Functions according to the Data of Cross-Correlative Analysis. Mat. Metody Analiza Sergechnogo Ritma. Moscow, 1968 (Mathematical Methods for Analysis of Heart Rhythm. M., 1968).
  20. Buteyko K.P., Odintsova M.P., Nasonkina P.S. The Ventilation Test for Patients -with Bronchial Asthma. Vrachebnoe Delo, 1968, No.4 (Medical Treatment. 1968, No.4).
  21. Buteyko K.P., Odintsova M.P. Hyperventilation as One of the Reasons for the Spasm of Nonstriated Musculature of the Bronchi and Arterial Vessels. Materialy 4-oy Nauchn.-Praktich. Conf. po Vrachebn- Kontrolyu i Lechebnoy Fizkulture. Sverdlovsk, 1968 (Proceedings of the 4th Scientific-Practical Conference on Medical Control and Medical Physical Culture. Sverdlovsk, 1968).
  22. Buteyko K.P. Complex Methods for Investigation of Cardiovascular System and Respiration. Voprosy Funktsionallnoy Diagnostiki. Novosibirsk,, 1969 (Problems of Functional Diagnostics. Novosibirsk, 1969).
  23. Buteyko K.P. The Theory of CO2-Deficient Diseases of Civilisation as an Adaptation to the Evolution of Atmosphere. Kiberneticheskie Aspekty Adaptatsii Sistemy "Chelovek-Sredall. Tez. Seminars. Moscow, 1975 (Cybernetic Aspects of Adaptation of the System "Man-Environment". Seminar Thesis, M., 1975).
  24. Buteyko K.P. Therapy of Hemohypocarbia. Patent No.1067640. Registered in the State Record of Inventions of the U.S.S.R., 15.9.1983.
  25. Buteyko K.P., Genina V.A. Concerning Pathogenesis of Asthma Attack during Physical Exercise. Non-medical Methods for Treatment of Patients with Bronchial Asthma. Tez. Dokl. Vsesoyuzn. Conf. Moscow, 1986 (Report Thesis from the All-Union Conference. M., 1986).
  26. Buteyko K.P., Genina V.A. The Comparison of Justification and Effectiveness of the Complex, Symptomatic and Monoetiological Principles of Treatment of Bronchial Asthma and Other Allergies. Ibid.
  27. Buteyko K.P., Genina V.A. The Theory of Discovery of Deep Respiration (Hypervention) as a Main Cause of Allergic,, Bronchial-vascular-spasmodic and Other Diseases of Civilisation. Ibid.
  28. Buteyko K.P., Genina V.A., Nasonkina N.S The Reactions of Sanogenesis in Medical Treatment Using the ISDR Method. Ibid.
  29. Putintsev E.V., Varlamova Z.A., Meshcheryakova L.R. Concerning Medical Physical Culture for-Bronchial Asthma. Sb. Materialov k Godichnoy Nauchnoy Sessii Instituta. Novokuznetsk, 1967 (Collection of Reports for Annual Sci. Session of the Institute. Novokuznetsk, 1967).
  30. Shelomova K.V. Intentional Normalisation of Respiration in the Complex of Medical Physical Culture for Bronchial Asthma. Proceedings of the 4th Sci. -Practical Conf. on Medical Control and Medical Physical Culture. Sverdlovsk, 1968 (as in 22).
  31. Panova L.A. Bronchial Asthma - a Model of Adaptation to the Changed Environmental Conditions. (As in 24.).
  32. Gavalov S.M., Genina V.A., Gavalova R.F. Intentional Regulation of Respiration in Complex Medical Treatment of Bronchial Asthma in Children. Saratov, 1976.
  33. Genina V.A., Glur-,henko I.R. The Construction of a Generalised Indicator of the Bronchial Asthma Condition. Methods for Physical Measurements of Parameters of the Ecological Systems and the Mathematical Processing of the Obtained Data. Novosibirsk, 1982.
  34. Genina V.A. The Role of Hyperventilation in the Pathogenesis of Bronchial Asthma and Its Medical Treatment by means of Reduction in Ventilation of the Lungs. Epidemiological Characteristics of Non-r.,pecific Diseases of the Lungs in Various Professional Groups. Novosibirsk, 1982.
  35. Genina V.A. et al. The Medical Treatment of Bronchial Asthma in Children Using the Method of Intentional Normalisation of Respiration (INR) according to the Data of the 1st MMI Children's Clinic. Pediatriya, 1982, No.2 (Pediatrics, 1982, No.2).
  36. Genina V.A. The Technique for Elimination of Chronic Hyperventilation in the Treatment of Patients with Obstructive Syndrome. Medical Treatment of Non-specific Diseases of the Lungs.

[edit] Clinical trials

  • See[10][15]
  • Cooper S, Oborne J, Newton S, Harrison V, Thompson-Coon J, Lewis S, Tattersfield A, "Effect of two breathing exercises (Buteyko and Pranayama) in asthma: a randomized controlled trial.", Thorax, VOL 58, 2003, 674-679
  • McGowan J, "Health Education: Does the Buteyko Institute Method make a difference?", Thorax, VOL 58/Sup3, December 2003, p28
  • Opat AJ, Cohen MM, Bailey MJ, Abramson MJ, "A Clinical Trial of the Buteyko Breathing Technique in Asthma as Taught by Video", J. of Asthma, VOL 37(7), 2000, 557-564
  • McHugh P, Duncan B, Houghton F, "Buteyko breathing technique and asthma in children: a case series.", The New Zealand Medical Journal, VOL 119 No1234, May 2006

[edit] References

  • Brashear R (1983). "Hyperventilation syndrome.". Lung 161 (5): 257-73. PMID 6138480. 
  • DaCosta JM (1871). "On irritable heart: a clinical study of a form of functional cardiac disorder and its consequences.". Am J Med Sci 61: 17-53. 
    for disussion on DaCosta's contribution, see: Jacob Mendez Da Costa doctor/2452 at Who Named It and Da Costa's syndrome synd/2882 at Who Named It as well as Wooley C (1982). "Jacob Mendez DaCosta: medical teacher, clinician, and clinical investigator.". Am J Cardiol 50 (5): 1145-8. PMID 6753556. 
  • Donnelly P (Jan 19 1991). "Exercise induced asthma: the protective role of CO2 during swimming.". Lancet 337 (8734): 179-80. PMID 1670821. 
  • Gayrard P, Orehek J, Grimaud C, CHarpin J (Apr 1975). "Bronchoconstrictor effects of a deep inspiration in patients with asthma.". Am Rev Respir Dis 111 (4): 433-9. PMID 123713. 
  • Guyton AC, Hall JE (1996). "Chemical control of respiration", Textbook of medical physiology, 9th edition, WB Saunders, 527-8. ISBN 0-7216-5944-6. 
  • Hibbert G, Pilsbury D (Nov 1988). "Demonstration and treatment of hyperventilation causing asthma.". Br J Psychiatry 153: 687-9. PMID 3151279. 
  • Jefferies M (1996). Safe uses of Cortisol, 2nd Edition, Springfield: Charles C.Thomas. ISBN 0-398-06621-3. 
  • Morgan W (1983). "Hyperventilation syndrome: a review.". Am Ind Hyg Assoc J 44 (9): 685-9. PMID 6356858. 
  • Neill W, Hattenhauer M (1975). "Impairment of myocardial O2 supply due to hyperventilation.". Circulation 52 (5): 854-8. PMID 1175266. 
  • Pfeffer J (1984). "Hyperventilation and the hyperventilation syndrome.". Postgrad Med J 60 Suppl 2: 12-5. PMID 6431401. 
  • Pfeffer J (1978). "The aetiology of the hyperventilation syndrome. A review of the literature.". Psychother Psychosom 30 (1): 47-55. PMID 358247. 
  • Wheatley C (1975). "Hyperventilation syndrome: a frequent cause of chest pain.". Chest 68 (2): 195-9. PMID 1149547. 

[edit] Notes

  1. ^ a b Bass C (Oct/Nov 1990 1990). "The hyperventilation syndrome". Respiratory Diseases in Practice: 13-16. 
  2. ^ a b Cluff R (Sep 1984). "Chronic hyperventilation and its treatment by physiotherapy: discussion paper." (Scanned copy or PDF). J R Soc Med 77 (10): 855-62. PMID 6387113. 
  3. ^ a b c Demeter S, Cordasco E (Dec 1986). "Hyperventilation syndrome and asthma.". Am J Med 81 (6): 989-94. PMID 3541595. 
  4. ^ a b c Lum L (1975). "Hyperventilation: the tip and the iceberg." (PDF). J Psychosom Res 19 (5-6): 375-83. PMID 1214233. 
  5. ^ a b c d Magarian G, Middaugh D, Linz D (1983). "Hyperventilation syndrome: a diagnosis begging for recognition." (Scanned copy or PDF). West J Med 138 (5): 733-6. PMID 6880192. 
  6. ^ a b c Nixon P (Dec 1989). "Hyperventilation and cardiac symptoms.". Internal Medicine 10 (12): 67-84. 
  7. ^ a b c d e Sher T (1991). "Recurrent chest tightness in a 28-year-old woman.". Ann Allergy 67 (3): 310-4. PMID 1897807. 
  8. ^ a b Tavel M (1990). "Hyperventilation syndrome--hiding behind pseudonyms?". Chest 97 (6): 1285-8. PMID 2189694. 
  9. ^ a b c Waites T (1978). "Hyperventilation--chronic and acute.". Arch Intern Med 138 (11): 1700-1. PMID 718322. 
  10. ^ a b c d e f Bowler S, Green A, Mitchell C (Dec 7-21 1998). "Buteyko breathing techniques in asthma: a blinded randomised controlled trial.". Med J Aust 169 (11-12): 575-8. PMID 9887897. 
  11. ^ Magarian G (1982). "Hyperventilation syndromes: infrequently recognized common expressions of anxiety and stress.". Medicine (Baltimore) 61 (4): 219-36. PMID 7045570. 
  12. ^ a b c d Clarke P, Gibson J (1980). "Asthma hyperventilation and emotion.". Aust Fam Physician 9 (10): 715-9. PMID 7425962. 
  13. ^ a b c McFadden E, Lyons H (May 9 1968). "Arterial-blood gas tension in asthma.". N Engl J Med 278 (19): 1027-32. PMID 5644962. 
  14. ^ a b Kazarinov VA (1990). "[The biochemical basis of KP Buteyko's theory of the diseases of deep respiration]", in Ed. Buteyko KP: [Buteyko Method: The experience of implementation in medical practice] (Translation from Russian), Moscow: Patriot Press, 198-218. 
  15. ^ a b McHugh P, Aitcheson F, Duncan B, Houghton F (2003). "Buteyko Breathing Technique for asthma: an effective intervention.". N Z Med J 116 (1187): U710. PMID 14752538. 

[edit] External links

Retrieved from "http://en.wikipedia.org../../../b/u/t/Buteyko_method.html"