Comparison of Buteyko and Papworth Breathing Techniques on Pulmonary Function and Oxygen Saturation in Adults with Asthma: A Randomized Controlled Trial

Abstract

Background: Asthma is a chronic respiratory disorder associated with impaired lung function and reduced quality of life. While pharmacological therapy remains central to management, breathing retraining techniques such as Buteyko and Papworth have gained interest. However, comparative evidence remains limited. Objective: To compare the short-term effects of the Buteyko and Papworth breathing techniques on pulmonary function and oxygen saturation in adults with asthma. Methods: In this single-centre randomized controlled trial, 42 adults with physician-diagnosed asthma (FEV₁ <80% predicted, FEV₁/FVC <75%) were randomized to Buteyko (n=21) or Papworth (n=21) interventions, in addition to conventional physiotherapy, over four weeks. The primary outcomes were FEV₁, FVC, and FEV₁/FVC ratio, measured by spirometry. The secondary outcome was peripheral oxygen saturation (SpO₂), measured by pulse oximetry. Outcomes were assessed at baseline, week 2, and week 4. Data were analysed using non-parametric tests under an intention-to-treat framework. Results: Both groups demonstrated significant within-group improvements in pulmonary function and SpO₂ over four weeks (all p < 0.001). Between-group comparisons favoured the Buteyko group for FEV₁, FVC, FEV₁/FVC ratio, and SpO₂ at weeks 2 and 4 (all p < 0.01). By week 4, the Buteyko group achieved greater median improvements in FEV₁ (+12.3% vs. +6.8%) and SpO₂ (+2.1% vs. +1.0%) compared with the Papworth group. No adverse events were reported. Conclusion: Both Buteyko and Papworth breathing techniques improved pulmonary function and oxygen saturation in adults with asthma, but the Buteyko method yielded consistently greater benefits. These findings support Buteyko as a valuable, low-cost adjunct to conventional asthma care, particularly in resource-limited settings.