A Modified Breathing Exercise Program For Asthma Is Easy To Perform And Effective

Published online (June 2016) is this new study in the Journal of Asthma, A modified breathing exercise program for asthma is easy to perform and effective. The study evaluated a simple, modified breathing exercise program investigating how easy it was to perform and how effective it was as an adjunctive therapy. The program incorporated three different breathing exercises (yoga pranayama techniques, diaphragmatic breathing and pursed lip breathing), each of which was taught to the 74 subjects. Conclusion: “A simple program of breathing exercises was found to be effective and could be completed in less than 10 minutes per day. Furthermore, there was a statistically significant improvement in Asthma Control Test (ACT) scores post-exercise.” One of the exercises, diaphragmatic breathing, can be performed easily in the home without tuition by using POWERbreathe Inspiratory Muscle Training devices. (Please check with your healthcare provider first.) The scientifically proven training regimen is just 30 breaths twice a day which takes about 5 minutes. POWERbreathe exercises the muscles used to breathe in, primarily the diaphragm and intercostal muscles. It uses the principles of resistance training to exercise these inspiratory muscles by making you breathe in through the device against an adjustable variable ‘load’. It’s like ‘dumbbells for your diaphragm’, and the more you use it the stronger your breathing muscles become; the stronger they become the more you increase the load, improving your ability to take a deeper, more satisfying breath. This training not only makes your breathing muscles stronger but it also improves their stamina and reduces fatigue, improving quality of life in those with breathing problems such as asthma and COPD, and improving performance in those who’re physically active.

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Breathing Exercises for Asthma

We recently came across this article on Breathe, The Respiratory Professional’s Source for Continuing Medical Education, which summarises the evidence of the role of breathing control approaches in asthma and provides information on the content of evidence-based breathing exercise programmes.


Breathing Exercises for Asthma

The article initially states the three broad groups of breathing exercises for asthma:

1. Exercises aimed at manipulating the pattern of breathing (breathing retraining)
2. Exercises aimed at increasing the strength and/or endurance of the respiratory muscles (respiratory muscle training) e.g. POWERbreathe
3. Exercises aimed at increasing the flexibility of the thoracic cage and improving posture (musculoskeletal training)

This particular article focuses on breathing retraining techniques, which, after years of neglect, has recently seen a resurgence. A typical first breathing training session they suggest contains teaching the use of the abdomen (as opposed to upper chest breathing) and offers advice on the use of the lower thoracic and abdominal expansion rather than upper chest expansion. Breathing Control they define as “breathing at normal rate and depth initially, but using only lower thoracic and abdominal compartment expansion (also known as diaphragmatic breathing)”. POWERbreathe Inspiratory Muscle Training (IMT) teaches people to use their diaphragm (the main inspiratory muscle) for deep breathing, strengthening it and making it more resistant to fatigue.

The authors go on to suggest that the main components at the core of the breathing training packages that may be modified are, rate of breathing (number of breaths per minute), depth of breathing (volume of air inspired per breath), airflow velocity (flow rate), timing (inspiratory/expiratory phase, duration, ratio and pauses), rhythm of breathing (within-individual variability of rate, volume and timing) and primary region of movement (upper thoracic expansion, lower thoracic expansion, abdominal expansion). The POWERbreathe K2 IMT device offers a Single Breathe Test that measures inspiratory muscle strength, peak inspiratory flow rate and inhaled volume in a single breath.

The article informs us that there’s now “a convincing body of evidence that breathing training for people with asthma is effective in improving patient-reported endpoints, such as symptoms, health status and psychological well-being, and may be effective in reducing rescue bronchodilator medication usage.”

In addition to this, we’re able to show that in randomised controlled trials on mild/moderate asthmatics, POWERbreathe IMT:

  • Increased inspiratory muscle strength by a mean of 11% in just 3 weeks1.
  • Has been shown to relieve the symptoms of asthma by improving lung function, resulting in reduction of medication and a fall in hospitalisations2.

Also, after as little as 3 weeks’ POWERbreathe IMT1, asthma patients experienced a reduction in dyspnoea (difficult or laboured breathing; shortness of breath) as well as improvements in quality of life.

And in laboratory studies and randomised controlled trials, IMT was shown to generate:

  • A reduction in the consumption of asthma medication of up to 79%2
  • A reduction of ß2-agonists consumption by up to 79%2
  • An improvement in asthma symptoms by up to 75% in 3 weeks1

Read more about POWERbreathe for Asthma or have a look at the models most suited to people with asthma (please consult your health care provider before beginning any health related program), in addition to the book from the Bradcliff Breathing Method for managing your asthma, ‘Dynamic Breathing’:  

The article goes on to say that the latest Global Initiative for Asthma (GINA) iteration states that “breathing exercises may be a useful supplement to medications” and that the recently updated non-pharmacological management section of the British Thoracic Society (BTS)/Scottish Intercollegiate Guidelines Network (SIGN) UK Asthma Guideline gives grade-A recommendation to the statement ‘Breathing exercise programmes (including physiotherapist-taught methods) can be offered to people with asthma as an adjuvant to pharmacological treatment to improve quality of life and to reduce symptoms’, based on evidence graded as 1++. This should now be a standard part of the range of treatments offered to patients.”


  1. Inspiratory muscle training improves lung function and reduces exertional dyspnoea in mild/moderate asthmatics
  2. lnspiratory Muscle Training in Patients with Bronchial Asthma

Breathing Big in 2013

So, 2013 is the year for Breathing Big! Well, all you POWERbreathe users are one-step ahead in setting the trend for improving your breathing strength and breathing pattern. You’ll already be familiar with the benefits that inspiratory muscle training has on your breathing and ultimately your sports performance, or if you have breathing difficulties, on your quality of life.

We’ve heard from the US that Breathing Big is going to be making its mark in 2013, with “fitness professionals taking more credence in assessing breathing patterns in their clients”.

“While we’re just scratching the tip of the iceberg in this regard, it’s profound how much of an effect faulty breathing patterns – in this case people relying too much on their accessory breathing muscles like the upper traps, scalanes, levator etc and NOT their diaphragm – has on everything from posture and many common dysfunctions we see in the general population (neck pain, shoulder pain, evel lower back pain) to performance, in and outside the gym,” says Tony Gentilcore, co-owner of Cressey Performance.

He goes on to add, “Taking as little as five minutes to show clients how to “use” their diaphragm can go a long ways in helping them not only feel better but set themselves up for success, whether their goal is to lift a Mack truck or just look better naked.”

POWERbreathe users will know that training with POWERbreathe for only 5-minutes twice a day will make a big difference to their breathing strength and endurance, and can be done just as easily at the gym, at home – or when out and about.

Jordan Syatt, Author, Trainer and Greatist Expert, also predicts that one of the top 3 trends for 2013 will be diaphragmatic breathing.

“It’s progressively become more of a mainstream term among health and fitness professionals, but it hasn’t received much attention in the media or lay public. Granted, it’s not sexy of very appealing, but the benefits are astounding and it’s bound to pick up big time” he says.

Your diaphragm is you most efficient breathing muscle, and is a large, dome-shaped muscle located at the base of your lungs. It’s your abdominal muscles that help to move your diaphragm and give you the power to empty your lungs. People with breathing problems, such as those with COPD, have difficulty with their diaphragm working effectively.

This is because air becomes trapped in the lungs, pushing down on the diaphragm.  Because of this, the neck and chest muscles take on an increased share of the work of breathing which can leave the diaphragm weak and flattened, causing it to work less efficiently.

POWERbreathe inspiratory muscle training is intended to help you use your breathing muscles correctly to strengthen your breathing muscles, including your diaphragm and use less effort and energy to breathe.  At first you’ll notice an increased effort will be needed to use your diaphragm correctly while using POWERbreathe, and you’re breathing muscles will get tired. But stick at it because with regular use (following the scientific proven regimen of 30 breaths twice a day) your breathing strength and stamina will increase, allowing you to increase the resistance on your POWERbreathe and continue to improve.

Read more about the benefits of inspiratory muscle training (IMT) with POWERbreathe, and if you are already a POWERbreathe user, we’d love to hear how it’s helping you. Please leave a comment here.

Top breathing exercises for runners

Respiratory SymptomRunning is a form of aerobic exercise. Quite literally, ‘aerobic’ means ‘with oxygen’. We need to breathe to get oxygen into the lungs.  Although this sounds obvious, some runners have a shallow or laboured breathing style.  However, there are some cases where this style of breathing results in severe muscle cramps, side stitches, poor performance or premature fatigue. Not only that, shallow breathing can also result in anxiety, which can be counter-productive if you run for relaxation. Anxiety also causes physical tension which can result in a loss of energy – resulting in less energy for your workout.

Deep Breathing

The majority of runners only use the upper two thirds of their lung capacity. However, diaphragmatic breathing, which fills the lower part of the lungs, can increase a runner’s aerobic capacity, reduce stress and even help to eliminate the dreaded runner’s cramps.

Deep breathing exercises can be performed prior to a run or during a run. However, depending on when they are performed, there is a slight variation in technique. Prior to a run, take a deep breath in through the nose and hold for five counts. Then, slowly release the breath through the mouth. Holding the breath during a run is not recommended. Simply breathe in for five counts, and then breathe out for five counts. Keep in mind that it is not always easy to breathe through the nose while running. If this is the case, go ahead and breathe through the mouth.

Many runners do not realise that while they run, they are holding tension in their shoulders, wrists, hands and jaws. The exhalation phase of the deep breathing exercise is a good time to release this tension. As you exhale, you can shake out your hands, roll your shoulders and open your mouth to relax your jaw.

Rhythmic Breathing
Although rhythmic breathing may be difficult to master, it can be an excellent way to coordinate your breathing patterns with your running movements. In fact, elite runners use this method as a means of ensuring an even rhythm to their running. Most elite athletes use a 2-to-2 breathing rhythm. This means that they take two steps per inhale, and two steps per exhale. At the end of the race, they might switch to a 2-to-1 rhythm, which involves a two-count inhalation followed by one-count exhalation.

The Cleansing Breath
When you wake up feeling congested, it may be difficult to motivate yourself for a run. Provided that you are not seriously ill, the cleansing breath can open your sinuses and clear out congestion, which might make it easier to go for a run.

The cleansing breath is borrowed from yoga. Use the two middle fingers of your left hand to close off your right nostril. Breathe in for four counts through your left nostril. Then, use your thumb to close the nostril. Hold the breath for four counts, and then release your fingers from your right nostril, and let the breath out for eight counts.

Repeat the process on the right nostril, using your right hand to close off the left nostril. After you’ve repeated the exercise a few times, you might want, and in fact be able to blow your nose.

Warming up your breathing muscles

These breathing techniques for running will help with your running performance, but don’t forget that you also need to warm-up your breathing muscles before a run, just as you warm –up your other muscles to help prevent injury. Warming up your breathing muscles can help to eliminate excessive breathlessness during the start of your run, and help you get into a natural breathing rhythm. Inspiratory muscle training targets your breathing muscles and is ideal for a pre-run warm-up and to help improve running performance.

Breathing exercises that can help with COPD treatment

What-is-COPDChronic obstructive pulmonary disease also known as COPD is the term that is given to a group of lung diseases. these lung diseases block your airflow as you exhale, making it very difficult for you to breathe.  Practising regular breathing exercises can help you cope with COPD and also aid your COPD treatment.  Worldwide COPD is a major cause of death.

Relax and breathe

If you have COPD then the most effective way to overcome breathlessness is to relax and breathe. Find a quiet spot and lay down in a comfortable position completely focus on your breathing.  With each breathe that you take you should try and slow down the pace and relax your body each more and more.  Eventually you will be able to control your breath. Anytime you are feeling breathless you should use this technique.

Counting Breath

Try counting silently in your head while breathing. Doing this automatically slows and relaxes the breathing. To start with count to two on your inhale and two on your exhale. Then gradually increase to three then four. Become comfortable with counting to four on your inhales and exhales before you take the next step and increase exhales to a count of five while keeping the inhales to a count of four. Eventually you want to increase your exhales to a count of six.

Ujjayi Pranayama

Ujjayi pranayama can be performed while laying flat on your back or with your head and chest slightly elevated. It is important that you get the correct position and that your head is sits higher than your chest. Always start with a few cycles of normal breathing, then inhale naturally and exhale fully keeping your chest elevated.  This should be repeated for 15-20 cycles, then you should return to your normal breathing pattern. This method of breathing helps to improve the function of the lungs.

Viloma Pranayama

Anyone who suffers from a breathing order should practice this breathing exercise. Start by inhaling three-fourths of a breath and then exhale fully. Continue this breathing pattern for a few breaths. Next, inhale only two-thirds of a breath and exhale fully. Continue this pattern for a few breaths. Go back to breathing three-fourths in and fully exhaling for a few rounds. Then slowly return to normal, relaxed breathing.

If you suffer from breathing difficulties you will know just how difficult it is to breathe. Inspiratory muscle training helps to strengthen and condition your breathing muscles. Practicing any of the above breathing methods can aid you with your COPD treatment as well as increase the quality of your life as a COPD sufferer.


Breathing techniques for singing

Singing is all about having a good technique. Like any other sport you can train yourself to become better at it. How do you do this? Simple, you need to use various breathing techniques related to singing which help you exercise and train your lungs, vocal chords, diaphragm and help you with breath control to enable you to make your voice more powerful which means you can hold notes for much longer.

Before using any breathing techniques to help your singing you first need to learn some basic breathing techniques to help you breathe normally. These basics will teach you how the lungs, diaphragm and trachea all work together to help you breathe.

When you breathe in your lungs will fill up with air. This should be a natural process. Under no circumstance should you be sucking in your stomach to make room for your diaphragm. At this point your body extracts the oxygen from your lungs leaving only carbon dioxide which you breathe back out. Also, when you breathe out your diaphragm will gently squeeze the lungs to push the air out

To put in simple terms, you should be breathing deeply and exhaling all the waste carbon dioxide from your lungs without forcing it out. This is done to make room for the new fresh air that your draw with your next breath. The more you breathe in and the more you manage to breathe out will help you hold your notes much longer. Breathing naturally also affects your singing performance as your notes will not sound forced or as though you are shouting them instead of singing them.

Breathing correctly

A quick breathing technique will tell you if you are breathing correctly. To start with lie flat on your back. Place your hand on your stomach so your fingers touch.  Start breathing in, you will feel how your stomach and chest move as they are filled with oxygen. You will be breathing correctly if you notice your stomach filling with air and expanding upwards towards your chest so that you end up with your stomach concave and your chest puffed outwards.

This is how you breathe normally and from here if you find you are breathing poorly you should use this position to consciously alter how you breathe and force yourself to allow for that ‘rolling’ motion up your stomach into your chest. Using these breathing techniques singing you can then fix your general breathing to enable you to sing and talk with more power and with more available air.

However singing is quite different from breathing normally as it requires you to exhale for long periods of time and to control the rate at which you let air escape. This requires control and again this can be trained using breathing techniques.

Controlling your breath

By using the method described above, you can try to alter the speed at which you breathe and how you let air escape. While maintaining good technique, breathe in continuously for the count of five seconds, then hold your breath for five seconds, then exhale continuously for five and begin again. You will find that breathing out for five whole seconds can be tricky as you quickly run out of breath, it is here then that control comes in to play as you have to use your breath control to let the air out slowly enough that you can breathe out for that long. This is how you learn to make the best of the amount of air your lungs can hold when holding a note. As you improve you can then begin increasing the number to control your inwards and outwards breaths for longer or shorter periods of time, just as you will need to in order to fit the phrasing of various songs.

A similar exercise used by some singers to train control is to breathe using a steady rhythm then ‘sing’ a number on each outwards breath, counting to say 20. This again requires control and each time it comes round to a count you need to be ready to have the right amount of air ready. This means inhaling and exhaling the correct amount at a steady rate.

As well as using breathing techniques singing style to control your breath, you can also benefit from simply holding more air in your lungs and so should work on increasing your lung capacity. You can do this with cardiovascular exercise which will help train your lungs, as will swimming underwater and holding your breath. By combining a larger lung capacity with a greater ability to control your breathing you will be armed with the ability to hold your notes and project them loudly and proudly.

Of course like all forms of training, the best form is to keep practicing. If you want to get better at singing, and singing in a certain way, then simply make sure you do vocal exercises and carry out breathing exercises often and try to enjoy what you do. That is the best way to improve on every facet of your technique.


What is inspiratory muscle training

Respiratory SymptomInspiratory muscle training also known as IMT is a regimen of breathing exercises that aims to strengthen the respiratory muscles in our body to make it easier for us to breathe comfortably. IMT can be used specifically for patients who suffer from any form of respiratory illness including emphysema, bronchitis, asthma, dyspnoea, chronic obstructive pulmonary disease (COPD) or any other breathing illness.

These types of illnesses have been shown to weaken and even deteriorate muscle bulk, including the muscles of the respiratory system, thereby depriving the body of necessary oxygen. This training is designed to strengthen and rebuild those muscles with controlled breathing exercises. Studies have also shown that IMT may also increase endurance during cardiovascular exercise or in high performance sports such as tennis, rugby and football.

During a normal breath, a person will typically use between 10 and 15 percent of his or her useable lung capacity. With respiratory muscle training, a person typically can increase the amount of useable lung capacity. Deeper breathing uses a bit more energy but at the same time also allows more oxygen to enter the bloodstream with each breath while strengthening the breathing muscles.

As one of the most popular respiratory training techniques, inspiratory muscle training can be performed at home with a breathing training device, at a doctor’s office, or at a rehabilitation centre. Devices provide resistance to force the diaphragm to expand more during breathing. Inspiratory Muscle Training (IMT) is scientifically proven to benefit patients with respiratory illness and healthy people.

If you are looking to train your respiratory muscles to work better when you breathe then using an inspiratory muscle training device twice a day can certainly help you to a much healthier lifestyle and more importantly help you with your breathing. A good pair of lungs helps you on your way to a better quality of life.

Breathing and vocal exercises for singers

One of the foundations of learning to sing correctly is knowing how to breathe correctly as well as learning how to correctly control the way you breathe so that when you are singing your breathing is being used to optimum effect.

As soon as we are born our breathing is naturally correct. A baby can breathe, yell and scream at optimum capacity because they are using their lungs without any conscious thought. However, as we grow older some people become lazy in how they breathe and breathe using only the upper part of their lungs – taking a shallow breath instead of a normal breath.

Understanding how to correctly breathe and use breath control, you need to first understand the process involved to help you achieve this. Our lungs are surrounded by a system of muscles known as the diaphragm. The diaphragm is attached to the lower ribs – on the sides, bottom and to the back acting as an inhalation device.  When we take a breath in the whole muscle lowers displacing the intestines and stomach and when you breathe out the diaphragm helps to manage the abdominal muscles surrounding the lungs control how quickly the breath is exhaled.

If you hold a finger close to your lips and breathe out slowly, your breath should be warm and moist and you should notice the action of the diaphragm as you exhale. For singing normally this is the correct amount of breath that should be used.  A singer does not need to ‘force’ or ‘push’ air through the vocal chords to produce a good strong sound, doing so creates too much pressure against the chords, preventing them from operating correctly which can cause damage to the voice.

Your stomach area should move naturally inward toward the end of the breath but it should not be sucked in as doing this will prevent the diaphragm working effectively. Instead the abdominal area should remain expanded to the level it was when you inhaled and allowed to gradually decrease naturally at the end of the breath.

At this point ‘control’ comes into play. As a singer you expand your lungs by inhaling therefore controlling the amount of air that is expelled when singing a note by allowing the muscle support system to remain expanded – this doesn’t mean the stomach is pushed out, rather that it is blown up like a balloon when the air goes in and the singer slows down the natural rate at which it goes down. In most people the breathing is shallow and only the top half of the lungs are used – breathing correctly uses the whole of the lungs so that more air is available, the singer then uses the natural action of the muscles (diaphragm and abdominals) surrounding the lungs to control the amount of air that is exhaled when singing a note.

Good breath support during singing and speech requires good posture, abdominal breathing and breathing during natural pauses. Breathing and correct support does not require great physical strength – although having toned abdominal muscles and doing some vocal exercises does help.

However, it is important to remember one thing…….the diaphragm doesn’t exhale for you – just helps to control the amount of air exhaled.

Breath Control for Singers featured on The One Show 18th April 2012

BBC iPlayer - The One ShowThe One Show recently included a feature on breath control for singers. Presented by Carrie Grant, British vocal coach and session singer, the feature began – and ended – with two extraordinary facts: the longest note in UK chart history is held by Morten Harket from Aha who held a note for 20-seconds, in ‘Summer Moved On’. This record is followed by Bill Withers who held a note for 18-seconds in his song ‘Lovely Day’.

How do they do it? Is lung capacity the key?

Could lung capacity be the reason why one person is able to hold a note longer than another person? Does this have an impact on the length of note held?

The peak flow test used in the feature revealed how the person with half the value of the second test subject was able to hold a note for far longer. This most important factor in holding the note longer was how the subject ‘breathed’. How she breathed in and how she controlled her breathing.

To illustrate breath control Dane Chalfin, Vocal Coach, suggested thinking of the lungs as a tube of toothpaste being slowly squeezed by the stomach muscles. Using this analogy, imagine the toothpaste emerging from the tube in a slow and controlled manner. As the muscle contracts it pushes everything up and assists air back up to the vocal folds (like toothpaste being pushed to the opening of the tube).

Most singers will experience 50% of air lost in the first note if they don’t use breath control, whereas with breath control less air is lost and a purer, longer note can be produced.

The One Show programme shown on 18/04/2012 is available to view on BBC iPlayer until 25/04/2012. The feature starts from about the 22.54 minute mark.

Please leave a comment here if you’re using POWERbreathe as part of your vocal exercises for singers and breath control. We’d love to hear from you.

Increase your lung efficiency with exercise

Inspiratory Muscle TrainingExercising on a regular basis is critical for fitness. Regular aerobic exercise is essential for cardiovascular fitness as the exercise reduces the amount of work the lungs need to do. However, you cannot increase your lung capacity with regular exercise and if you suffer from lung disorders such as COPD, asthma or emphysema regular exercise will not improve lung function.

Regular physical activity will help strengthen your limb muscles  and help to reduce shortness of breath symptoms and increase your stamina.

Function of the respiratory system

The respiratory system is made up of the nose, throat, windpipe and lungs.  This whole system works together to provide your body with life nourishing air in order for you to survive, as well as removing the waste gasses from your body.  To breathe correctly the airways must be open and clear of inflammation and large amounts of mucus.

Do you have asthma

You do if you suffer from shortness of breath, wheezing and constant coughing. These are all triggered by physical exertion or exercise..  When your airways constrict, extra mucus is produced and this is when the above symptoms will occur.

This doesn’t mean to say an asthma sufferer cannot enjoy running or jogging it just means they should choose indoor track venues rather than running outdoors as indoor their lungs will not breathe in any air pollutants.  Another important point to remember is warm up and cool down. Correct warm up and cool down exercises can also reduce the risk of exercise induced asthma.

Perfect exercise for asthma sufferers include swimming and yoga. Yoga is particularly good as it concentrates on breathing techniques, stretching and meditation.

Do you suffer from Emphysema?

Anyone who has this respiratory condition should take up walking as this is the best form of exercise for emphysema sufferers. Emphysema is a permanent form of COPD and is mainly found in people who are heavy smokers. If you do suffer from emphysema then two or three 15 minute walks per day are advisable. Strength training exercises can help build arm and leg muscles which may ease breathing difficulty while improving endurance. Breathing and balance techniques practiced may also benefit emphysema patients and help with their COPD treatment.