Background: Various complementary or alternative medicines (including breathing
exercises and yoga/pranayama) have been tried as an attractive option to pharmacotherapy in childhood
Objective: To evaluate the role of breathing exercise and yoga/pranayama as add on therapy to the
“pharmacologically recommended treatment” of childhood asthma.
Methods: We searched the published literature in the major databases: Medline via Ovid, PubMed,
CENTRAL, Embase, and Google Scholar till June 2018. Randomized trials comparing breathing
exercises and yoga/ pranayama versus control or as part of a composite intervention versus control
were included. The primary outcome measures were quality of life and change in asthma symptoms.
Secondary outcomes were: decrease in medication use, number of exacerbations, change in
lung function and immunological parameters, school absenteeism and adverse events.
Results: A total of 10 trials (466 children, 6-14 years age) were included. The severity of asthma
varied among the trials. The data for primary outcome measures could not be pooled, there were
mixed results for both primary and secondary outcomes. No significant benefit was obtained in
acute asthma and the lung function tests [except PEFR % at 4-6 weeks, PEF absolute at 3 months,
and FVC absolute at 3 months] in chronic asthma. One trial compared breathing exercise versus
yoga and found no difference. Adverse events were not significant.
Conclusions: Breathing exercise and yoga/ pranayama may have some additive role in the treatment
of childhood asthma. However, at present, it cannot be recommended as a standard of care
due to insufficient data.