Biofeedback in the treatment of asthma

Bronchial asthma is a chronic, inflammatory condition of the airways. The airways are narrowed either temporarily or permanently, and the bronchi are hypersensitive to various internal and external triggers such as cold air, physical exertion, house dust mites and psychological stress. This lung condition manifests itself as episodic shortness of breath, coughing, a tightness in the chest and difficulty breathing. The symptoms are subjectively experienced as very alarming, as an asthma attack is often accompanied by a feeling of suffocation. Objectively measurable changes also occur in respiratory parameters.

An asthma attack can be frightening for those affected. This fear causes breathing to become shallower, which in turn reduces the supply of oxygen. Rapid, shallow breathing causes the airways to narrow further, which in turn exacerbates breathlessness. This vicious circle, in which asthma symptoms and anxiety feed off each other, places a double burden on sufferers, particularly those with anxiety disorders.

This is where the training with Biofeedback with the aim of breaking this vicious circle. Through breathing and muscle relaxation exercises, the aim is to achieve systematic desensitisation and the development of relaxation skills, which help those affected to reduce their anxiety both before and during an asthma attack. During an asthma attack, the mutual reinforcement of anxiety and attack symptoms can be self-directed and avoided; those affected are shown a way out of their perceived helplessness. Children, in particular, embrace this opportunity to gain greater self-determination and self-efficacy in managing their own asthma with great enthusiasm.

The treatment

Through breathing exercises and training aimed at reducing muscle tension in the musculus frontalis (forehead muscle) and the musculus trapezius (trapezius muscle; neck area), those affected are encouraged to practise relaxation during an imagined asthma attack, as part of a systematic desensitisation process. Additional training in chest and abdominal breathing can help to deepen relaxation. Breathing is measured during the training using a contactless infrared breath sensor. Compared with a breathing belt, this offers the advantage that participants do not experience any feeling of constriction during the measurement.

Effectiveness

Biofeedback is an effective and cost-effective treatment method, particularly for children, and it also achieves good long-term results after 10–20 sessions.

The specific benefits are:

• Changes in coping with illness: an improvement in one’s attitude towards one’s own illness
• Reducing general anxiety through greater self-determination
• This reduces susceptibility to stress-related impairment of lung function
• Improvement in respiratory parameters (particularly forced expiratory volume, FEV₁)
• Reduction in muscle tension in the frontalis muscle and the trapezius muscle