This meta-analysis describes the efficacy of breathing exercises in patients with chronic obstructive pulmonary disease and asthma published in the last 25 years in international journals. The breathing exercises were grouped according to the goals of breathing exercises in these patients, ie, reducing hyperinflation of the rib cage, improving respiratory muscle function and coordination of breathing movements. The analysis was based on a firm methodological framework, focusing on controlled and statistically valid studies. In the view of the few statistically valid true experiments only patterns could be observed: a quantitative analysis was not possible. This stresses the necessity of duplication of studies to confirm or deny these patterns. It is concluded that mainly specific effects, effects on variables directly related to the breathing exercise, were observed. For example, during pursed lips breathing, training of respiratory muscles and forward leaning position. Transfer effects, effects on variables not directly related to the breathing exercise, were hardly studied and if so, improvements were not unequivocally found. It was suggested that in future research breathing exercises should be trained and evaluated in the specific condition or task in which they are meant to be helpful.

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