OBJECTIVE: To compare two breathing exercises (Buteyko and Pranayama) with a control group in patients with asthma. DESIGN: Randomized controlled trial. SUBJECTS: One hundred and twenty subjects were randomized to three groups through block randomization. Subjects with an Asthma Quality of Life Questionnaire score < 5.5 participated in the study. SETTING: Outpatient pulmonary medicine department. INTERVENTIONS: Subjects in the Buteyko and pranayama groups were trained for 3 to 5 days and instructed to practise the exercises for 15 minutes twice daily, and for three months duration. The control group underwent routine pharmacological management during the study period. OUTCOME MEASURES: Asthma Quality of Life Questionnaire, Asthma Control Questionnaire and pulmonary function test. RESULTS: The baseline characteristics were similar in all three groups. Post intervention, the Buteyko group showed better trends of improvement (mean (95% confidence interval), p-value) in total Asthma Quality of Life Questionnaire score than the pranayama (0.47 (-0.008 to 0.95), p = 0.056) and control groups (0.97 (0.48 to 1.46), p = 0.0001). In comparison between the pranayama and control groups, pranayama showed significant improvement (0.50 (0.01 to 0.98), p = 0.042) in total Asthma Quality of Life Questionnaire score. CONCLUSION: The Buteyko group showed better trends of improvement in quality of life and asthma control than the group performing the pranayama breathing exercise.

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