Nurse-led Buteyko versus diaphragmatic breathing retraining in hospitalized children with asthma: A three-group...

Pediatric asthma may involve dysfunctional breathing patterns and autonomic dysregulation not directly addressed by pharmacotherapy. Comparative evidence on breathing retraining in hospitalized children remains limited.

To compare nurse-led Buteyko Breathing Technique (BBT) and Diaphragmatic Breathing Technique (DBT) versus routine care on heart rate (HR), respiratory rate (RR), systolic blood pressure (SBP), peripheral oxygen saturation (SpO₂), Control Pause (CP) time, and Modified Becker's Score (MBS) in hospitalized children with bronchial asthma.

A three-group quasi-experimental pretest-posttest study enrolled 90 hospitalized children aged 6-12 years in BBT, DBT, or routine care groups (30/group) at the inpatient pediatric department of a university hospital in Upper Egypt, preceded by a small pilot study with nine children (three per group) not included in the main analysis, which confirmed feasibility and informed sample-size refinement. Two nurse-delivered sessions (30-45 min each) were initiated 24-48 h after stabilization with prescribed pharmacotherapy.

Both intervention groups were associated with significant reductions in HR and RR versus controls on adjusted analyses: HR (F = 6.72, p = .002, partial η² = 0.136) and RR (F = 9.18, p < .001, partial η² = 0.178). BBT was associated with the largest CP improvement; normalization (≥ 40 s) occurred in 60.0% of BBT versus 0% in DBT and controls (F = 12.05, p < .001, partial η² = 0.221). SpO₂ normalized in 56.7% of BBT, 23.3% of DBT, and 0% of controls. Adjusted SBP differences were not significant (p = .250).

Nurse-led breathing retraining was associated with short-term physiological improvement during pediatric asthma hospitalization, with BBT showing a greater association with improvement in CP and oxygenation. Given the non-randomized design, baseline severity imbalance, brief dose, and absence of follow-up, findings are preliminary and require confirmation in rigorously designed randomized controlled trials.