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CONTINUING PROFESSIONAL DEVELOPMENT
agitation, palpitations, arrhythmias,
insomnia, diarrhoea and caffeine
can occur in children even at low doses
(~3 mg/kg daily).27
Based on several small-scale studies,
restricting dietary sodium intake may
improve lung function in people with
exercise-induced asthma, but larger
studies are required to confirm
Results from studies on exercise training
interventions in people with asthma
have produced variable results, largely
due to the considerable heterogeneity
of the studies.
In those with stable
asthma, exercise training may improve
the number of days without asthma
symptoms, exercise capacity and
Due to methodological differences and
poor study reporting, it is difficult to
draw conclusions regarding the potential
benefits of breathing exercises for asthma
sufferers. However, breathing exercises
appear to improve asthma symptoms and
quality of life.31 The Buteyko technique
is a breathing exercise which may assist
in the relief of acute asthma symptoms.
A systematic review of breathing retraining
in asthma management reported that
studies investigating the Buteyko
technique demonstrated a significant
reduction in beta2-agonist use, with some
studies showing improved quality of life or
a reduction in inhaled corticosteroid use.
Cautions and counselling points
• People with asthma should be advised
of the potential benefits of caffeine
consumption, but warned about
the adverse effects and possible
interference with lung function tests.
• The benefits of exercise are likely
to outweigh risks in people with
• Breathing exercises may be a useful
adjunct to conventional therapies
The evidence for CAM treatments in
the management of asthma is limited.
Several herbal medicines have been
investigated over a number of years,
but further large scale studies are
required to confirm the efficacy and
safety of such treatments before they
can be recommended for routine
use. Some patients may experience
benefits but, due to concerns
for adverse reactions, cautions
and possible contraindications,
such herbs should only be prescribed
by an appropriately-trained health
professional. Moderate caffeine
consumption may be mildly beneficial
for some people with asthma,
but patients should be alert to
possible adverse effects and refrain
from caffeine consumption for at least
4 hours prior to lung function tests. For
most people with asthma a sensible
exercise training program and breathing
exercises may be a useful adjunct to
KEY LEARNING POINTS
• Many people with asthma are already
using CAM therapies in addition
to their conventional treatments,
or wish to do so. They need to be
able to discuss their preferences in a
non-judgemental environment and
be provided with current information
regarding the efficacy and safety of
• Research for CAM use in people with
asthma is limited, but some patients
may benefit from sensible adjunctive
treatment by an appropriately-trained
1. Australian Bureau of Statistics. Profiles of Health, Australia,
2011-13: Asthma. 2013. At: www.abs.gov.au/ausstats/abs@.
2. Chen W, FitzGerald JM, Rousseau R, et al. Complementary
and alternative asthma treatments and their association with
asthma control: a population-based study. BMJ Open 2013;3(9).
3. Philp JC, Maselli J, Pachter LM, et al. Complementary and
alternative medicine use and adherence with pediatric
asthma treatment. Pediatrics 2012;129(5):e1148-54.
4. National Asthma Council Australia. Asthma & complementary
therapies. South Melbourne: NACA; 2012. At: www.
5. Arnold E, Clark CE, Lasserson TJ, et al. Herbal interventions for
chronic asthma in adults and children. Cochrane Database
of Systematic Reviews 2008, Issue 1. Art. No.: CD005989. DOI:
6. Clark CE, Arnold E, Lasserson TJ, et al. Herbal interventions for
chronic asthma in adults and children: a systematic review
and meta-analysis. Prim Care Respir J 2010;19(4):307–14 .
7. Houssen ME, Ragab A, Mesbah A, et al. Natural anti-
inflammatory products and leukotriene inhibitors as
complementary therapy for bronchial asthma. Clin Biochem
8. Gupta I, Gupta V, Parihar A, et al. Effects of Boswellia serrata
gum resin in patients with bronchial asthma: results of a
double-blind, placebo-controlled, 6-week clinical study. Eur J
Med Res 1998;3(11):511–4 .
9. Gonzalez-Sanchez R, Trujillo X, Trujillo-Hernandez B, et al.
Forskolin versus sodium cromoglycate for prevention of
asthma attacks: a single-blinded clinical trial. J Int Med Res
10. Huerta M, Urzua Z, Trujillo X, et al. Forskolin compared with
beclomethasone for prevention of asthma attacks: a single-
blind clinical trial. J Int Med Res 2010;38(2):661–8.
THE COMPLEMENTARY APPROACH
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