New clinical trial: Breathing power and lung volume significantly improved by simple counter-pressure resistance breathing exercises and warm steam

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Four weeks and 15 minutes a day of training significantly strengthened the lung function of asthma patients


Asthma is the most common lung disease in Finland. It affects half a million people. The symptoms and lung function of patients suffering from mild asthma often improve quickly even with current asthma medications. In any case, the strength of the respiratory muscles cannot be increased with drug treatment, and in more severe cases, the drugs are not enough to eliminate all the symptoms and do not improve lung function sufficiently. A combination of counter-pressure resistance breathing training and warm steam has not been clinically studied in the treatment of asthma before. A new study shows that this combination method provides a significant improvement in respiratory muscle strength and lung function.

The results of a clinical study conducted in Finland were presented at the beginning of September during the ERS 2022 Congress of the European Pulmonary Society in Barcelona. The results show that light daily training, where resistance breathing training is combined with warm steam, strengthened respiratory muscles by 12-20 percent in just four weeks. In addition, this combination training significantly improved the functional volume of the lungs.

45 people with mild or moderate asthma participated in the study. Throughout the study, they regularly used their own asthma medication which was considered optimal. The patients were randomly divided into an experimental group and a control group. Participants in the experimental group used a WellO2 breathing training device, which uses a combination of counter-pressure resistance and warm steam. The control group continued their lives as before.

Unique method and arrangement

A combination of two-way resistance breathing training and warm steam has not been clinically studied in the treatment of asthma before. Respiratory muscle strength was assessed by measuring maximal airway pressure during exhalation and inhalation. Lung volumes and air flow in the lungs were measured by spirometry.

- The better the condition respiratory muscles are in, the easier it is to breathe even for asthmatics, whose bronchial tubes tend to contract due to various stimuli. Respiratory muscles which are in better condition, reduce lung patients' shortness of breath during exertion and help them cope with severe lung infections more easily, for example in connection with COVID-19, says Emeritus Professor of Clinical Physiology Anssi Sovijärvi.

- It is therefore worth strengthening the respiratory muscles. It can be done effectively and conveniently with counter-pressure resistance breathing. In the study, steam breathing was combined with counter-pressure resistance breathing. It has long been known to relieve asthma patients' bronchoconstriction tendency and facilitate the removal of mucus from the lungs, Sovijärvi continues.


The authors of the study and the publication of the results

The effects of counterpressure and steam breathing training on lung function in stable asthma

The authors of the study are respiratory specialist (Master of Health Care) and nurse Katri Lindberg, PhD (biochemistry) Ilpo Kuronen, ear, nose, and throat specialist Jukka Heinijoki (MD) and professor emeritus of clinical physiology Anssi Sovijärvi. The main results of the study were presented at the ERS 2022 congress in Barcelona at the beginning of September. The congress is organized by the European Respiratory Society, which is Europe's largest scientific and research organization focused on lung diseases. The organization has more than 35,000 industry professionals as its members.

Summary of the study:

Introduction: Intensive counter-pressure breathing training improves lung function of asthma patients. However, the effects of training with a mild or moderate load have been scarcely studied.

Target: To investigate the effects of mild counter-pressure breathing training combined with steam on lung function in patients with medically treated asthma.  

Method: adults with mild to moderate asthma (N=45) were randomly divided into two groups A (N=25) and B (N=20). Group A used the WellO2™ device to do a 15-minute counter-pressure breathing exercise every day for four weeks, which included steam inhalation with warm water. Group B continued their life normally without any changes. The expiratory and inspiratory counter-pressure of the device was adjusted to 30% of the individual MEP (Maximum Expiratory Power) value. All trial participants used at least two inhaled medications prescribed for lung disease throughout the study. The spirometry variables, MEP and MIP, were measured from patients in group A and group B before and after the procedure at the same measurement interval.

Score: The baseline values measuring the lung function of the group members did not differ significantly from each other. The following values measured at the end of the experiment improved significantly more in group A than in group B: MEP (mean +12.4%, vs. +3.5%, p=0.047), MIP (mean +20.1% vs. +0.82%, p=0.046), VC (mean +3.7 % vs. 1.5%, p=0.017) and FET (mean +15.5%, vs. -5.0%, p=0.024.). In group A, the improvement from baseline values was very significant: MEP (p=0.004), MIP (p<0.001), VC (p<0.001) and FET (p<0.001). There were no adverse effects from the training.

Conclusions: Light counter-pressure breathing combined with steam breathing for four weeks increases respiratory muscle strength and vital capacity (VC) in patients whose asthma and its medication are under control.

Effects of counterpressure breathing with steam inhalation on lung function in stable asthma

Katri Lindberg, Ilpo Kuronen, Jukka Heinijoki, Anssi Sovijärvi


Asthma is the annoying daily companion of up to half a million Finns

In Finland, 10 percent of men over 30 years old and 14 percent of women over 30 years old suffer from asthma. The information comes from the FinTerveys 2017 study. In addition, the Institute of Health and Welfare has estimated that approximately 6–10 percent of children suffer from asthma.

According to a report by the Global Asthma Network, 334 million people worldwide suffer from asthma. It is the most common chronic lung disease in the world.

A recent study shows that people diagnosed with asthma have other ways to make themselves feel better, in addition to medication. A short daily lung exercise also improves lung function.

Poster: Effects of counterpressure breathing with steam inhalation on lung function in stable asthma E-poster Barcelona ver 1.0

Abstract: Effects of counterpressure breathing with steam inhalation on lung function in stable asthma   PA 3317

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WellO2 Oy

Katri Lindberg




One of the authors of the research report, Ilpo Kuronen is a minority shareholder of WellO2, which develops breathing exercise equipment. Katri Lindberg works at WellO2 Oy as an expert in lung diseases. The other authors have no ties to Wello Oy.

Wello2 is a versatile, lung-strengthening and cleansing breathing exercise device. It is an internationally patented Finnish innovation with over 100,000 users. The device is available in pharmacies, large retail stores, well-stocked sporting goods stores and physical therapy companies, as well as in the WellO2 online store.