I think the major part of what makes it useful is just adding resistance for breathing. It helps to train the breathing muscles, just like any other resistance training.
From the "Medical Evidence" section, it seems I'm not missing much.
If you demand extensive peer reviewed medical evidence of some specific quantified outcome before doing any activity in life you will miss quite a lot of valuable things that can’t be easily quantified or measured, or funded academically.
volkk•1h ago
callumprentice•1h ago