Development of a Screening Protocol to Identify Individuals With Dysfunctional Breathing

Abstract

Introduction: Dysfunctional breathing (DB) has been linked to health conditions including low back pain and neck pain and adversely effects the musculoskeletal system. Individuals with DB often have decreased pain thresholds and impaired motor control, balance, and movement. No single test or screen identifies DB, which is multi-dimensional, and includes biochemical, biomechanical, and psychophysiological components. Several tools assess and test for DB, but no screen exists to determine whether additional testing and assessment are indicated.Purpose/Background: The purpose of this study was to develop a breathing screening procedure that could be utilized by fitness and healthcare providers to screen for the presence of disordered breathing. A diagnostic test study approach was utilized to establish the diagnostic accuracy of the newly developed screen for DB.Methods: A convenience sample of 51 subjects (27 females, 27.0 years, BMI 23.3) were included. To test for DB related to the biochemical dimension, end-tidal CO2 (ETCO2) was measured with a capnography unit. To test for DB related to biomechanical dimension, the Hi-Lo test was utilized. To test for DB related to the psychophysiological dimension, the Self Evaluation of Breathing Symptoms Questionnaire (SEBQ) and Nijmegen questionnaires were utilized. Potential screening items that have been shown to be related to DB in previous research and that could be performed by non-health care personnel were utilized to create the index test including activity level, breath hold time (BHT), respiration rate, and the Functional Movement Screen (FMS™).Results: There were no strong correlations between the three measures of DB. Five subjects had normal breathing, 14 failed at least one measure, 20 failed at least two, and 12 failed all three. To develop screening items for each dimension, data were examined for association with failure. BHT and a four-item mini-questionnaire were identified as the most closely associated variables with failure of all three dimensions. A BHT of <25 seconds and four questions were combined and yielded a sensitivity of 0.89 (0.85-0.93) and a specificity of 0.60 (0.18-0.92) for clinical identification of DB. Conclusion:Easily obtained clinical measures of BHT and four questions can be utilized to screen for the presence of DB. If the screen is passed, there is an 89% chance that DB is not present. If the screen is failed, further assessment is recommended. Level of Evidence: 2b

Effect of Dynamic Neuromuscular Stabilization Breathing Exercises on Some Spirometry Indices of Sedentary Students With Poor Posture

“…Inhala-tion and exhalation were done respectively through the nose and the mouth. Also, during the breathing, the diaphragm falls into the abdominal cavity during the inhalation, the ribs rise and move laterally, expand the transverse dimensions of the thorax [20,[22][23][24]. The same DNS breathing exercise program was performed with participants at home.…”

“…Exercise intensity based on developmental positions automatically proper activation stereotype of stabilization and breathing of natural postural-locomotion patterns as defined by developmental kinesiology. This aim can be achieved via the activation of the stabilizers when placing the participants in developmental positions of an infant at third three months of developmental age to 13 months, as performed in this study [20,[22][23][24][25]. The protocol is implemented under the supervision of a trainer.…”

Breathing Re-Education and Phenotypes of Sleep Apnea: A Review

“…It is known that high loop gain during sleep is determined by a low breath-hold time during wakefulness [ 5 ]. Short breath holding time is a known trait of individuals with chronic idiopathic hyperventilation and other types of dysfunctional breathing [ 97 , 98 , 99 , 100 , 101 , 102 , 103 ].…”

Nijmegen Questionnaire: A valid measure for hyperventilation syndrome

“…Dysfunctional breathing is increasingly recognised as a costly health concern, given the involvement of various medical or surgical investigations prior to correctly identifying susceptible individuals (Chaitow, Morrison & Gilbert, 2014;Mooney & Candy, 2008). With the lack of population-based cohort studies in the literature, the prevalence of dysfunctional breathing is largely an estimate (Kiesel, Rhodes, Mueller, Waninger & Butler, 2017). Two cross-sectional studies based at a general practice of 7,033 clients in the United Kingdom showed that approximately 8% of adults without asthma who had visited a general practitioner, suffered from symptoms associated with dysfunctional breathing (Thomas, McKinley, Freeman, Foy, & Price, 2005).…”