Identification of Breathing Pattern Disorder in Athletes With Exercise-Induced Laryngeal Obstruction: A Novel Assessment Tool

Milstein, Claudio F.; Patel, Rita R.; Laurash, Emma; Kampert, Matthew

doi:10.1016/j.jvoice.2023.01.006

Cited by 9 publications

(9 citation statements)

References 22 publications

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“…Our search identified the following ten outcome measures that have examined reliability and/or validity components: Breathing Vigilance Questionnaires (Breathe-VQ),32 MARM,15 21 NQ,33–37 BPAT,38 39 Hi Lo test,21 clinical assessments of increased work of breathing,40 Milstein Breathing Pattern Assessment Index (M-BPAI),41 SEBQ,14 22 TFBS24 26 and Dyspnoea-12 (D12) questionnaire 38. The Hi-Lo and D-12 scales were not included in this review for evaluation because they are not the primary scales used to assess DB 21 38.…”

Section: Resultsmentioning

confidence: 99%

“…In total, 10 studies reported reliability measures. M-BPAI41 and TFBS24 26 were rated to have ‘very good’ methodological quality and ‘sufficient’ rating 41. The methodological quality and rating were the same as the MARM and SEBQ 15 21 22.…”

Section: Resultsmentioning

confidence: 99%

“…The remaining outcome measures, such as MARM, clinical evaluation of increased effort of breathing, TFBS, SEBQ and M-BPAI, had examined only a few psychometric properties 15 21 22 24 26 40 41. The reviewers could only comment on its clinical utility once the remaining properties had been thoroughly investigated.…”

Section: Discussionmentioning

confidence: 99%

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Validity and reliability of outcome measures to assess dysfunctional breathing: a systematic review

Mohan,

Rathinam,

Yates

et al. 2024

BMJ Open Resp Res

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ObjectiveThis study aimed to systematically review the psychometric properties of outcome measures that assess dysfunctional breathing (DB) in adults.MethodsStudies on developing and evaluating measurement properties to assess DB were included. The study investigated the empirical research published between 1990 and February 2022, with an updated search in May 2023 in the Cochrane Library database of systematic reviews and the Cochrane Central Register of Controlled Trials, the Ovid Medline (full), the Ovid Excerta Medica Database, the Ovid allied and complementary medicines database, the Ebscohost Cumulative Index to Nursing and Allied Health Literature and the Physiotherapy Evidence Database. The included studies’ methodological quality was assessed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) risk of bias checklist. Data analysis and synthesis followed the COSMIN methodology for reviews of outcome measurement instruments.ResultsSixteen studies met the inclusion criteria, and 10 outcome measures were identified. The psychometric properties of these outcome measures were evaluated using COSMIN. The Nijmegen Questionnaire (NQ) is the only outcome measure with ‘sufficient’ ratings for content validity, internal consistency, reliability and construct validity. All other outcome measures did not report characteristics of content validity in the patients’ group.DiscussionThe NQ showed high-quality evidence for validity and reliability in assessing DB. Our review suggests that using NQ to evaluate DB in people with bronchial asthma and hyperventilation syndrome is helpful. Further evaluation of the psychometric properties is needed for the remaining outcome measures before considering them for clinical use.PROSPERO registration numberCRD42021274960.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Validity and reliability of outcome measures to assess dysfunctional breathing: a systematic review

Mohan,

Rathinam,

Yates

et al. 2024

BMJ Open Resp Res

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“…The relationship between reflexive glottal closure and hypocapnia needs to be further investigated in patients with EILO in future studies. Stridor/noisy breathing is one of the three most common symptoms (the other two being shortness of breathy and throat tightness) of patients with EILO 4,39–41 . Not all patients with EILO may present with stridor.…”

Section: Discussionmentioning

confidence: 99%

“…Stridor/noisy breathing is one of the three most common symptoms (the other two being shortness of breathy and throat tightness) of patients with EILO. 4,[39][40][41] Not all patients with EILO may present with stridor.…”

Section: Relationship Between Area Airflow and Pressures During Eilo ...mentioning

confidence: 99%

Computational fluid dynamics of upper airway aerodynamics for exercise‐induced laryngeal obstruction: A feasibility study

Döllinger,

Jakubaß,

Cheng

et al. 2023

Laryngoscope Investig Oto

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ObjectiveUse of computational fluid dynamic (CFD) simulations to measure the changes in upper airway geometry and aerodynamics during (a) an episode of Exercise‐Induced Laryngeal Obstruction (EILO) and (b) speech therapy exercises commonly employed for patients with EILO.MethodsMagnetic resonance imaging stills of the upper airway including the nasal and oral cavities from an adult female were used to re‐construct three‐dimensional geometries of the upper airway. The CFD simulations were used to compute the maximum volume flow rate (l/s), pressure (Pa), airflow velocity (m/s) and area of cross‐section opening in eight planes along the vocal tract, separately for inhalation and exhalation.ResultsNumerical predictions from three‐dimensional geometrical modeling of the upper airway suggest that the technique of nose breathing for inhalation and pursed lip breathing for exhalation show most promising pressure conditions and cross‐sectional diameters for rescue breathing exercises. Also, if EILO is due to the constriction at the vocal fold level, then a quick sniff may also be a proper rescue inhalation exercise. EILO affects both the inspiratory and the expiratory phases of breathing.ConclusionsA prior knowledge of the supraglottal aerodynamics and the corresponding upper airway geometry from CFD analysis has the potential to assist the clinician in choosing the most effective rescue breathing technique for optimal functional outcome of speech therapy intervention in patients with EILO and in understanding the pathophysiology of EILO on a case‐by‐case basis with future studies.Level of Evidence4

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Long-Term Outcomes of Respiratory Retraining Therapy for Exercise-Induced Laryngeal Obstruction

Vos,

Milstein

2024

Journal of Voice

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Identification of Breathing Pattern Disorder in Athletes With Exercise-Induced Laryngeal Obstruction: A Novel Assessment Tool

Cited by 9 publications

References 22 publications

Validity and reliability of outcome measures to assess dysfunctional breathing: a systematic review

Validity and reliability of outcome measures to assess dysfunctional breathing: a systematic review

Computational fluid dynamics of upper airway aerodynamics for exercise‐induced laryngeal obstruction: A feasibility study

Long-Term Outcomes of Respiratory Retraining Therapy for Exercise-Induced Laryngeal Obstruction

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