Protocol for a multicentre randomised controlled trial to investigate the effect on asthma-related quality of life from breathing retraining in patients with incomplete asthma control attending specialist care in Denmark

Background and Purpose Dysfunctional breathing (DB) with or without an underlying medical condition is associated with impaired quality of life. DB-related symptoms can be measured with the 25-item Self Evaluation of Breathing Questionnaire (SEBQ). However, the SEBQ is not available in Danish.The aim of the present study was to translate and cross-culturally adapt the SEBQ into Danish and to assess the face validity of the Danish version of the questionnaire in individuals with DB-related symptoms. Materials and Methods The SEBQ was translated and cross-culturally adapted into Danish using an internationally acknowledged six-step forward-backward translation guideline in an interactive process with an expert committee of clinicians, translators, methodologists and the SEBQ developer. Face validity was explored through semi-structured interviews with 24 adult individuals with DB-related symptoms (age 20–70 years, female n = 14). Results The SEBQ was successfully translated and cross-culturally adapted into Danish. Three major modifications were made following the translation process and participant interviews. First, an introductory paragraph, including a recall period of the previous seven days, was added. Second, the administration of the questionnaire was changed from a paper to an electronic version. Finally, adaptations regarding semantic equivalence, especially concerning being ‘breathless’ and ‘short of breath’, were performed. The participants expressed that the final version of the SEBQ embraced their DB-related symptoms, was understandable, and easy to complete. Conclusion The SEBQ is the first available Danish questionnaire to measure DB-related symptoms, following an internationally acknowledged cross-cultural adaptation and face validity evaluation approach. This promising validation should be followed by an assessment of measurement properties in individuals with DB-related symptoms to investigate the adequacy of the SEBQ in a Danish context.

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Breathing Exercises for Patients with Asthma in Specialist Care: A Multicenter Randomized Clinical Trial

Andreasson

Skou

Ulrik

et al. 2022

Annals ATS

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Rationale Moderate to severe asthma is associated with impaired asthma control and quality of life (QoL) despite access to specialist care and modern pharmacotherapy. Breathing exercises (BrEX) improve QoL in incompletely controlled mild asthma, but impact in moderate to severe asthma is unknown. Objectives To investigate the effectiveness of BrEX as adjuvant treatment on QoL in patients with uncontrolled moderate to severe asthma. Methods Adult patients with incompletely controlled asthma attending respiratory specialist clinics were randomized to usual specialist care (UC) or UC and BrEX (UC + BrEX) with three individual physiotherapist-delivered sessions and home exercises. Primary outcome was asthma-related QoL (Mini-Asthma Quality of Life Questionnaire [Mini-AQLQ]) at 6 months on the basis of intention-to-treat analysis. Secondary outcomes: Mini-AQLQ at 12 months, lung function, 6-minute-walk test, physical activity level, Nijmegen Questionnaire, Hospital Anxiety and Depression Scale, and adverse events. Repeated-measures mixed-effects models were used to analyze data. Poisson regression models were used to analyze adverse event incidence rate ratio. Results A total of 193 participants were allocated to UC + BrEX ( n = 94) or UC ( n = 99). UC + BrEX was superior in the primary outcome (adjusted mean change difference, 0.35; 95% confidence interval [CI], 0.07 to 0.62). Superiority in Mini-AQLQ was sustained at 12 months (0.38; 95% CI, 0.12 to 0.65). A minor improvement in Hospital Anxiety and Depression Scale depression score at 6 months favoring UC + BrEX (−0.90; 95% CI, −1.67 to −0.14) was observed. Asthma-related adverse events occurred similarly in UC + BrEX and UC participants: 14.9% versus 18.1% ( P = 0.38). Conclusions BrEX as add-on to usual care improve asthma-related QoL in incompletely controlled asthma regardless of severity and with no evidence of harm. Clinical trial registered with www.clinicaltrials.gov (NCT 03127059).

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Protocol for a multicentre randomised controlled trial to investigate the effect on asthma-related quality of life from breathing retraining in patients with incomplete asthma control attending specialist care in Denmark

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Translation and cross-cultural adaptation of the self evaluation of breathing questionnaire (SEBQ) into Danish

Breathing Exercises for Patients with Asthma in Specialist Care: A Multicenter Randomized Clinical Trial

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