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Breathing retraining: A five-year follow-up of patients with dysfunctional breathing
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Physiotheraphy. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.
2011 (English)In: Respiratory Medicine, ISSN 0954-6111, E-ISSN 1532-3064, Vol. 105, no 8, p. 1153-1159Article in journal (Refereed) Published
Abstract [en]

Introduction: The term dysfunctional breathing (DB) has been introduced to describe patients who display divergent breathing patterns and have breathing problems that cannot be attributed to a specific medical diagnosis. Patients with DB are often misdiagnosed as having asthma. Objectives: To describe patients with DB, five years after a breathing retraining intervention. Methods: Out of initially 25 patients with DB and 25 age and sex-matched patients with asthma, 22 patients with DB and 23 patients with asthma (ages 25-78 years) were followed up after five years. Data were collected from posted self-report questionnaires. Only patients with DB had received breathing retraining, consisting of information; advice and diaphragmatic breathing. Patients were evaluated regarding quality of life (SF-36), anxiety, depression, sense of coherence, hyperventilation, influence on daily life, emergency room (ER) visits, and symptoms associated with DB. Results: Quality of life (SF-36), physical component summary scale (PCS), had improved in patients with DB from 43 to 47 (p = 0.03). The number of ER visits had decreased from 18 to 2 in patients with DB (p = 0.02). Symptoms associated with DB had decreased extensively, from a mean score of 6.9 to 2.7, on a DB criterion list (p < 0.001). Patients with DB were less impaired by their breathing problems both in daily life and when exercising (p < 0.001). The only difference found over time in the asthma group concerned quality of health, bodily pain, which had deteriorated, from 77 to 68 (p = 0.049). Conclusion: This five-year follow-up study indicates that patients with dysfunctional breathing benefit from breathing retraining.

Place, publisher, year, edition, pages
2011. Vol. 105, no 8, p. 1153-1159
Keywords [en]
Dysfunctional breathing, Asthma, Breathing retraining, Health-related quality of life, Emergency room visits, Influence on daily life
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-156613DOI: 10.1016/j.rmed.2011.03.006ISI: 000292672000006OAI: oai:DiVA.org:uu-156613DiVA, id: diva2:432796
Available from: 2011-08-07 Created: 2011-08-04 Last updated: 2017-12-08Bibliographically approved
In thesis
1. Dysfunctional breathing: Clinical characteristics and treatment
Open this publication in new window or tab >>Dysfunctional breathing: Clinical characteristics and treatment
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Dysfunctional breathing (DB) is a respiratory disorder involving an upper chest breathing pattern and respiratory symptoms that cannot be attributed to a medical diagnosis.

Aim: The overall aim of this thesis was to describe patients with DB and investigate clinical outcomes after physiotherapy treatment.

Methods: Study I was descriptive and comparative, that included 25 patients with DB and 25 age- and sex-matched patients with asthma. Health-related quality of life (HRQoL), anxiety, depression, sense of coherence, influence on daily life due to breathing problems, respiratory symptoms, emergency room visits and asthma medication were investigated. Study II, a 5-year follow-up study based on the same sample as study I (22 patients with DB, 23 patients with asthma), studied treatment outcomes after information and breathing retraining. Study III was descriptive and correlational (20 healthy subjects), investigating whether the Respiratory Movement Measuring Instrument (RMMI) can discriminate between different breathing patterns in varying body positions. Study III also studied correlations between respiratory movements and breathing volumes (12 healthy subjects). Study IV was a single-subject AB design with follow-ups. Self-registered patient-specific respiratory symptoms and respiratory-related activity limitations and breathing pattern (measured with the RMMI) were evaluated after an intervention consisting of information and breathing retraining in five patients with DB.

Results: Patients with DB had lower HRQoL (SF-36): vitality (mean 47 vs. 62), social functioning (70 vs. 94) and role emotional (64 vs. 94) (p<0.05) than patients with asthma. The DB group had a higher prevalence of anxiety (56% vs. 24%) and experienced more breathing problems than the asthma group. Patients with DB had made several emergency room visits and had been treated with asthma medication. At the 5-year follow-up, patients with DB showed improved HRQoL (SF-36): physical function 77 to 87 (p=0.04), decreased breathing problems and emergency room visits, and they were not treated with asthma medication. The RMMI can differentiate between different breathing patterns in different body positions. Strong correlations between respiratory movements and breathing volumes were observed (rs 0.86-1.00). The results in study IV indicate that patients with DB benefit from information and breathing retraining regarding decreased respiratory symptoms and activity limitations and improved breathing pattern.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2016. p. 67
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1239
Keywords
dysfunctional breathing, breathing pattern, breathing retraining, respiratory movement measuring instrument, respiratory symptoms, respiratory-related activity limitations
National Category
Medical and Health Sciences
Research subject
Physiotherapy
Identifiers
urn:nbn:se:uu:diva-295667 (URN)978-91-554-9629-6 (ISBN)
External cooperation:
Public defence
2016-09-16, Falu lasarett, Föreläsningssalen, Söderbaums väg 8, Falun, 10:00 (Swedish)
Opponent
Supervisors
Available from: 2016-08-26 Created: 2016-06-08 Last updated: 2016-09-05

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Hagman, CarinaJanson, ChristerEmtner, Margareta

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