Abstract:The prevalence of symptoms indicative of HVS in an unselected population of adolescents was relatively high. Symptoms were more common in girls and in subjects with asthma, and there was a significant effect of asthma activity on the probability of suffering from HVS. Further studies need to be performed in order to validate a screening tool for HVS in both adolescents and asthmatic subjects.
“…In this service evaluation, the prevalence of DB symptoms (NQ score ≥ 23) was 35%, which is higher than the 25.8% prevalence previous research has found . This may be due to our targeted cohort that was referred to physiotherapy based on a suspicion of DB.…”
Section: Discussionsupporting
confidence: 91%
“…This may be due to our targeted cohort that was referred to physiotherapy based on a suspicion of DB. Nevertheless, our findings support previous work that DB may be a clinically relevant comorbidity in pediatric asthma. High NQ scores (≥23) can be associated with non‐DB symptoms, for example, anxiety or stress, however, in this service evaluation it predominately correlated with an observed DB pattern.…”
Section: Discussionsupporting
confidence: 91%
“…More recent studies have used the NQ to identify DB symptoms in adults and in children. A NQ score of more than or equal to 23 indicated symptoms of DB . In addition, participant's breathing patterns were observed and classified as a DB pattern if it was from the upper chest (rather than diaphragmatic) and also if there was the presence of a high respiratory rate for their age, mouth breathing, or excessive sighing.…”
Section: Methodsmentioning
confidence: 99%
“…DB symptoms can mimic or worsen those of asthma, frequently evident as exercise‐induced dyspnea, and chest tightness . The prevalence of DB in asthma may be as high as 25.8% . Methods to help evaluate DB in pediatrics include structured observation by a trained physiotherapist in addition to the Nijmegen Questionnaire (NQ) symptom score .…”
Section: Introductionmentioning
confidence: 99%
“…DB is a dysfunctional breathing pattern that causes symptoms, so both the presence of a DB pattern and symptoms are required to assess changes. There are no validated measures of DB in pediatrics; however, the NQ has previously been used to detect and monitor DB symptoms in pediatric patients …”
Objective
To assess the impact of breathing retraining on asthma symptoms and dysfunctional breathing (DB) in children. Breathing retraining can improve DB but there is a lack of evidence in pediatrics.
Methods
Participants attended outpatient physiotherapy appointments and received individually tailored interventions, particularly Buteyko breathing techniques. The primary outcome was the change in the Asthma Control Test (ACT) score or change in childhood ACT (CACT) score from first to final appointment. The ACT and CACT are validated in children more than or equal to 12 years and children aged 4 to 11, respectively. The secondary outcome measure was the change in Nijmegen Questionnaire (NQ) score from first to the final appointment (score range, 0‐64) with a score of more than or equal to 23 indicating DB symptoms.
Results
One hundred and sixty‐nine children with asthma attended and completed a mean of six physiotherapy sessions, over a mean of 15 weeks. Patients were aged 2 to 18, mean 10 years. Fifty‐five patients were more than or equal to 12 years old and 114 were less than or equal to 11 years. One hundred and seven patients were receiving BTS/SIGN asthma guideline step 1 to 3 therapy and 62 were on step 4 to 5 therapy. The mean ACT score improved by 4.4 (P < 0.0001), the mean CACT score improved by 4.9 (P < 0.0001), and the mean NQ score change improved by −9.3 points (P < 0.0001).
Conclusion
In addition to standard medical therapy, individually tailored physiotherapy interventions improved asthma control and DB in children on all levels of asthma treatment. A randomized controlled study is required to determine whether these improvements are due to the intervention.
“…In this service evaluation, the prevalence of DB symptoms (NQ score ≥ 23) was 35%, which is higher than the 25.8% prevalence previous research has found . This may be due to our targeted cohort that was referred to physiotherapy based on a suspicion of DB.…”
Section: Discussionsupporting
confidence: 91%
“…This may be due to our targeted cohort that was referred to physiotherapy based on a suspicion of DB. Nevertheless, our findings support previous work that DB may be a clinically relevant comorbidity in pediatric asthma. High NQ scores (≥23) can be associated with non‐DB symptoms, for example, anxiety or stress, however, in this service evaluation it predominately correlated with an observed DB pattern.…”
Section: Discussionsupporting
confidence: 91%
“…More recent studies have used the NQ to identify DB symptoms in adults and in children. A NQ score of more than or equal to 23 indicated symptoms of DB . In addition, participant's breathing patterns were observed and classified as a DB pattern if it was from the upper chest (rather than diaphragmatic) and also if there was the presence of a high respiratory rate for their age, mouth breathing, or excessive sighing.…”
Section: Methodsmentioning
confidence: 99%
“…DB symptoms can mimic or worsen those of asthma, frequently evident as exercise‐induced dyspnea, and chest tightness . The prevalence of DB in asthma may be as high as 25.8% . Methods to help evaluate DB in pediatrics include structured observation by a trained physiotherapist in addition to the Nijmegen Questionnaire (NQ) symptom score .…”
Section: Introductionmentioning
confidence: 99%
“…DB is a dysfunctional breathing pattern that causes symptoms, so both the presence of a DB pattern and symptoms are required to assess changes. There are no validated measures of DB in pediatrics; however, the NQ has previously been used to detect and monitor DB symptoms in pediatric patients …”
Objective
To assess the impact of breathing retraining on asthma symptoms and dysfunctional breathing (DB) in children. Breathing retraining can improve DB but there is a lack of evidence in pediatrics.
Methods
Participants attended outpatient physiotherapy appointments and received individually tailored interventions, particularly Buteyko breathing techniques. The primary outcome was the change in the Asthma Control Test (ACT) score or change in childhood ACT (CACT) score from first to final appointment. The ACT and CACT are validated in children more than or equal to 12 years and children aged 4 to 11, respectively. The secondary outcome measure was the change in Nijmegen Questionnaire (NQ) score from first to the final appointment (score range, 0‐64) with a score of more than or equal to 23 indicating DB symptoms.
Results
One hundred and sixty‐nine children with asthma attended and completed a mean of six physiotherapy sessions, over a mean of 15 weeks. Patients were aged 2 to 18, mean 10 years. Fifty‐five patients were more than or equal to 12 years old and 114 were less than or equal to 11 years. One hundred and seven patients were receiving BTS/SIGN asthma guideline step 1 to 3 therapy and 62 were on step 4 to 5 therapy. The mean ACT score improved by 4.4 (P < 0.0001), the mean CACT score improved by 4.9 (P < 0.0001), and the mean NQ score change improved by −9.3 points (P < 0.0001).
Conclusion
In addition to standard medical therapy, individually tailored physiotherapy interventions improved asthma control and DB in children on all levels of asthma treatment. A randomized controlled study is required to determine whether these improvements are due to the intervention.
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