Assessment of the measurement tools of dysfunctional breathing

Introduction

Prevalence of dysfunctional breathing (DB) has been claimed to range from 10%⁵ to 90%.¹ Currently the clinical assessment of dysfunctional breathing is problematic and there is controversy about the role of hypocapnia and the proposed relationship between symptoms and signs of dysfunctional breathing with CO₂ levels.3, 4 Dysfunctional breathing is being implicated in many conditions commonly seen by osteopaths including fibromyalgia and chronic pain² and work related musculo-skeletal problems.⁶ In this study we aimed to determine how measurement tools used to predict dysfunctional breathing reflect CO₂ levels and how they correlate with each other.

Methods

Breathing assessment was performed on 120 adults. Assessment include carbon dioxide measurement via capnometry, breath holding time according to the Buteyko Method protocol, a manual assessment of respiratory motion (MARM), Nijmegen Questionnaire, self-assessment of breathing questionnaire, and Heart Rate Variability coherence with respiration. Various anthropometrical, health outcome and emotional status evaluations were also performed.

Results

Preliminary results indicate that none of the measures of dysfunctional breathing correlate significantly with CO₂ levels. Claims that breath holding time could accurately predict PCO₂ were not supported. D.B. measures that did show a correlation with each other include respiratory motion balance as tested by MARM and ability to achieve high levels of coherence between respiration and heart rate variability. The self-evaluation of breathing questionnaire showed good correlation with the validated Nijmegen Questionnaire in scores for breathlessness, breathing restriction and breathing pattern disturbance.

Conclusions

Signs and symptoms of dysfunctional breathing appear to exist even when PCO₂ levels appear normal. Breathing may reflect the function of many systems of the body and a purely biochemical view of breathing dysfunction may be limited. For a complete picture of patients' breathing it is necessary to evaluate the biomechanical aspects of breathing pattern and symptom patterns in addition to the assessment of carbon dioxide.