The Management of Breathing Pattern Disorders
Introduction[edit | edit source]
Dysfunctional breathing (DB) is defined as chronic or recurrent changes in the breathing pattern that cause respiratory and non-respiratory complaints.[1] For a discussion of the aetiology of breathing pattern disorders and assessment techniques, please click here.
Management[edit | edit source]
When managing breathing pattern disorders, it is important to consider factors that may have initially triggered the BPD or that could cause future events.[2] These causative factors need to be addressed if we are to successfully rehabilitate the habitual dysfunctional breathing pattern.[3]
Education[edit | edit source]
Education about the pathophysiology of BPD/HVS is key and should be the initial step of any management plan. Important points to cover include:
- the effects of abnormal versus diaphragmatic breathing
- reassurance that symptoms have a physiological basis and are treatable[2]
Manual Therapy Techniques[edit | edit source]
Many patients who have BPDs have co-existing musculoskeletal concerns, particularly back and neck pain.[4] Manual techniques on their own will not be sufficient to address changes in length/tension; the BPD needs to also be addressed.[2] However, manual techniques can still be beneficial.[3]
The choice of technique will depend on assessment findings, but there are several techniques that can be used to help address issues such as increased tone or activity, elevated and depressed ribs and alterations in the mobility of thoracic articulations. These include thoracic mobilisations, stretches, muscle energy techniques (MET), positional release, trigger point release and integrated neuromuscular inhibition techniques.[3]
Breathing Retraining[edit | edit source]
When retraining breathing, there are four principles to consider:[3]
- Becoming aware of faulty breathing patterns
- Being able to relax the jaw, upper chest, shoulders and accessory muscles
- Re-education on abdominal/low-chest nose breathing pattern
- Being aware of normal breathing rates and rhythms at rest, as well as during speech and activity[3]
It is important to note that a patient may report transient discomfort or air hunger when beginning breathing re-education. Using pulse oximetry at various stages during the treatment can help to reinforce to patients that their SpO2 remains at a normal level.[3]
- ↑ Lum L 1987 Hyperventilation syndromes in medicine and psychiatry: a review. J. R Soc Med. 80:229-231.
- ↑ 2.0 2.1 2.2 Clifton‐Smith T, Rowley J. Breathing pattern disorders and physiotherapy: inspiration for our profession. Phys Ther Rev. 2011; 16: 75–86.
- ↑ 3.0 3.1 3.2 3.3 3.4 3.5 Chaitow, L., Bradley, D., and Gilbert, C. Recognizing and Treating Breathing Pattern Disorders. Chaitow, L., Bradley, D., and Gilbert, C. 2014, Elsevier.
- ↑ McLaughlin L, Goldsmith CH, Coleman K. Breathing evaluation and retraining as an adjunct to manual therapy Man Ther. 2011 Feb;16(1):51-2.
