| Popis: |
Dysfunctional breathing (DB) is a recognised comorbidity in difficult asthma. Pattern disordered breathing (PDB) is a central component of DB, breathing therapy (BT) to improve breathing pattern (BP) is recommended. The Brompton Breathing Pattern Assessment Tool (BPAT) is an emerging, semi-objective measure of BP. Our aim was to measure changes in BP following a physiotherapy BT programme in a tertiary asthma service, using the BPAT. Patients identified by the MDT with probable DB, referred to the physiotherapist for BT, who completed treatment and were reassessed from October 2017 to January 2019 were included. Patients BP was measured on initial and final assessment with the BPAT. Other measures were the Nijmegan Questionnaire (NQ) and Asthma Control Questionnaire (ACQ). Therapy included breathing exercises, relaxation and lifestyle modification advice. Wilcoxon signed-rank analysis of differences was performed. 15 patients (12 (80%) female; mean(SD) age, 45(12) years) completed BT. 13 (87%) were diagnosed with difficult asthma according to BTS/SIGN 2016 guidelines and 2 (13%) without asthma. Median(IQR) ACQ score was 2.56(2.63). BPAT scores improved following BT, median(IQR) scores before and after therapy were 7(5) and 3(4) (z=-3.19, p=0.001, r=-0.58), respectively. All patients scored BPAT >4 on assessment, 10 (67%) scored BPAT ≤4, below the cut-off for likely disordered breathing, following BT. The NQ (n=12) and ACQ (n=8) median(IQR) scores improved by 8(13) (p=0.005) and 0.55(0.69) (p = 0.018), respectively. Patients with difficult asthma showed an improvement in BP and asthma control after physiotherapy delivered BT. Clinically, the BPAT is a useful tool to aid screening for PDB and may be responsive to BT. |
