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P231 Breathing pattern disorders in a complex breathlessness service; classification and clinical characteristics
  1. RM Stacey1,
  2. A Vyas2,
  3. SJ Fowler2,3
  1. 1Therapies Department, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
  2. 2Respiratory Medicine, Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
  3. 3Centre for Respiratory Medicine and Allergy, University of Manchester, Manchester Academic Health Science Centre, University Hospital of South Manchester NHS Foundation Trust, Manchester, UK

Abstract

Background and aim Many patients presenting to our complex breathlessness service appear to have breathing pattern disorders (BPDs). When suspected clinically, they are referred to a specialist respiratory physiotherapist for assessment and treatment. Here we describe the prevalence of identifiable breathing patterns and their clinical characteristics

Methodology We performed a retrospective review of our clinical database including patients seen for initial physiotherapy assessment between December 2015 and June 2016. Patients underwent a standardised diagnostic assessment (clinical history, physiotherapy assessment, lung function and Nijmegan questionnaire).

Results Data from 43 patients with confirmed BPD were included, 77% female, mean age 58 yrs. Relevant respiratory comorbidities included chronic cough (33%), asthma (30%) and vocal cord dysfunction (30%), with no comorbidity in 23%. Other associated conditions included musculoskeletal conditions (47%), chronic pain (44%), obesity (44%), nasal blockage (42%) and anxiety (31%). Four categories of breathing patterns were identified: thoracic dominant (58%), irregular/crescendo (51%), forced abdominal expiration (30%), and thoraco-abdominal asynchrony (2%). More than one BPD was seen in 35% of patients; only forced abdominal expiration and thoracic dominant didn’t co-exist. Conversely all pattern types could be found in isolation, although irregular/crescendo was more likely to co-exist with another pattern type.

Conclusion Four separate breathing pattern types were identified, in isolation or in combination. Although anxiety was fairly common, many other associated disease and conditions were seen, especially relating to biomechanical factors. This preliminary data may enable clinicians to identify breathing pattern types, lead to the development of targeted treatment options and promote screening of particular conditions associated with BPD.

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