Abstract

Research Article

Dysfunctional breathing in children

Amanda MP Trompenaars#, Aalt PJ Van Roest# and Anja APH Vaessen-Verberne*

Published: 30 May, 2020 | Volume 4 - Issue 1 | Pages: 001-005

Objective: Dysfunctional breathing (DB) refers to abnormal patterns of breathing. No gold standard exists for diagnosis. In clinical practice we regularly see children with functional breathing problems. We collected data from this patient group to gain more insight into the characteristics of children with dysfunctional breathing.

Methods: We composed a retrospective, cross-sectional study. The population consisted of children referred to a physiotherapist by a pediatrician due to suspected dysfunctional breathing. Data from 2013-2015 were collected from patient files, selected according to patterns and onset of symptoms, concomitant asthma, Nijmegen questionnaire (NQ) score, maximum exercise capacity and breathing pattern.

Results: A total of 201 patients were included in the study, 66% of whom were female. The mean age was 13.9 years; 26% of the children were overweight. The most frequently reported symptoms were breathlessness, chest pain/tightness and dizziness. Fifty-two percent had a NQ score ≥23, mainly female. Twenty-eight percent of the children scored < p5 for their age on maximum exercise capacity; this proportion was substantially higher among males. Of the total population, 78% scored < p50 for their age. Subgroups with a higher body mass index (BMI) showed lower maximum exercise capacity. Children presenting with pulmonary symptoms were primarily misdiagnosed with asthma.

Conclusion: Dysfunctional breathing is a common cause of respiratory complaints. Most children with dysfunctional breathing have a high BMI and are in poor physical condition, which suggests a clinically relevant comorbidity and possible options for therapy. Children are often falsely diagnosed with asthma; better recognition will decrease unnecessary medication use.
Introduction

Read Full Article HTML DOI: 10.29328/journal.jprr.1001013 Cite this Article Read Full Article PDF

Keywords:

Hyperventilation; Breathlessness; Asthma; Maximum exercise capacity; Obesity; Nijmegen questionnaire

References

  1. Barker N, Everard ML. Getting to grips with 'dysfunctional breathing'. Paediatr Respir Rev. 2015; 16: 53-61. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/25499573
  2. Boulding R, Stacey R, Niven R, Fowler SJ. Dysfunctional breathing: a review of the literature and proposal for classification. Eur Respir Rev. 2016; 25: 287-294. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/27581828
  3. van Dixhoorn J, Duivenvoorden HJ. Efficacy of Nijmegen Questionnaire in recognition of the hyperventilation syndrome. J Psychosom Res. 1985; 29: 199-206. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/4009520
  4. Thomas M, McKinley RK, Freeman E, Foy C, Price D. The prevalence of dysfunctional breathing in adults in the community with and without asthma. Prim Care Respir J. 2005 14: 78-82. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/16701702
  5. Lear SA, Brozic A, Myers JN, Ignaszewski A. Exercise stress testing. An overview of current guidelines. Sports Med. 1999; 27: 285-312. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/10368877
  6. Stuart RJ, Jr., Ellestad MH. National survey of exercise stress testing facilities. Chest. 1980; 77: 94-97. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/7351157
  7. van der Cammen-van Zijp MH, van den Berg-Emons RJ, Willemsen SP, Stam HJ, Tibboel D, H IJ. Exercise capacity in Dutch children: new reference values for the Bruce treadmill protocol. Scand J Med Sci Sports. 2010; 20: e130-136. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/19422656
  8. Gulmans VA, de Meer K, Binkhorst RA, Helders PJ, Saris WH. Reference values for maximum work capacity in relation to body composition in healthy Dutch children. Eur Respir J. 1997; 10: 94-97. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/9032499
  9. TNO Groeicalculator voor professionals: TNO (toegepast-natuurwetenschappelijk onderzoek); 2010. https://groeiweb.pgdata.nl/calculator.asp
  10. Stanton AE, Vaughn P, Carter R, Bucknall CE. An observational investigation of dysfunctional breathing and breathing control therapy in a problem asthma clinic. J Asthma. 2008; 45: 758-765. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/18972291
  11. Agache I, Ciobanu C, Paul G, Rogozea L. Dysfunctional breathing phenotype in adults with asthma - incidence and risk factors. Clin Transl Allergy. 2012; 2: 18. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/22992302
  12. Courtney R, van Dixhoorn J, Cohen M. Evaluation of breathing pattern: comparison of a Manual Assessment of Respiratory Motion (MARM) and respiratory induction plethysmography. Appl Psychophysiol Biofeedback. 2008; 33: 91-100. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/18320303
  13. Parreira VF, Vieira DS, Myrrha MA, Pessoa IM, Lage SM, Britto RR. Optoelectronic plethysmography: a review of the literature. Rev Bras Fisioter. 2012; 16: 439-453. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/23184278
  14. Ozgen IT, Cakir E, Torun E, Gules A, Hepokur MN, Cesur Y. Relationship Between Functional Exercise Capacity and Lung Functions in Obese Chidren. J Clin Res Pediatr Endocrinol. 2015; 7: 217-221. PubMed: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4677557/
  15. Sin DD, Jones RL, Man SF. Obesity is a risk factor for dyspnea but not for airflow obstruction. Arch Intern Med. 2002;162: 1477-1481. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/12090884
  16. Gridina I, Bidat E, Chevallier B, Stheneur C. Prevalence of chronic hyperventilation syndrome in children and teenagers. Arch Pediatr. 2013; 20: 265-268. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/23375424
  17. de Groot EP, Duiverman EJ, Brand PL. Dysfunctional breathing in children with asthma: a rare but relevant comorbidity. Eur Respir J. 2013; 41: 1068-1073. PubMed: https://www.ncbi.nlm.nih.gov/pubmed/23018913

Figures:

Figure 1

Figure 1

Similar Articles

Recently Viewed

Read More

Most Viewed

Read More

Help ?