Optoelectronic plethysmography derived breathing parameters can differ between athletes with and without a dysfunctional breathing pattern during exercise

BACKGROUND In an increasingly comorbid population, there are significant challenges to diagnosing the cause of breathlessness, and once diagnosed, considerable difficulty in detecting deterioration early enough to provide effective intervention. The burden of the breathless patient on the health care economy is substantial, with asthma, chronic heart failure, and pneumonia affecting over 6 million people in the United Kingdom alone. Furthermore, these patients often have more than one contributory factor to their breathlessness symptoms, with conditions such as dysfunctional breathing pattern disorders—an under-recognized component. Current methods of diagnosing and monitoring breathless conditions can be extensive and difficult to perform. As a consequence, home monitoring is poorly complied with. In contrast, capnography (the measurement of tidal breath carbon dioxide) is performed during normal breathing. There is a need for a simple, easy-to-use, personal device that can aid in the diagnosis and monitoring of respiratory and cardiac causes of breathlessness. OBJECTIVE The aim of this study was to explore the use of a new, handheld capnometer (called the N-Tidal C) in different conditions that cause breathlessness. We will study whether the tidal breath carbon dioxide (TBCO2) waveform, as measured by the N-Tidal C, has different characteristics in a range of respiratory and cardiac conditions. METHODS We will perform a longitudinal, observational study of the TBCO2 waveform (capnogram) as measured by the N-Tidal C capnometer. Participants with a confirmed diagnosis of asthma, breathing pattern disorders, chronic heart failure, motor neurone disease, pneumonia, as well as volunteers with no history of lung disease will be asked to provide twice daily, 75-second TBCO2 collection via the N-Tidal C device for 6 months duration. The collated capnograms will be correlated with the underlying diagnosis and disease state (stable or exacerbation) to determine if there are different TBCO2 characteristics that can distinguish different respiratory and cardiac causes of breathlessness. RESULTS This study’s recruitment is ongoing. It is anticipated that the results will be available in late 2018. CONCLUSIONS The General Breathing Record Study will provide an evaluation of the use of capnography as a diagnostic and home-monitoring tool for various diseases. REGISTERED REPORT IDENTIFIER RR1-10.2196/9767

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Cardiopulmonary Exercise Testing in the Assessment of Dysfunctional Breathing

Frontiers in Physiology ◽

10.3389/fphys.2020.620955 ◽

2021 ◽

Vol 11 ◽

Author(s):

Maria F. Ionescu ◽

Sethu Mani-Babu ◽

Luiza H. Degani-Costa ◽

Martin Johnson ◽

Chelliah Paramasivan ◽

...

Keyword(s):

Exercise Testing ◽

Breathing Pattern ◽

Cardiopulmonary Exercise Testing ◽

Periodic Breathing ◽

Underlying Disease ◽

Presenting Symptoms ◽

Cardiopulmonary Exercise ◽

Co Morbidity ◽

Dysfunctional Breathing

Dysfunctional breathing (DB) is a disabling condition which affects the biomechanical breathing pattern and is challenging to diagnose. It affects individuals in many circumstances, including those without underlying disease who may even be athletic in nature. DB can also aggravate the symptoms of those with established heart or lung conditions. However, it is treatable and individuals have much to gain if it is recognized appropriately. Here we consider the role of cardiopulmonary exercise testing (CPET) in the identification and management of DB. Specifically, we have described the diagnostic criteria and presenting symptoms. We explored the physiology and pathophysiology of DB and physiological consequences in the context of exercise. We have provided examples of its interplay with co-morbidity in other chronic diseases such as asthma, pulmonary hypertension and left heart disease. We have discussed the problems with the current methods of diagnosis and proposed how CPET could improve this. We have provided guidance on how CPET can be used for diagnosis, including consideration of pattern recognition and use of specific data panels. We have considered categorization, e.g., predominant breathing pattern disorder or acute or chronic hyperventilation. We have explored the distinction from gas exchange or ventilation/perfusion abnormalities and described other potential pitfalls, such as false positives and periodic breathing. We have also illustrated an example of a clinical pathway utilizing CPET in the diagnosis and treatment of individuals with suspected DB.

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Optoelectronic plethysmography: reference values for breathing pattern

10.1183/13993003.congress-2020.2871 ◽

2020 ◽

Author(s):

Liliane Mendes ◽

Raquel Britto ◽

Guilherme Fregonezi ◽

Vanessa Resqueti ◽

Marina Fagundes ◽

...

Keyword(s):

Reference Values ◽

Breathing Pattern ◽

Optoelectronic Plethysmography

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Identification and management of dysfunctional breathing in primary care

Practice Nursing ◽

10.12968/pnur.2021.32.12.474 ◽

2021 ◽

Vol 32 (12) ◽

pp. 474-479

Author(s):

Heather Henry ◽

Charlotte Wells

Keyword(s):

Primary Care ◽

General Practice ◽

Cardiac Disease ◽

Breathing Pattern ◽

Diagnosis And Treatment ◽

Breathing Patterns ◽

Front Line ◽

Practice Nurses ◽

Dysfunctional Breathing

Dysfunctional breathing can lead to a range of symptoms that can be confused with neurological, respiratory and cardiac disease. Heather Henry and Charlotte Wells give an overview of the signs, symptoms, diagnosis and treatment of this condition General practice nurses (GPNs) are often on the front-line of respiratory assessment. Dysfunctional breathing (often termed breathing pattern disorder) is a term that relates to changes in breathing patterns. Since dysfunctional breathing can be confused with neurological, respiratory and cardiac disease, this article will help GPNs to understand the signs, symptoms, diagnosis and treatment.

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Novel Real-Time OEP Phase Angle Feedback System for Dysfunctional Breathing Pattern Training—An Acute Intervention Study

Sensors ◽

10.3390/s21113714 ◽

2021 ◽

Vol 21 (11) ◽

pp. 3714

Author(s):

Carol M. E. Smyth ◽

Samantha L. Winter ◽

John W. Dickinson

Keyword(s):

Real Time ◽

Chest Wall ◽

Phase Angle ◽

Breathing Pattern ◽

Feedback System ◽

Control Group ◽

Breathing Patterns ◽

Breathing Retraining ◽

Dysfunctional Breathing ◽

Experimental Group

Dysfunctional breathing patterns (DBP) can have an impact on an individual’s quality of life and/or exercise performance. Breathing retraining is considered to be the first line of treatment to correct breathing pattern, for example, reducing ribcage versus abdominal movement asynchrony. Optoelectronic plethysmography (OEP) is a non-invasive 3D motion capture technique that measures the movement of the chest wall. The purpose of this study was to investigate if the use of a newly developed real-time OEP phase angle and volume feedback system, as an acute breathing retraining intervention, could result in a greater reduction of phase angle values (i.e., an improvement in movement synchrony) when compared to real-time OEP volume feedback alone. Eighteen individuals with a DBP performed an incremental cycle test with OEP measuring chest wall movement. Participants were randomly assigned to either the control group, which included the volume-based OEP feedback or to the experimental group, which included both the volume-based and phase angle OEP feedback. Participants then repeated the same cycle test using the real-time OEP feedback. The phase angle between the ribcage versus abdomen (RcAbPhase), between the pulmonary ribcage and the combined abdominal ribcage and abdomen (RCpAbPhase), and between the abdomen and the shoulders (AbSPhase) were calculated during both cycle tests. Significant increases in RcAbPhase (pre: −2.89°, post: −1.39°, p < 0.01), RCpAbPhase (pre: −2.00°, post: −0.50°, p < 0.01), and AbSPhase (pre: −2.60°, post: −0.72°, p < 0.01) were found post-intervention in the experimental group. This indicates that the experimental group demonstrated improved synchrony in their breathing pattern and therefore, reverting towards a healthy breathing pattern. This study shows for the first time that dysfunctional breathing patterns can be acutely improved with real-time OEP phase angle feedback and provides interesting insight into the feasibility of using this novel feedback system for breathing pattern retraining in individuals with DBP.

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