Physiotherapy and Dysfunctional Breathing (HVS)

A Comparison of the Effects of Respiratory Physiotherapy Alone and Respiratory Physiotherapy Combined With Musculoskeletal Techniques in the Management of Dysfunctional Breathing

Traditionally, the physiotherapy management of people with dysfunctional breathing or hyperventilation syndrome is breathing re-training. There is increasing clinical evidence that structural and functional changes develop in the muscles and connective tissues of the chest wall, abdomen and back when the upper chest accessory pattern of breathing is used over time. When treatment includes breathing techniques only it is difficult for a person with chronic hyperventilation, who has developed muscle and connective tissue changes, to revert to using the normal lower chest diaphragmatic breathing pattern. In clinical practice when the problems which have developed in the musculoskeletal system are addressed, the patient reverts more quickly to the lower chest pattern of breathing but there is as yet little evidence to support this clinical finding.

Study Overview

• Status: Unknown
• Conditions: Hyperventilation
• Intervention / Treatment: Other: Breathing re-training; Other: Breathing re-training and musculoskeletal techniques

• Study Type: Interventional
• Enrollment (Actual): 60
• Phase: Phase 3

Contacts and Locations

Study Locations

• United Kingdom
  • London, United Kingdom, SW3 6NP
    • Royal Brompton Hospital

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 16 years and older (Child, Adult, Older Adult)
• Accepts Healthy Volunteers: No
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• diagnosis of dysfunctional breathing (Nijmegen score of more than 23)

Exclusion Criteria:

• active metastatic disease
• osteoporotic disease
• dysfunctional breathing as a consequence of respiratory or cardiac disease

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Active Comparator: 1; Breathing re-training	Other: Breathing re-training; Breathing re-training
Active Comparator: 2; Breathing re-training and musculoskeletal physiotherapy techniques	Other: Breathing re-training and musculoskeletal techniques; Breathing re-training and musculoskeletal physiotherapy techniques including mobilisation techniques to normalise muscle and joint restrictions, doming of the diaphragm to enhance contraction and relaxation, and rib raising to free restriction in rib cage motion.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Time Frame
Nijmegen Questionnaire	0, 2, 4, 8, 12 and 26 weeks

Secondary Outcome Measures

Outcome Measure	Time Frame
Six-minute walking test	0, 2, 4, 8, 12 & 26 weeks

Collaborators and Investigators

• Sponsor: Royal Brompton & Harefield NHS Foundation Trust
• Investigators: Study Director: Margaret E Hodson, MD, Royal Brompton & Harefield NHS Foundation Trust

Study record dates

Study Major Dates

• Study Start: July 1, 2007
• Primary Completion (Anticipated): July 1, 2009
• Study Completion (Anticipated): December 1, 2009

Study Registration Dates

• First Submitted: May 7, 2009
• First Submitted That Met QC Criteria: May 7, 2009
• First Posted (Estimate): May 8, 2009

Study Record Updates

• Last Update Posted (Estimate): May 8, 2009
• Last Update Submitted That Met QC Criteria: May 7, 2009
• Last Verified: April 1, 2009

More Information

Terms related to this study

• Keywords: Physiotherapy; Dysfunctional breathing; Hyperventilation; Musculoskeletal techniques
• Additional Relevant MeSH Terms: Pathologic Processes; Respiratory Tract Diseases; Respiration Disorders; Signs and Symptoms, Respiratory; Respiratory Aspiration; Hyperventilation
• Other Study ID Numbers: 06/Q0404/64