Dysfunctional Breathing, Exercise Capacity, and Balance in Hypertension

Relationship Between Dysfunctional Breathing, Exercise Capacity, and Balance in Patients With Hypertension: A Prospective Cross-Sectional Study

This prospective cross-sectional study aims to investigate the relationship between dysfunctional breathing (DB), exercise capacity, and balance in patients with arterial hypertension (HT). DB is characterized by abnormal breathing patterns and is associated with symptoms such as dyspnea and inefficient ventilation, regardless of the presence of organic respiratory disease. Hypertension may further exacerbate these symptoms and contribute to impaired exercise performance and postural balance. The study will assess DB using the Nijmegen Questionnaire, along with anthropometric measurements, balance tests, and functional exercise capacity evaluations. Findings may contribute to better understanding of respiratory dysfunctions in hypertensive individuals and their impact on physical performance.

Study Overview

• Status: Completed
• Conditions: Arterial Hypertension; Exercise Capacity; Dysfunctional Breathing; Balance

• Study Type: Observational
• Enrollment (Actual): 50

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Istanbul, Turkey (Türkiye)
    • Istınye University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: No

• Sampling Method: Probability Sample

Study Population

The study population will consist of adults aged 18 to 70 years who have been clinically diagnosed with arterial hypertension and have been under follow-up for at least six months. All participants must have a Nijmegen Questionnaire score of 23 or higher, indicating a probable presence of dysfunctional breathing. Individuals must be willing to voluntarily participate in the study. Participants with recent medication changes (within the past month) or with unstable metabolic diseases will be excluded.

Description

Inclusion Criteria:

• Aged between 18 and 70 years
• Diagnosed with hypertension and under follow-up for at least 6 months
• Willing to participate in the study voluntarily
• Nijmegen Questionnaire score of 23 or above

Exclusion Criteria:

• Medication change within the last month prior to study enrollment
• Presence of unstable metabolic disease

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
Hypertensive Patients With Dysfunctional Breathing; Participants diagnosed with arterial hypertension who exhibit symptoms of dysfunctional breathing, as determined by the Nijmegen Questionnaire. Assessments will include anthropometric measurements, functional exercise capacity tests, and balance evaluations.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Assessment of Dysfunctional Breathing Level	Nijmegen Questionnaire: The questionnaire is used for the assessment and identification of respiratory dysfunction, unexplained respiratory symptoms, and hyperventilation syndrome indicators. It consists of 16 items covering neurological, cardiovascular, respiratory, gastrointestinal, and psychological factors. Each item is rated on a 5-point Likert scale, with a total score ranging from 0 to 64. Higher scores indicate an increased likelihood of respiratory dysfunction and hyperventilation syndrome. A score above 23 supports the possible diagnosis of dysfunctional breathing. The questionnaire has a sensitivity of 91% and a specificity of 95%. The Turkish version of the questionnaire has been validated and found to be reliable.	At baseline
Assessment of Balance-I	The Timed Up and Go Test is a method used to rapidly assess an individual's balance control. During the test, the participant is instructed to rise from a seated position in a chair, walk a distance of 3 meters, turn around a reference object, return to the chair, and sit down again. The time taken to complete the task is recorded in seconds. The test will be repeated three times, and the average of the three trials will be used for analysis.	At baseline
Assessment of Balance-II	The Berg Balance Scale is used to assess balance through progressively challenging tasks by reducing the level of support provided by the surface. The scale consists of 14 items, each scored from 0 to 4 (4: best performance, 0: poorest performance). A total score between 41-56 indicates a low risk of falling, 21-40 reflects a medium fall risk, and scores below 20 indicate a high fall risk.	At baseline
Neck Circumference Measurements	Neck circumference will be measured using a flexible plastic measuring tape at the level of the cricoid cartilage, with the participant in an upright and relaxed position	At baseline
Waist Circumference Measurement	Waist circumference will be measured using a flexible plastic measuring tape at the level of the iliac crest, with the participant standing upright and breathing normally.	At baseline

Collaborators and Investigators

• Sponsor: Istinye University
• Investigators: Study Chair: Kabasakal, Istinye University

Study record dates

Study Major Dates

• Study Start (Actual): January 10, 2025
• Primary Completion (Actual): February 15, 2025
• Study Completion (Actual): July 15, 2025

Study Registration Dates

• First Submitted: April 1, 2025
• First Submitted That Met QC Criteria: April 1, 2025
• First Posted (Actual): April 8, 2025

Study Record Updates

• Last Update Posted (Actual): February 10, 2026
• Last Update Submitted That Met QC Criteria: February 6, 2026
• Last Verified: April 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Vascular Diseases; Cardiovascular Diseases; Hypertension
• Other Study ID Numbers: ISU-2025-002

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No