Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine 1239

Dysfunctional breathing clinical characteristics and treatment CARINA HAGMAN

ACTA UNIVERSITATIS UPSALIENSIS UPPSALA 2016

ISSN 1651-6206 ISBN 978-91-554-9629-6 urn:nbn:se:uu:diva-295667

Dissertation presented at Uppsala University to be publicly examined in Falu lasarett, Föreläsningssalen, Söderbaums väg 8, Falun, Friday, 16 September 2016 at 10:00 for the degree of Doctor of Philosophy (Faculty of Medicine). The examination will be conducted in Swedish. Faculty examiner: Docent Alf Tunsäter (Lunds universitet, Inst. för Lungmedicin och Allergologi, Lund, Sverige). Abstract Hagman, C. 2016. Dysfunctional breathing. Clinical characteristics and treatment. Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine 1239. 67 pp. Uppsala: Acta Universitatis Upsaliensis. ISBN 978-91-554-9629-6. Background: Dysfunctional breathing (DB) is a respiratory disorder involving an upper chest breathing pattern and respiratory symptoms that cannot be attributed to a medical diagnosis. Aim: The overall aim of this thesis was to describe patients with DB and investigate clinical outcomes after physiotherapy treatment. Methods: Study I was descriptive and comparative, that included 25 patients with DB and 25 age- and sex-matched patients with asthma. Health-related quality of life (HRQoL), anxiety, depression, sense of coherence, influence on daily life due to breathing problems, respiratory symptoms, emergency room visits and asthma medication were investigated. Study II, a 5-year follow-up study based on the same sample as study I (22 patients with DB, 23 patients with asthma), studied treatment outcomes after information and breathing retraining. Study III was descriptive and correlational (20 healthy subjects), investigating whether the Respiratory Movement Measuring Instrument (RMMI) can discriminate between different breathing patterns in varying body positions. Study III also studied correlations between respiratory movements and breathing volumes (12 healthy subjects). Study IV was a singlesubject AB design with follow-ups. Self-registered patient-specific respiratory symptoms and respiratory-related activity limitations and breathing pattern (measured with the RMMI) were evaluated after an intervention consisting of information and breathing retraining in five patients with DB. Results: Patients with DB had lower HRQoL (SF-36): vitality (mean 47 vs. 62), social functioning (70 vs. 94) and role emotional (64 vs. 94) (p