Limits...
Dysfunctional breathing and reaching one's physiological limit as causes of exercise-induced dyspnoea.

Depiazzi J, Everard ML - Breathe (Sheff) (2016)

Bottom Line: However for many, the cause will be simply reaching their physiological limit or be due to a functional form of dysfunctional breathing, neither of which require drug therapy.The physiological limit category includes deconditioned individuals, such as those who have been through intensive care and require rehabilitation, as well as the unfit and the fit competitive athlete who has reached their limit with both of these latter groups requiring explanation and advice.Dysfunctional breathing is an umbrella term for an alteration in the normal biomechanical patterns of breathing that result in intermittent or chronic symptoms, which may be respiratory and/or nonrespiratory.This alteration may be due to structural causes or, much more commonly, be functional as exemplified by thoracic pattern disordered breathing (PDB) and extrathoracic paradoxical vocal fold motion disorder (pVFMD).Careful history and examination together with spirometry may identify those likely to have PDB and/or pVFMD.This review provides an overview of the spectrum of conditions that can present as exercise--induced breathlessness experienced by young subjects participating in sport and aims to promote understanding of the need for accurate assessment of an individual's symptoms.

View Article: PubMed Central - PubMed

Affiliation: Physiotherapy Dept, Princess Margaret Hospital, Subiaco, Australia.

ABSTRACT

Key points: Excessive exercise-induced shortness of breath is a common complaint. For some, exercise-induced bronchoconstriction is the primary cause and for a small minority there may be an alternative organic pathology. However for many, the cause will be simply reaching their physiological limit or be due to a functional form of dysfunctional breathing, neither of which require drug therapy.The physiological limit category includes deconditioned individuals, such as those who have been through intensive care and require rehabilitation, as well as the unfit and the fit competitive athlete who has reached their limit with both of these latter groups requiring explanation and advice.Dysfunctional breathing is an umbrella term for an alteration in the normal biomechanical patterns of breathing that result in intermittent or chronic symptoms, which may be respiratory and/or nonrespiratory. This alteration may be due to structural causes or, much more commonly, be functional as exemplified by thoracic pattern disordered breathing (PDB) and extrathoracic paradoxical vocal fold motion disorder (pVFMD).Careful history and examination together with spirometry may identify those likely to have PDB and/or pVFMD. Where there is doubt about aetiology, cardiopulmonary exercise testing may be required to identify the deconditioned, unfit or fit individual reaching their physiological limit and PDB, while continuous laryngoscopy during exercise is increasingly becoming the benchmark for assessing extrathoracic causes.Accurate assessment and diagnosis can prevent excessive use of drug therapy and result in effective management of the cause of the individual's complaint through cost-effective approaches such as reassurance, advice, breathing retraining and vocal exercises. This review provides an overview of the spectrum of conditions that can present as exercise--induced breathlessness experienced by young subjects participating in sport and aims to promote understanding of the need for accurate assessment of an individual's symptoms. We will highlight the high incidence of nonasthmatic causes, which simply require reassurance or simple interventions from respiratory physiotherapists or speech pathologists.

No MeSH data available.


Related in: MedlinePlus

Conditions that can contribute to EID.
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Figure 1: Conditions that can contribute to EID.

Mentions: Figure 1 outlines the range of conditions that may present with EID and provides a possible framework for clinicians when presented with a complaint of perceived excessive breathlessness during physical activity. In studies exploring the causes of EID in young people, those with asthma are usually in the minority [1–5]. The most common diagnosis appears to be that the breathlessness is appropriate and that individuals are reaching their physiological limit. This can apply to those attempting to compete at the highest levels as well as those who are “deconditioned” due to lack of adequate training, obesity or indeed recent severe illness. Also common are the conditions grouped under the umbrella term dysfunctional breathing, which can be due to thoracic or extrathoracic problems and include both structural and functional causes. This area is perhaps the least well understood and researched. Patients with chronic pulmonary disease may manifest any of these as a comorbidity and this needs to be borne in mind while accepting that the disease alone can be responsible for reported EID. The prevalence of the various causes of EID in the community has not been determined.


Dysfunctional breathing and reaching one's physiological limit as causes of exercise-induced dyspnoea.

Depiazzi J, Everard ML - Breathe (Sheff) (2016)

Conditions that can contribute to EID.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4933621&req=5

Figure 1: Conditions that can contribute to EID.
Mentions: Figure 1 outlines the range of conditions that may present with EID and provides a possible framework for clinicians when presented with a complaint of perceived excessive breathlessness during physical activity. In studies exploring the causes of EID in young people, those with asthma are usually in the minority [1–5]. The most common diagnosis appears to be that the breathlessness is appropriate and that individuals are reaching their physiological limit. This can apply to those attempting to compete at the highest levels as well as those who are “deconditioned” due to lack of adequate training, obesity or indeed recent severe illness. Also common are the conditions grouped under the umbrella term dysfunctional breathing, which can be due to thoracic or extrathoracic problems and include both structural and functional causes. This area is perhaps the least well understood and researched. Patients with chronic pulmonary disease may manifest any of these as a comorbidity and this needs to be borne in mind while accepting that the disease alone can be responsible for reported EID. The prevalence of the various causes of EID in the community has not been determined.

Bottom Line: However for many, the cause will be simply reaching their physiological limit or be due to a functional form of dysfunctional breathing, neither of which require drug therapy.The physiological limit category includes deconditioned individuals, such as those who have been through intensive care and require rehabilitation, as well as the unfit and the fit competitive athlete who has reached their limit with both of these latter groups requiring explanation and advice.Dysfunctional breathing is an umbrella term for an alteration in the normal biomechanical patterns of breathing that result in intermittent or chronic symptoms, which may be respiratory and/or nonrespiratory.This alteration may be due to structural causes or, much more commonly, be functional as exemplified by thoracic pattern disordered breathing (PDB) and extrathoracic paradoxical vocal fold motion disorder (pVFMD).Careful history and examination together with spirometry may identify those likely to have PDB and/or pVFMD.This review provides an overview of the spectrum of conditions that can present as exercise--induced breathlessness experienced by young subjects participating in sport and aims to promote understanding of the need for accurate assessment of an individual's symptoms.

View Article: PubMed Central - PubMed

Affiliation: Physiotherapy Dept, Princess Margaret Hospital, Subiaco, Australia.

ABSTRACT

Key points: Excessive exercise-induced shortness of breath is a common complaint. For some, exercise-induced bronchoconstriction is the primary cause and for a small minority there may be an alternative organic pathology. However for many, the cause will be simply reaching their physiological limit or be due to a functional form of dysfunctional breathing, neither of which require drug therapy.The physiological limit category includes deconditioned individuals, such as those who have been through intensive care and require rehabilitation, as well as the unfit and the fit competitive athlete who has reached their limit with both of these latter groups requiring explanation and advice.Dysfunctional breathing is an umbrella term for an alteration in the normal biomechanical patterns of breathing that result in intermittent or chronic symptoms, which may be respiratory and/or nonrespiratory. This alteration may be due to structural causes or, much more commonly, be functional as exemplified by thoracic pattern disordered breathing (PDB) and extrathoracic paradoxical vocal fold motion disorder (pVFMD).Careful history and examination together with spirometry may identify those likely to have PDB and/or pVFMD. Where there is doubt about aetiology, cardiopulmonary exercise testing may be required to identify the deconditioned, unfit or fit individual reaching their physiological limit and PDB, while continuous laryngoscopy during exercise is increasingly becoming the benchmark for assessing extrathoracic causes.Accurate assessment and diagnosis can prevent excessive use of drug therapy and result in effective management of the cause of the individual's complaint through cost-effective approaches such as reassurance, advice, breathing retraining and vocal exercises. This review provides an overview of the spectrum of conditions that can present as exercise--induced breathlessness experienced by young subjects participating in sport and aims to promote understanding of the need for accurate assessment of an individual's symptoms. We will highlight the high incidence of nonasthmatic causes, which simply require reassurance or simple interventions from respiratory physiotherapists or speech pathologists.

No MeSH data available.


Related in: MedlinePlus