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

Classification of dysfunctional breathing.
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Figure 2: Classification of dysfunctional breathing.

Mentions: The biomechanical patterns of breathing typified by dysfunctional breathing may be altered by structural or functional factors (figure 2). An awareness of structural causes such as repaired diaphragmatic hernia and abnormalities of the vocal cords is important. Recognition of exercise-induced laryngomalacia with the advent of continuous laryngeal examination to characterise the cause of upper obstruction occurring during intense exercise, represents a significant advance in this field [19, 20]. This structural abnormality is important in that surgery can be undertaken and is increasingly being carried out for competitive sports men and women [19].


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

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

Classification of dysfunctional breathing.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 2: Classification of dysfunctional breathing.
Mentions: The biomechanical patterns of breathing typified by dysfunctional breathing may be altered by structural or functional factors (figure 2). An awareness of structural causes such as repaired diaphragmatic hernia and abnormalities of the vocal cords is important. Recognition of exercise-induced laryngomalacia with the advent of continuous laryngeal examination to characterise the cause of upper obstruction occurring during intense exercise, represents a significant advance in this field [19, 20]. This structural abnormality is important in that surgery can be undertaken and is increasingly being carried out for competitive sports men and women [19].

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