Abstract
Dysfunctional breathing is characterised by an abnormal breathing pattern leading to respiratory symptoms. The 25-item Self Evaluation of Breathing Questionnaire (SEBQ) has been developed to measure breathing-related symptoms and their severity but lacks thorough evaluation. To determine reproducibility, internal consistency and predictors of SEBQ score, 180 participants completed an online SEBQ with additional demographic and lifestyle questions. Two weeks later, 155 of those repeated SEBQ. Test–retest correlation of the SEBQ was high [intraclass correlation coefficient (3, 1) = 0.89; 95 % CI 0.85–0.92]. There was no difference in SEBQ score between test and retest (15.1 (11.6) [mean (SD)] versus 14.7 (12.4); P = 0.4) and the score showed a typical error (standard error of measurement) of 4.0. Internal consistency was high (Cronbach’s α = 0.93), and a single factor structure for items was shown. Smoking status, reported respiratory disease, recent respiratory illness and female gender were positively-associated predictors of SEBQ score, and together explained 25.6 % of score variance (P ≤ 0.001). The SEBQ has high test–retest reproducibility and its score may be predicted by current smoking, chronic respiratory disease, recent respiratory illness and female gender, thus may be a useful clinical screening tool for dysfunctional breathing.
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References
Barker, N., & Everard, M. L. (2015). Getting to grips with ‘dysfunctional breathing’. Paediatric Respiratory Reviews, 16(1), 53–61. doi:10.1016/j.prrv.2014.10.001.
Bartley, J. (2011). Breathing and temporomandibular joint disease. Journal of Bodywork & Movement Therapies, 15(3), 291–297. doi:10.1016/j.jbmt.2010.06.002.
Bolman, C., Lechner, L., & van Dijke, M. (2007). Question order in the assessment of misperception of physical activity. International Journal of Behavioral Nutrition & Physical Activity, 4, 42. doi:10.1186/1479-5868-4-42.
Bradley, D. (2014). Physiotherapy in rehabilitation of breathing pattern disorders. In L. Chaitow, D. Bradley, & C. Gilbert (Eds.), Recognizing and treating breathing disorders: A multidisciplinary approach (pp. 185–202). Amsterdam: Elsevier.
Chadha, T. S., Lang, E., Birch, S., & Sackner, M. A. (1985). Respiratory drive in nonsmokers and smokers assessed by passive tilt and mouth occlusion pressure. Response to rebreathing carbon dioxide. Chest, 87(1), 6–10. doi:10.1378/chest.87.1.6.
Chaitow, L., Bradley, D., & Gilbert, C. (2014a). The structure and function of breathing. In L. Chaitow, D. Bradley, & C. Gilbert (Eds.), Recognizing and treating breathing disorders: A multidisciplinary approach (pp. 23–43). Amsterdam: Elsevier.
Chaitow, L., Bradley, D., & Gilbert, C. (2014b). What are breathing pattern disorders? In L. Chaitow, D. Bradley, & C. Gilbert (Eds.), Recognizing and treating breathing disorders: A multidisciplinary approach (2nd ed., pp. 1–10). Amsterdam: Elsevier.
Courtney, R., Cohen, M., & Reece, J. (2009). Comparison of the manual assessment of respiratory motion (MARM) and the Hi Lo breathing assessment in determining a simulated breathing pattern. International Journal of Osteopathic Medicine, 12(3), 86–91. doi:10.1016/j.ijosm.2008.10.002.
Courtney, R., & Greenwood, K. (2009). Preliminary investigation of a measure of dysfunctional breathing symptoms: The Self Evaluation of Breathing Questionnaire (SEBQ). International Journal of Osteopathic Medicine, 12(4), 121–127. doi:10.1016/j.ijosm.2009.02.001.
Courtney, R., Greenwood, K. M., & Cohen, M. (2011a). Relationships between measures of dysfunctional breathing in a population with concerns about their breathing. Journal of Bodywork & Movement Therapies, 15(1), 24–34. doi:10.1016/j.jbmt.2010.06.004.
Courtney, R., & van Dixhoorn, J. (2014). Questionnaires and manual methods for assessing breathing dysfunction. In L. Chaitow, D. Bradley, & C. Gilbert (Eds.), Recognizing and treating breathing disorders: A multidisciplinary approach (2nd ed., pp. 137–146). Amsterdam: Elsevier.
Courtney, R., van Dixhoorn, J., Greenwood, K. M., & Anthonissen, E. L. M. (2011b). Medically unexplained dyspnea: Partly moderated by dysfunctional (thoracic dominant) breathing pattern. Journal of Asthma, 48(3), 259–265. doi:10.3109/02770903.2011.554942.
Cowley, D. S., & Roy-Byrne, P. P. (1987). Hyperventilation and panic disorder. American Journal of Medicine, 83(5), 929–937. doi:10.1016/0002-9343(87)90654-1.
David, P., Laval, D., Terrien, J., & Petitjean, M. (2012). Postural control and ventilatory drive during voluntary hyperventilation and carbon dioxide rebreathing. European Journal of Applied Physiology, 112(1), 145–154. doi:10.1007/s00421-011-1954-8.
de Vet, H. C. W., Terwee, C. B., Knol, D. L., & Bouter, L. M. (2006). When to use agreement versus reliability measures. Journal of Clinical Epidemiology, 59(10), 1033–1039. doi:10.1016/j.jclinepi.2005.10.015.
Field, A. (2009). Discovering statistics using SPSS (3rd ed.). London: Sage Publications.
Freitas, D. A., Holloway, E. A., Bruno, S. S., Chaves, S. S. G., Fregonezi, A. F. G., & Mendonca, M. P. P. K. (2013). Breathing exercises for adults with asthma. Cochrane Database of Systematic Reviews., 10, CD001277. doi:10.1002/14651858.CD001277.pub3.
Hagman, C., Janson, C., & Emtner, M. (2008). A comparison between patients with dysfunctional breathing and patients with asthma. The Clinical Respiratory Journal, 2(2), 86–91. doi:10.1111/j.1752-699X.2007.00036.x.
Han, J. N., Schepers, R., Stegen, K., Van den Bergh, O., & Van de Woestijne, K. P. (2000). Psychosomatic symptoms and breathing pattern. Journal of Psychosomatic Research, 49(5), 319–333. doi:10.1016/S0022-3999(00)00165-3.
Hodges, P. W., Heijnen, I., & Gandevia, S. C. (2001). Postural activity of the diaphragm is reduced in humans when respiratory demand increases. Journal of Physiology, 537(Pt 3), 999–1008. doi:10.1111/j.1469-7793.2001.00999.x.
Holland, A. E., Hill, C. J., Jones, A. Y., & McDonald, C. F. (2012). Breathing exercises for chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews., 10, CD008250. doi:10.1002/14651858.CD008250.pub2.
Hopkins, W. G. (2009). A scale of magnitudes in a new view of statistics: Summarizing data: Simple statistics and effect statistics: Effect statistics. Retrieved from http://sportsci.org/resource/stats/index.html.
Hopkins, W. G., Wilson, N. C., & Russell, D. G. (1991). Validation of the physical activity instrument for the Life in New Zealand national survey. American Journal of Epidemiology, 133(1), 73–82.
Hornsveld, H. K., Garssen, B., Dop, M. J., van Spiegel, P. I., & de Haes, J. C. (1996). Double-blind placebo-controlled study of the hyperventilation provocation test and the validity of the hyperventilation syndrome. Lancet, 348(9021), 154–158. doi:10.1016/S0140-6736(96)02024-7.
Hruska, R. J, Jr. (1997). Influences of dysfunctional respiratory mechanics on orofacial pain. Dental Clinics of North America, 41(2), 211–227.
Hyland, M. E., Singh, S. J., Sodergren, S. C., & Morgan, M. P. (1998). Development of a shortened version of the Breathing Problems Questionnaire suitable for use in a pulmonary rehabilitation clinic: A purpose-specific, disease-specific questionnaire. Quality of Life Research, 7(3), 227–233.
Jones, M., Harvey, A., Marston, L., & O’Connell, N. E. (2013). Breathing exercises for dysfunctional breathing/hyperventilation syndrome in adults. Cochrane Database of Systematic Reviews., 5, CD009041. doi:10.1002/14651858.CD009041.pub2.
McArdle, W. D., Katch, F. I., & Katch, V. L. (2001). Exercise physiology: Energy, nutrition, and human performance (5th ed.). Philadelphia: Lippincott, Williams and Wilkins.
McLaughlin, L. (2014). Capnography assessment. In L. Chaitow, D. Bradley, & C. Gilbert (Eds.), Recognizing and treating breathing disorders: A multidisciplinary approach (pp. 23–43). Amsterdam: Elsevier.
Murugan, A. T., & Sharma, G. (2008). Obesity and respiratory diseases. Chronic Respiratory Disease, 5(4), 233–242. doi:10.1177/1479972308096978.
Penninx, B. W. J. H., Nolen, W. A., Lamers, F., Zitman, F. G., Smit, J. H., Spinhoven, P., et al. (2011). Two-year course of depressive and anxiety disorders: Results from the Netherlands Study of Depression and Anxiety (NESDA). Journal of Affective Disorders, 133(1–2), 76–85. doi:10.1016/j.jad.2011.03.027.
Schleifer, L. M., Ley, R., & Spalding, T. W. (2002). A hyperventilation theory of job stress and musculoskeletal disorders. American Journal of Industrial Medicine, 41(5), 420–432.
Smith, M. D., Russell, A., & Hodges, P. W. (2006). Disorders of breathing and continence have a stronger association with back pain than obesity and physical activity. Australian Journal of Physiotherapy, 52(1), 11–16. doi:10.1016/S0004-9514(06)70057-5.
Smith, M. D., Russell, A., & Hodges, P. W. (2014). The relationship between incontinence, breathing disorders, gastrointestinal symptoms, and back pain in women: A longitudinal cohort study. Clinical Journal of Pain, 30(2), 162–167. doi:10.1097/AJP.0b013e31828b10fe.
Stanton, A. E., Vaughn, P., Carter, R., & Bucknall, C. E. (2008). An observational investigation of dysfunctional breathing and breathing control therapy in a problem asthma clinic. Journal of Asthma, 45(9), 758–765. doi:10.1080/02770900802252093.
Statistics New Zealand. (2006). Labour force status. Retrieved from http://www.stats.govt.nz/Census/2006CensusHomePage/Tables/AboutAPlace/SnapShot.aspx?type=region&ParentID=&tab=Work&id=1000002.
Thomas, M., McKinley, R. K., Freeman, E., & Foy, C. (2001). Prevalence of dysfunctional breathing in patients treated for asthma in primary care: Cross sectional survey. BMJ, 322(7294), 1098–1100. doi:10.1136/bmj.322.7294.1098.
Thomas, M., McKinley, R. K., Freeman, E., Foy, C., & Price, D. (2005). The prevalence of dysfunctional breathing in adults in the community with and without asthma. Primary Care Respiratory Journal, 14(2), 78–82. doi:10.1016/j.pcrj.2004.10.007.
Urrutia, I., Capelastegui, A., Quintana, J. M., Muniozguren, N., Basagana, X., Sunyer, J., & Spanish Group of the European Community Respiratory Health. (2005). Smoking habit, respiratory symptoms and lung function in young adults. European Journal of Public Health, 15(2), 160–165. doi:10.1093/eurpub/cki113.
van Dixhoorn, J., & Duivenvoorden, H. J. (1985). Efficacy of Nijmegen Questionnaire in recognition of the hyperventilation syndrome. Journal of Psychosomatic Research, 29(2), 199–206.
Warburton, C. J., & Jack, S. (2006). Can you diagnose hyperventilation? Chronic Respiratory Disease, 3(3), 113–115. doi:10.1191/1479972306cd116ed.
Willemse, B. W. M., ten Hacken, N. H. T., Rutgers, B., Postma, D. S., & Timens, W. (2005). Association of current smoking with airway inflammation in chronic obstructive pulmonary disease and asymptomatic smokers. Respiratory Research, 6(1), 38. doi:10.1186/1465-9921-6-38.
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Mitchell, A.J., Bacon, C.J. & Moran, R.W. Reliability and Determinants of Self-Evaluation of Breathing Questionnaire (SEBQ) Score: A Symptoms-Based Measure of Dysfunctional Breathing. Appl Psychophysiol Biofeedback 41, 111–120 (2016). https://doi.org/10.1007/s10484-015-9316-7
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DOI: https://doi.org/10.1007/s10484-015-9316-7