Examination of Respiration in Patients with Long-lasting Musculoskeletal Pain: Reliability and Validity

Abstract

Clinical examination of respiration may be an important aspect of musculoskeletal problems, but has scarcely been reported. The aims of this study were to evaluate the reliability and validity of the domain Respiration, containing 12 items oriented towards the inspection of respiratory movement and rhythm. Inter-tester reliability was examined by three physiotherapists examining 19 persons. Construct and discriminative validity of the Respiration method was studied by data from 247 patients with long-lasting muscu loskeletal pain and 104 healthy subjects. Concurrent validity to psychological variables and pain was also examined. Responsiveness was studied by comparing change in Respiration in patients who returned fully to work vs. those still on sick leave 6 months after rehabilitation. The results indicated fair but acceptable reliability. A modified Respiration scale consisting of eight items was obtained by means of Structural Equation Modeling (SEM). Respiration scores differed significantly between healthy subjects and patients. A relationship was found between Respiration and psychological characterisin tics, and between Respiration and pain, particularly in patients with widespread pain. Responsiveness of the Respiration method to clinically important change was demonstrated. Respiration can be reliably and validly assessed, and the method seems useful in the evaluation of patients with musculoskeletal problems and used as an outcome measure in rehabilitation.