Physiotherapy outcomes for treating breathing pattern disorder during the COVID-19 pandemic

Abstract

<b>Background:</b> Prior to COVID-19, patients in our service diagnosed with breathing pattern disorder (BPD) were seen face to face for physiotherapy intervention. The pandemic has changed the way services are delivered with remote virtual consultations being used more frequently. <b>Objective:</b> To compare outcome measures at baseline and post physiotherapy intervention (breathing retraining and breathlessness management) for patients diagnosed with BPD. <b>Methods:</b> The Medical Research Council dyspnoea scale (MRC), Dyspnoea-12 questionnaire (D-12) and Nijmegen Questionnaire (NQ) scores were collected at baseline and post physiotherapy intervention for patients diagnosed with BPD from July 2020 to November 2021. Mode of consultation (face to face or virtual), demographic data and comorbidities were also recorded. <b>Results:</b> Data were available for 18 patients (15 female, mean age 53yrs). 11 had asthma, 5 had inducible laryngeal obstruction and 2 had tracheomalacia. The majority (80%) of the appointments were carried out virtually, with face to face appointments used where needed. Mean NQ and D-12 scores improved significantly post physiotherapy intervention from 29.9 to 18.3 (95% CI for difference 7.0 to 16.3) and from 24.8 to 14.2 (95% CI for difference 6.8 to 14.4) respectively. In contrast, mean MRC scores did not change (3.4 baseline, 3.3 post-therapy). <b>Conclusion:</b> Physiotherapy interventions for BPD, using predominantly virtual methods, significantly reduced patient’s symptoms and distress as measured using the NQ and D-12. The lack of improvement in MRC score suggests patients may benefit additionally from specific interventions aimed at improving breathlessness symptoms with activity.