Prevalence of inducible laryngeal obstruction with breathing pattern disorders and the outcomes of physiotherapy management

Abstract

Background: It is increasingly recognised that breathing pattern disorders (BPD) and inducible laryngeal obstruction (ILO) are related. BPD are typically managed by Specialist Respiratory Physiotherapists (SRP) and ILO by Speech and Language Therapists (SLT), however outside of specialist centres access to SLT is uncommon. Objectives: To evaluate the prevalence of BPD in patients with ILO and assess treatment response with breathing retraining techniques (BRT) +/- release of laryngeal obstruction techniques (ROLOT) administered by a SRP. Methods: We reviewed 71 patients (80.3% female) treated by a SRP for presumed ILO (based on description of sudden onset of upper airway symptoms following exposure to a specific trigger). Results: 55/71 (77.5%) were identified with a comorbid BPD: –13/55 (23.6%) were taught BRT alone and reported full symptom control –24/55 (45.5%) reported partial improvement with BRT, were then taught ROLOT and 22/24 patients then reported full symptom control (2 were lost to follow up) –15/55 (27.3%) were taught BRT and ROLOT at the initial consultation and 10/15 reported full symptom control (5 were lost to follow up) –2/55 were taught ROLOT and reported partial improvement, were taught BRT and then both patients reported full symptom control –1/55 reported no improvement with BRT, but full symptom control with subsequent ROLOT 16/71 (22.5%) without a comorbid BPD were taught ROLOT: –11/16 reported full symptom control (5/16 were lost to follow up) Conclusion: All patients completing treatment reported full control of their symptoms. BPD commonly coexist with ILO and SRP are ideally placed to address both conditions.