University of Twente Student Theses


Breathing patterns of asthma patients during cycling ergometry

Pelgröm, A.T. (2021) Breathing patterns of asthma patients during cycling ergometry.

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Abstract:Introduction In the asthma population, 29% of patients suffer from dysfunctional breathing (DB) often leading to exercise induced dyspnoea (EID). Most of the time, EID is attributed to exercise induced bronchoconstriction (EIB), but the possible effect of DB on EID in patients with asthma is often overlooked, potentially leading to suboptimal treatment. Therefore, this study aims to investigate whether asthma patients have different, and possibly dysfunctional, breathing patterns than healthy subjects. Additionally, it will be investigated whether breathing patterns can be quantified and related to certain forms of DB. Methods Breathing patterns of 15 healthy subjects and 12 asthma patients were analysed in rest and during maximal cycling ergometry using the Hexoskin sports vest with integrated respiratory inductance plethysmography (RIP) sensors. Subjects were classified in different groups based on the change of the new parameter BPratio (which is the tidal volume (Vt) divided by the breathing frequency (Bf) and the predicted vital capacity (VCpred)) and Ldis (new parameter to quantify the level of asynchrony of breathing) as a result of increasing exercise load. Results Based on the BPratio subjects could be distributed in three groups according to the change in contribution of Vt and Bf. Asthma patients with worse asthma control than others (ACQ of 1.6 vs 0.14 (p=0.137), VAS for dyspnoea over past 7 days 16.5mm vs 2.0mm (p=0.041), and mini-AQLQ scores of 4.65 vs 6.67 (p=0.111)) tend to increase their Bf earlier than those with better asthma control. Based on the level of asynchronous breathing, quantified with Ldis, subjects with highly increasing Ldis during physical exercise showed a lowered performance level, while subjects with an almost stable Ldis showed elevated levels of dyspnoea at the end of exercise (VAS 91.5mm vs 52.9mm, p=0.058). These phenomena were more common in patients with asthma than in healthy subjects (33% vs 7%). Discussion It is hypothesized that subjects with worse asthma control developed a deviant natural breathing pattern (earlier increase of Bf) as a response to elevated stress perception. The differences in Ldis among subjects showed that both lowered and increased levels of asynchrony might be a sign of DB. Conclusion Based on Ldis it appears that asthma patients more often show deviant breathing patterns. To quantify the breathing patterns, this study introduces two new parameters (BPratio and Ldis). Subjects with deviant breathing patterns based on these parameters showed indications of dysfunctional breathing. This gives promising possibilities to analyse breathing patterns for the diagnosis of DB in asthma patients using these parameters, which could result in more optimal treatment of asthma patients suffering from EID.
Item Type:Essay (Master)
Faculty:TNW: Science and Technology
Subject:44 medicine, 50 technical science in general
Programme:Technical Medicine MSc (60033)
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