Treatment Outcomes Following a Holistic Breathing Approach for Exercise-Induced Laryngeal Obstruction

Objective: In exercise-induced laryngeal obstruction (EILO), laryngeal structures adduct during exertional activities leading to dyspnea and other symptoms. Medical or behavioral interventions are often insufficient to address patient concerns. We developed a holistic speech-language pathology treatment to manage the physical, intellectual, and emotional (P.I.E.) aspects of EILO. Effect of treatment schedule was examined in patient-reported outcome measures. Method: We conducted a retrospective chart review for 84 individuals who received the P.I.E. Approach for EILO at a private clinic. Participants averaged 14–21 sessions of treatment across groups (range: seven to 38 sessions), n = 35 in a condensed schedule ( M = 14.1 sessions over 1–7 days), n = 42 in a distributed schedule ( M = 14 sessions: one session/week for 14 weeks), and n = 7 in an other schedule ( M = 21 sessions on a combined condensed + distributed schedule). Patients completed three outcome measures: Dyspnea Index (Gartner-Schmidt et al., 2014), Self-Evaluation of Breathing Questionnaire (Courtney & Greenwood, 2009), and the Exercise-Induced Laryngeal Obstruction Dyspnea Index (Olin et al., 2022). Results: Prior to treatment, all participants reported breathing symptoms, scoring outside the normal range on at least one of the measures. Following treatment, significant improvements were evident on all three measures. No significant differences were noted for the treatment schedule subgroups; all showed significant gains associated with treatment with no significant treatment by schedule interactions. Conclusions: The holistic P.I.E. Approach can be an effective intervention for individuals with EILO as it addresses various aspects of the disorder. The higher cumulative amount of treatment is likely essential to treatment success, more than treatment schedule, to promote generalization of appropriate breathing to competitive exertional activities.