Breathing retraining for paediatric dysfunctional breathing with objective improvements in breathing patterns

Dysfunctional breathing is an important cause of breathlessness, characterised by alterations in breathing patterns. Breathing retraining (BRtr) is believed to aid patients re-establish a normal diaphragmatic breathing pattern. Structured light plethysmography was used to assess the breathing pattern of 23 children and adolescents before and after attending a specialist BRtr clinic. It showed that a 3-month physiotherapist-led BRtr programme was associated with a significant reduction in the contribution of rib cage movement to the total change in thoracic volume and respiratory rate, which was maintained when reassessed 3 months later, despite having persisted for the 3 months prior to intervention. This study provides the first objective evidence that BRtr may result in sustained improvements in breathing patterns in children and adolescents with dysfunctional breathing. TRIAL REGISTRATION: ClinicalTrials.gov, TRN: NCT04215341. Date of registration: 23 April 2015. WHAT IS KNOWN: • Dysfunctional breathing has significant effects on children and adolescents, affecting academic and sport performance, social interactions and activities of daily living. • Breathing retraining-based physiotherapy interventions are known to improve symptoms and quality of life in children and adolescents with dysfunctional breathing. WHAT IS NEW: • Breathing retraining may result in positive objective changes in the biomechanics of breathing. • Objective improvements in breathing pattern are maintained for at least 3 months after intervention.