Key result
Participants at high risk of dysfunctional breathing had significantly higher Breathe-VQ scores compared to low-risk peers (19.1 vs 13.8, p<0.001), demonstrating the questionnaire's validity.
Why the study?
While anxiety can contribute to dysfunctional breathing, the underpinning mechanism is unclear, potentially involving conscious, vigilant monitoring of breathing that disrupts automatic breathing mechanics.
Cross-Sectional (n=323)
Standardized Mean Difference: 1.05
Absolute Event Rate: 19.1% vs 13.8%
p-value: p=<0.001
The Breathe-VQ is a valid and reliable 6-item self-reported tool for measuring breathing vigilance, which may help identify and assess individuals at risk for dysfunctional breathing.
Breathe-VQ may aid dysfunctional breathing screening; leaves open its clinical utility pending prospective outcome studies.
Background Dysfunctional breathing is common among people with and without primary respiratory pathology. While anxiety can contribute to dysfunctional breathing, the underpinning mechanism is unclear. One explanation is that anxiety induces conscious, vigilant monitoring of breathing, disrupting “automatic” breathing mechanics. We validated a new tool that quantifies such breathing-related “vigilance”: the Breathing Vigilance Questionnaire (Breathe-VQ). Methods 323 healthy adults (mean (range) age 27.3 (18–71) years; 161 males) were analysed. We developed an initial Breathe-VQ (11 items, 1–5 Likert scale) based on the Pain Vigilance and Awareness Scale, using feedback from the target population and clinicians. At baseline, participants completed the Breathe-VQ, Nijmegen Questionnaire (NQ), State-Trait Anxiety Inventory form 2 and Movement-Specific Reinvestment Scale (assessing general conscious processing). 83 people repeated the Breathe-VQ 3 weeks later. Results Five items were removed based on item-level analysis. The resulting six-item Breathe-VQ questionnaire (score range 6–30) has excellent internal (α=0.892) and test–retest reliability (intraclass correlation 0.810), a minimal detectable change of 6.5 and no floor/ceiling effects. Validity was evidenced by significant positive correlations with trait anxiety and conscious processing scores (r=0.35–0.46). Participants at high risk of having dysfunctional breathing (NQ >23; n=76) had significantly higher Breathe-VQ score (mean± sd 19.1±5.0) than low-risk peers (n=225; mean± sd 13.8±5.4; p<0.001). In this “high risk of dysfunctional breathing” group, Breathe-VQ and NQ scores were significantly associated (p=0.005), even when controlling for risk factors ( e.g. trait anxiety). Conclusions The Breathe-VQ is a valid and reliable tool to measure breathing vigilance. High breathing vigilance may contribute to dysfunctional breathing and could represent a therapeutic target. Further research is warranted to test Breathe-VQ's prognostic value and assess intervention effects.
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Steinmann et al. (2023) conducted a cross-sectional in Dysfunctional breathing (n=323). High risk of dysfunctional breathing (Nijmegen Questionnaire > 23) vs. Low risk of dysfunctional breathing (Nijmegen Questionnaire ≤ 23) was evaluated on Breathing Vigilance Questionnaire (Breathe-VQ) score (d=1.05, p=<0.001). Participants at high risk of dysfunctional breathing had significantly higher Breathe-VQ scores compared to low-risk peers (19.1 vs 13.8, p<0.001), demonstrating the questionnaire's validity.
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