Determining the efficacy of physiotherapy interventions in paediatric dysfunctional breathing

Dysfunctional breathing (DB) is a well-recognised condition in children. With improved diagnostic techniques, there are increasing referrals being made to respiratory physiotherapy services. However, there is little evidence/guidance on what physiotherapy treatment techniques to use and how effective they are. Aim: To determine the efficacy of physiotherapy interventions for paediatric DB with regards to symptoms, re-referral rates and post intervention medical follow-up. Methods: 89 patients (70%female, mean (range) age:13y(6-17y)) that completed physiotherapy interventions in a specialist paediatric DB clinic, who were discharged between Jan 2015 & Jun 2017, were included. Symptoms were measured using the Nijmegen Questionnaire (NQ) pre and post intervention, and post intervention medical follow-up was calculated based on the No. of appointments required post treatment before being discharged from Respiratory clinic. Results: All children received education, breathing retraining and postural correction, plus other interventions such as: Thoracic mobility; Core stability; Exercise advice; Exercise advice; SOB strategies; Airway clearance techniques; Relaxation; Inspiratory muscle training; Acupressure; Upper airway strategies and vocal hygiene; Nasal rinsing and/or Activity specific exercises. Mean pre and post intervention NQ scores were 22.2 and 13.4 respectively. 87% of scores had increased, 9% decreased and 4% remained unchanged. 72% were discharged after 0 or 1 appointment and only 2% were re-referred to physiotherapy. Conclusion: Individualised physiotherapy interventions have been shown to be effective in eliminating symptoms resulting in high rates of discharge from respiratory clinics.