Introduction:
The aim of this study is to analyse patients who were prescribed respiratory physiotherapy for dysfunctional breathing (DB) and exercise-induced asthma (EIA), as defined by a fall of FEV1 of ≥ 10%, in comparison to those with DB but negative exercise test defined as a fall of FEV1 of < 10%. Our hypothesis is that children or adolescents develop dysfunctional breathing patterns with obvious clinical signs, causing premature exercise interruption, to protect them from an EIA exacerbation. This is important as any treatment would involve on the one hand to address the dysfunctional breathing, whilst on the other hand the treatment of EIA.
Method:
Retrospective case series of patients followed at the respiratory outpatient clinic at the children's hospital Lausanne HEL. We studied the physiotherapeutic and medical records of those paediatric patients who were referred for dysfunctional breathing from the respiratory consultation to the physiotherapy department and analysed in case reports the patients presenting an association of EIA and DB more in detail.
Results:
The 5 patients with the association of both entities had a similar symptomatology to the sample presenting only DB. Even though EIA remained not optimally controlled for a longer period of time in most of the patients, there were only a few emergency consultations with a symptomatology evoking DB rather than EIA. In general, the predominant symptomatology was more suggestive of DB than EIA.
Conclusion:
Our hypothesis could not be confirmed or infirmed, due to the small numbers of cases. Our study suggests that DB might be playing instinctively a role in preventing EIA exacerbations, but the endpoint should be an effective treatment of both entities. A prospective study, conducted in a larger group, would be necessary to clarify if there is indeed a role played by this association.