DEVELOPMENT OF A SCREENING PROTOCOL TO IDENTIFY INDIVIDUALS WITH DYSFUNCTIONAL BREATHING.
DEVELOPMENT OF A SCREENING PROTOCOL TO IDENTIFY INDIVIDUALS WITH DYSFUNCTIONAL BREATHING.
复制标题
制定筛查方案来识别呼吸功能障碍的个体。
DOI：
10.26603/ijspt20170774
复制
发表时间：
2017
影响因子：
1.7
通讯作者：
R. Butler
中科院分区：
文献类型：
--
作者：
K. Kiesel;Tonya Rhodes;Jacob Mueller;A. Waninger;R. Butler
引言
呼吸功能障碍(DB)与包括腰痛和颈痛在内的健康状况有关，并对肌肉骨骼系统产生不利影响。患有糖尿病的患者通常痛阈值降低，运动控制、平衡和运动能力受损。没有单一的测试或筛查来识别DB，它是多维的，包括生化、生物力学和心理生理成分。有几个工具对数据库进行评估和测试，但没有屏幕来确定是否指示进行额外的测试和评估。
目的/背景
这项研究的目的是开发一种呼吸筛查程序，可供健身和医疗保健提供者用来筛查呼吸紊乱的存在。采用诊断性试验研究方法来确定新开发的DB筛查的诊断准确性。
方法
纳入方便样本51人(女性27人，年龄27.0岁，体重指数23.3)。为了测试与生化维度相关的Db，用二氧化碳描记仪测量呼气末二氧化碳(ETCO2)。采用Hi-Lo检验方法，对与生物力学维度相关的Db进行检验。采用呼吸症状自评量表(SEBQ)和奈梅根问卷进行与心理生理维度相关的DB测试。利用先前研究中已被证明与DB相关且可由非卫生保健人员执行的潜在筛查项目来创建指数测试，包括活动水平、屏气时间、呼吸频率和功能运动筛查(fms™)。
结果
Db的三个指标之间没有很强的相关性。5名受试者呼吸正常，14名受试者未能通过至少一项测试，20名受试者未能通过至少两项测试，12名受试者三项测试均未通过。为了开发每个维度的筛查项目，检查了与失败相关的数据。BHT和四项迷你问卷被确定为与所有三个维度的失败最密切相关的变量。将 <； 25s的BHT和4个问题相结合，得出诊断DB的敏感性为0.89(0.85-0.93)，特异性为0.60(0.18-0.92)。
结论
容易获得的BHT临床指标和四个问题可以用来筛查DB的存在。如果屏幕通过，则数据库不存在的可能性为89%。如果筛查不合格，建议进行进一步评估。
证据水平
2B。
Introduction
Dysfunctional breathing (DB) has been linked to health conditions including low back pain and neck pain and adversely effects the musculoskeletal system. Individuals with DB often have decreased pain thresholds and impaired motor control, balance, and movement. No single test or screen identifies DB, which is multi-dimensional, and includes biochemical, biomechanical, and psychophysiological components. Several tools assess and test for DB, but no screen exists to determine whether additional testing and assessment are indicated.
Purpose/Background
The purpose of this study was to develop a breathing screening procedure that could be utilized by fitness and healthcare providers to screen for the presence of disordered breathing. A diagnostic test study approach was utilized to establish the diagnostic accuracy of the newly developed screen for DB.
Methods
A convenience sample of 51 subjects (27 females, 27.0 years, BMI 23.3) were included. To test for DB related to the biochemical dimension, end-tidal CO2 (ETCO2) was measured with a capnography unit. To test for DB related to biomechanical dimension, the Hi-Lo test was utilized. To test for DB related to the psychophysiological dimension, the Self Evaluation of Breathing Symptoms Questionnaire (SEBQ) and Nijmegen questionnaires were utilized. Potential screening items that have been shown to be related to DB in previous research and that could be performed by non-health care personnel were utilized to create the index test including activity level, breath hold time (BHT), respiration rate, and the Functional Movement Screen (FMS™).
Results
There were no strong correlations between the three measures of DB. Five subjects had normal breathing, 14 failed at least one measure, 20 failed at least two, and 12 failed all three. To develop screening items for each dimension, data were examined for association with failure. BHT and a four-item mini-questionnaire were identified as the most closely associated variables with failure of all three dimensions. A BHT of < 25 seconds and four questions were combined and yielded a sensitivity of 0.89 (0.85-0.93) and a specificity of 0.60 (0.18-0.92) for clinical identification of DB.
Conclusion
Easily obtained clinical measures of BHT and four questions can be utilized to screen for the presence of DB. If the screen is passed, there is an 89% chance that DB is not present. If the screen is failed, further assessment is recommended.
Level of Evidence
2b.