An Observational Investigation of Dysfunctional Breathing and Breathing Control Therapy in a Problem Asthma Clinic
Abstract
Objectives Dysfunctional breathing (DB) is recognized as an associated problem in patients with asthma and may be identified by the Nijmegen questionnaire. We conducted an observational study to determine if breathing control therapy (BCT) improved Nijmegen scores or asthma-related quality of life in patients attending a problem asthma clinic. Methods Nijmegen and Mini Asthma Quality of Life (Mini-AQLQ) questionnaires were completed. Patients with a positive Nijmegen (> or = 23, DB) were referred for BCT and progressive exercise testing (PET) to seek confirmation of dysfunctional breathing. Follow-up questionnaire data were collected at 6 months. Results A total of 102 patients were studied. The total mean Nijmegen score was 26.4 (range 1-61). Those with a score > or = 23 (DB group, n = 65, 64%) had significantly lower Mini-AQLQ (mean 2.83) than the non-DB group (n = 37, mean 4.12, 95% CI for difference 0.87, 1.87, p Conclusions The strong relationship between Mini-AQLQ and Nijmegen scores and poor relationship between Nijmegen scores and PET-identified inappropriate hyperventilation suggest that a positive Nijmegen score overestimates the presence of dysfunctional breathing in patients with moderate to severe asthma. We found no evidence that a moderate intensity breathing control intervention had any impact on Nijmegen scores or asthma-related quality of life in this patient group.
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More recent studies of dysfunctional breathing in asthma have looked at combining use of the Nijmegen questionnaire with symptom limited exercise testing in an attempt to improve specificity for dysfunctional breathing.
“More recent studies of dysfunctional breathing in asthma have looked at combining use of the Nijmegen questionnaire with symptom limited exercise testing in attempt to improve specificity for dysfunctional breathing [16, 19].”
From Dysfunctional breathing: a review of the literature and proposal for classification (2016) · cites this paper as [19]
Around 29% to 64% of asthma patients exhibit HVS.
“Indeed, around 29% to 64% of asthma patients exhibit HVS,31,54–56”
From Physiotherapy Education and Breathing Retraining for Patients With Hyperventilation Syndrome: An Observational Study (2026) · cites this paper as [31]
The diagnosis of HVS is often based solely on the Nijmegen Questionnaire, which may overestimate its prevalence.
“even though the diagnosis of HVS is often based solely on the Nijmegen Questionnaire, which may overestimate its prevalence.31”
From Physiotherapy Education and Breathing Retraining for Patients With Hyperventilation Syndrome: An Observational Study (2026) · cites this paper as [31]
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Dysfunctional breathing: a review of the literature and proposal for classification
Boulding, R., Stacey, R., Niven, R., & Fowler, S. J. (2016) · European Respiratory Review · doi:10.1183/16000617.0088-2015 · Cited by 372 · see citing works
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Beaumont, M., Selleron, B., Passard, G., Karsandi, K., Proffit, M., Valentin, R., & Poncin, W. (2026) · Physiotherapy Canada · doi:10.3138/ptc-2024-0066
- Authors
- Stanton, A. E., Vaughn, P., Carter, R., & Bucknall, C. E.
- Affiliations
- Glasgow Royal Infirmary (GB)
- Venue
- Journal of Asthma
- Publisher
- Informa UK Limited
- Published
- 2008-01
- Volume
- 45
- Issue
- 9
- Pages
- 758-765
- ISSN
- 0277-0903 (ISSN-L)
- 1532-4303
- OpenAlex
- W2025380015
- Cited by
- 53
- References
- 6
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 2 · 2023: 4 · 2022: 3 · 2021: 5 · 2020: 2 · 2019: 5 · 2018: 2 · 2017: 4 · 2016: 3 · 2015: 2 · 2014: 3 · 2013: 3 · 2012: 2
- FWCI
- 1.58
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Asthma (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory and Cough-Related Research
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Keywords
- dysfunctional breathing, asthma, Nijmegen questionnaire, Mini Asthma Quality of Life Questionnaire, asthma quality of life, treatment outcomes
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Asthma, Exercise Test, Female, Humans, Male, Middle Aged, Quality of Life, Respiration Disorders, Respiratory Function Tests, Young Adult
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