Breathing pattern changes in response to bronchoconstriction in physically active adults.

OBJECTIVES: To determine whether Opto-Electronic Plethysmography (OEP) can distinguish Exercise-Induced Bronchoconstriction (EIB) breathing patterns by comparing individuals with and without EIB, and between broncho-constriction and recovery. Breathing pattern was quantified in terms of regional contribution, breathing timing, and the phase between chest sub-compartments which indicates the synchronization in movement of the different sub-compartments. METHODS: Individuals (n = 47) reporting no respiratory symptoms and no history of any respiratory disease or disorder were assumed to have a healthy breathing pattern. Of 38 participants reporting respiratory symptoms during exercise, and/or a previous diagnosis of asthma or EIB, 10 participants had a positive result to the Eucapnic Voluntary Hyperpnea test, defined as a fall of at least 10% in FEV1 from baseline at two consecutive time points and were classified into the EIB group. OEP data was obtained from 89 markers and an 11-camera motion capture system operating at 100 Hz as follows: pre- and post-EVH challenge, and post-inhaler in participants who experienced a bronchoconstriction, and 2) for the healthy group during tidal breathing. RESULTS: RCpRCa-Phase (upper versus lower ribcage), RCaS-Phase (lower ribcage versus shoulders), and RCpS-Phase (upper ribcage versus shoulders) differed between bronchoconstriction and rest in athletes with EIB and rest in healthy participants (p < 0.05), in all cases indicating greater asynchrony post-bronchoconstriction, and later movement of the abdominal ribcage (RCa) post-bronchoconstriction. RCpS-Phase was different (p < 0.05) between all conditions (rest, post-bronchoconstriction, and post-inhaler) in EIB. CONCLUSIONS: OEP can characterize and distinguish EIB-associated breathing patterns compared to rest and individuals without EIB at rest.

Breathing Pattern Disorders Distinguished from Healthy Breathing Patterns Using Optoelectronic Plethysmography.

There is no gold standard diagnostic method for breathing pattern disorders (BPD) which is commonly diagnosed through the exclusion of other pathologies. Optoelectronic plethysmography (OEP) is a 3D motion capture technique that provides a comprehensive noninvasive assessment of chest wall during rest and exercise. The purpose of this study was to determine if OEP can distinguish between active individuals classified with and without BPD at rest and during exercise. Forty-seven individuals with a healthy breathing pattern (HBP) and twenty-six individuals with a BPD performed a submaximal exercise challenge. OEP measured the movement of the chest wall through the calculation of timing, percentage contribution, and phase angle breathing pattern variables. A mixed model repeated measures ANOVA analysed the OEP variables between the groups classified as HBP and BPD at rest, during exercise, and after recovery. At rest, regional contribution variables including ribcage percentage contribution (HBP: 71% and BPD: 69%), abdominal ribcage contribution (HBP: 13% and BPD: 11%), abdomen percentage contribution (HBP: 29% and BPD: 31%), and ribcage and abdomen volume index (HPB: 2.5 and BPD: 2.2) were significantly (p < 0.05) different between groups. During exercise, BPD displayed significantly (p < 0.05) more asynchrony between various thoracic compartments including the ribcage and abdomen phase angle (HBP: -1.9 and BPD: -2.7), pulmonary ribcage and abdomen phase angle (HBP: -0.5 and BPD, 0.5), abdominal ribcage and shoulders phase angle (HBP: -0.3 and BPD: 0.6), and pulmonary ribcage and shoulders phase angle (HBP: 0.2 and BPD: 0.6). Additionally, the novel variables inhale deviation (HBP: 8.8% and BPD: 19.7%) and exhale deviation (HBP: -10.9% and BPD: -17.6%) were also significantly (p < 0.05) different between the groups during high intensity exercise. Regional contribution and phase angles measured via OEP can distinguish BPD from HBP at rest and during exercise. Characteristics of BPD include asynchronous and thoracic dominant breathing patterns that could form part of future objective criteria for the diagnosis of BPD.

Novel Real-Time OEP Phase Angle Feedback System for Dysfunctional Breathing Pattern Training-An Acute Intervention Study.

Dysfunctional breathing patterns (DBP) can have an impact on an individual's quality of life and/or exercise performance. Breathing retraining is considered to be the first line of treatment to correct breathing pattern, for example, reducing ribcage versus abdominal movement asynchrony. Optoelectronic plethysmography (OEP) is a non-invasive 3D motion capture technique that measures the movement of the chest wall. The purpose of this study was to investigate if the use of a newly developed real-time OEP phase angle and volume feedback system, as an acute breathing retraining intervention, could result in a greater reduction of phase angle values (i.e., an improvement in movement synchrony) when compared to real-time OEP volume feedback alone. Eighteen individuals with a DBP performed an incremental cycle test with OEP measuring chest wall movement. Participants were randomly assigned to either the control group, which included the volume-based OEP feedback or to the experimental group, which included both the volume-based and phase angle OEP feedback. Participants then repeated the same cycle test using the real-time OEP feedback. The phase angle between the ribcage versus abdomen (RcAbPhase), between the pulmonary ribcage and the combined abdominal ribcage and abdomen (RCpAbPhase), and between the abdomen and the shoulders (AbSPhase) were calculated during both cycle tests. Significant increases in RcAbPhase (pre: -2.89°, post: -1.39°, p < 0.01), RCpAbPhase (pre: -2.00°, post: -0.50°, p < 0.01), and AbSPhase (pre: -2.60°, post: -0.72°, p < 0.01) were found post-intervention in the experimental group. This indicates that the experimental group demonstrated improved synchrony in their breathing pattern and therefore, reverting towards a healthy breathing pattern. This study shows for the first time that dysfunctional breathing patterns can be acutely improved with real-time OEP phase angle feedback and provides interesting insight into the feasibility of using this novel feedback system for breathing pattern retraining in individuals with DBP.

Influence of Reactive and Maximum Strength Indicators on Sprint Performance.

Healy, R, Smyth, C, Kenny, IC, and Harrison, AJ. Influence of reactive and maximum strength indicators on sprint performance. J Strength Cond Res 33(11): 3039-3048, 2019-The primary aim of this study was to assess the relationship between reactive and maximal strength measures with 40 m sprint performance and mechanical properties. Fourteen male and 14 female sprinters participated in this study. On the first day, subjects performed 40 m sprints with 10-m split times recorded in addition to maximal theoretical velocity, maximal theoretical force and peak horizontal power, which were calculated from force-velocity relationships. On the second day, subjects performed isometric midthigh pulls (IMTPs) with peak force (PF) and relative PF calculated, drop jumps (DJs) and vertical hopping where the reactive strength index (RSI) was calculated as jump height (JH) divided by contact time (CT). Pearson correlations were used to assess the relationships between measures and independent samples t-tests were used to assess the differences between men and women. No significant correlations were found between DJ and hopping RSI and sprint measures. A significant strong positive correlation was found between IMTP PF and peak horizontal power in men only (r = 0.61). The male sprinters performed significantly better in all recorded measures apart from hopping (CT, JH and RSI) and DJ CT where no significant differences were found. The lack of association between reactive and maximal strength measures with sprint performance is potentially because of the test's prolonged CTs relative to sprinting and the inability to assess the technical application of force. Several methods of assessing reactive strength are needed that can better represent the demands of the distinct phases of sprinting e.g., acceleration, maximum velocity.

The Stanmore Nursing Assessment of Psychological Status (SNAPS): not just for spinal cord injury rehabilitation?

Spinal cord injury is an uncommon condition, potentially causing a wide range of consequences and requiring specialist rehabilitation to optimize health, activity and participation. Early psychological response to injury and relations with staff, as well as family, may set the foundations for long-term emotional adjustment, healthcare utilization and quality of life. The Stanmore Nursing Assessment of Psychological Status has been developed at the London Spinal Cord Injury Centre to empower nurses to adopt a consistently empathic approach to patient care, as part of a comprehensive range of rehabilitation team skills. Its use in other spinal cord injury centers and a broader range of clinical environments (hospital and community) should therefore be considered.

The Stanmore Nursing Assessment of Psychological Status: Understanding the emotions of patients with spinal cord injury.

CONTEXT: Research has shown that individuals who have sustained a spinal cord injury can experience strong and abrupt variations in their emotional state; however no instrument for nurses has been developed to assess these patients' psychological status. OBJECTIVE: To develop a brief, reliable instrument to enable nurses to accurately assess, record and respond to spinal cord injury patients' psychological status. METHODS: In Phase 1, semi-structured interviews were conducted with spinal cord injury patients (n = 10) and nurses (n = 10) which were audio recorded, transcribed and thematically analysed to develop the instrument. The instrument's content validity was then ensured via independent expert review. In Phase 2, the instrument was trialled on 80 spinal cord injury patients to determine inter-rater reliability, internal consistency and test-retest reliability. RESULTS: In Phase 1, four core themes (emotional impact, coping, relationships and assessment) were identified together with a number of related sub-themes. In Phase 2, the instrument was shown to have excellent inter-rater reliability, acceptable internal consistency and satisfactory test re-test reliability. Subsequently a rating sheet, user manual and prompt card were produced. CONCLUSION: The new instrument, the Stanmore Nursing Assessment of Psychological Status, was shown to be valid and reliable. It is anticipated that training nurses to use this instrument may help to enhance good emotional care of patients.