Evaluation of Physiotherapy Novel Assessment Tool in Assessing Breathing Pattern Dysfunction: A Service Evaluation

Abstract

Breathing Pattern Dysfunction (BPD) in patients with and without respiratory disease is linked to inconsistent dyspnoea. Various tools including the NQ and D-12 are used to evaluate BPD, however there is no Gold Standard Assessment. The Brompton BPAT is a novel assessment tool that has been used to assess BPD. The present study sought to increase the knowledge of the Brompton breathing pattern assessment tool (BPAT) in assessing BPD by evaluating four distinct areas: 1) the relationship between BPAT and other measures (i.e., NQ and D-12), 2) the responsiveness of BPAT to physiotherapy treatments, 3) factors that may influence the BPAT score and 4) the ability of BPAT to differentiate between different types of BPD. Methods We included all physiotherapy referrals to the Physiotherapy outpatient department of the Royal Brompton Hospital for BPD between 2017 and 2020. NQ, D-12, and BPAT scores were collected before and after physiotherapy treatment sessions, and the number of treatment sessions was also recorded. Results Data were available for 55 patients with a mean (standard deviation) age of 49.2 years (17.2 years); of these, 32 (58.1%) were female, and 23 (41.9%) had a diagnosis of BPD, hyperventilation syndrome, or BPD+. BPAT did not correlate with the NQ or D-12 in any of the groups. There was a statistically significant correlation between the NQ and D-12 (p = 0.001). A statistically significant difference between before and after physiotherapy treatment was apparent in the NQ, D-12, and BPAT scores (p < 0.001. However, only the NQ demonstrated a statistically significant difference in differentiating between various diagnosis groups (p = 0.038). Only physiotherapy treatments showed a statistically significant difference in predicting BPAT improvement after treatments (p = 0.032). Conclusion BPAT results did not correlate with NQ or D-12 scores but did show a significant difference between before and after physiotherapy treatment. Meanwhile, BPAT and D-12 did not differentiate between BPD and hyperventilation syndrome, but the NQ was able to. Finally, the number of physiotherapist treatments was a significant factor in predicting BPAT improvement.