An airflow in the first four generations of the tracheobronchial tree was simulated by the 1D model of incompressible fluid flow through the network of the elastic tubes coupled with 0D models of ...lumped alveolar components, which aggregates parts of the alveolar volume and smaller airways, extended with convective transport model throughout the lung and alveolar components which were combined with the model of oxygen and carbon dioxide transport between the alveolar volume and the averaged blood compartment during pathological respiratory conditions. The novel features of this work are 1D reconstruction of the tracheobronchial tree structure on the basis of 3D segmentation of the computed tomography (CT) data; 1D−0D coupling of the models of 1D bronchial tube and 0D alveolar components; and the alveolar gas exchange model. The results of our simulations include mechanical ventilation, breathing patterns of severely ill patients with the cluster (Biot) and periodic (Cheyne-Stokes) respirations and bronchial asthma attack. The suitability of the proposed mathematical model was validated. Carbon dioxide elimination efficiency was analyzed in all these cases. In the future, these results might be integrated into research and practical studies aimed to design cyberbiological systems for remote real-time monitoring, classification, prediction of breathing patterns and alveolar gas exchange for patients with breathing problems.
Dysfunctional breathing is characterised by an abnormal breathing pattern leading to respiratory symptoms. The 25-item Self Evaluation of Breathing Questionnaire (SEBQ) has been developed to measure ...breathing-related symptoms and their severity but lacks thorough evaluation. To determine reproducibility, internal consistency and predictors of SEBQ score, 180 participants completed an online SEBQ with additional demographic and lifestyle questions. Two weeks later, 155 of those repeated SEBQ. Test–retest correlation of the SEBQ was high intraclass correlation coefficient (3, 1) = 0.89; 95 % CI 0.85–0.92. There was no difference in SEBQ score between test and retest (15.1 (11.6) mean (SD) versus 14.7 (12.4);
P
= 0.4) and the score showed a typical error (standard error of measurement) of 4.0. Internal consistency was high (Cronbach’s α = 0.93), and a single factor structure for items was shown. Smoking status, reported respiratory disease, recent respiratory illness and female gender were positively-associated predictors of SEBQ score, and together explained 25.6 % of score variance (
P
≤ 0.001). The SEBQ has high test–retest reproducibility and its score may be predicted by current smoking, chronic respiratory disease, recent respiratory illness and female gender, thus may be a useful clinical screening tool for dysfunctional breathing.
Abstract Background Breathing retraining (BRT) is commonly used during osteopathic consultations as an adjunct to osteopathic manual therapy (OMT) for assessment and treatment of breathing-related ...dysfunction. Although BRT and OMT are widely recognised within osteopathy and other allied health disciplines, there are few descriptions of clinically applicable protocols in the literature. Objective To describe the development of a dual-protocol framework (BRT and OMT) for assessment and treatment of dysfunctional breathing. Design Development and evaluation of a complex intervention. Methods Cyclical, iterative processes of development, feasibility and piloting, evaluation and subsequent redevelopment were applied in the design of two conceptual protocols for BRT and OMT. Results The resulting BRT protocol consists of progressive steps of breathing practice in three body positions (neutral, flexion, extension), followed by a guide for more advanced breathing challenges that can be tailored towards the individual. The OMT protocol provides a semi-standardised assessment and treatment plan, which details body regions for assessment of somatic dysfunction and a list of techniques that can be selected according to practitioner clinical judgement, based on patient presentation and preferences, and clinical context. Conclusions Here we present a clinically applicable guide for a complex intervention entailing assessment and management of dysfunctional or abnormal breathing. Implementation of this protocol within the clinical setting is now recommended, along with ongoing development, and further randomised clinical trials assessing its efficacy, effectiveness, and acceptability.
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