P247 The physiotherapy assessment of breathing pattern in patients with respiratory symptoms: a systematic review

Résumé fourni par la source

Introduction Breathing pattern disorders are characterised by breathing (or specifically breathing patterns) that deviate from allostasis (respiratory or metabolic requirements) when conscious or unconscious processes override autonomic control. This systematic review appraised the evidence of measurement properties (reliability, validity, and responsiveness) of patient and clinician-reported measures for the evaluation of breathing pattern disorder in people with respiratory symptoms. Methods Inclusion criteria: adults ≥18 years with a diagnosis or suspicion of a disordered breathing pattern and primary studies evaluating outcome measures published before September 2023. The databases searched were: Embase, PubMed, MEDLINE and PEdro. Further searches of the identified outcome measures and secondary sources of citations in the included studies were undertaken. COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) risk of bias checklist was robustly applied to assess methodological quality in nine separate measurement properties (see table 1). Content validity was additionally evaluated for PROMS as per COSMIN standards. The certainty of evidence was determined using a modified GRADE approach. Results The results are summarised using narrative synthesis. Eleven studies were included in our final review; three patient reported outcome measures outcome measures: The Nijmegen Questionnaire (NQ), the Self Evaluation of Breathing Questionnaire (SEBQ) and The Rowley Scale of Self Efficacy (ROBE) and one clinician-reported outcome measure; the Breathing Pattern Assessment Tool (BPAT). Content validity was evaluated from the PROMS only, per COSMIN guidance, with the NQ showing the best evidence across the PROMS. Construct validity across all the tools was moderate to low, influenced by a lack of a gold standard to use as a comparator for this measurement property. Overall, there was moderate quality evidence across some of the measurement properties for the NQ and the BPAT (See table 1) suggesting they maybe helpful in clinical evaluation. Conclusions From the current literature, no clear recommendations of a single outcome measure can be made for the evaluation of this condition due to significant heterogeneities in the study designs and participant characteristics. Further research is needed to develop and validate tools that more accurately reflect the complexity of breathing pattern disorders. PROSPERO registration number: CRD42022297134.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.