Skip to main content

Anne Bruton

University of Southampton, School of Health Sciences, Faculty Member

University of Southampton, Rehabilitation and Health Technologies Research Group, Faculty Member

University of Southampton, Southampton NIHR Respiratory Biomedical Research Unit, Faculty Member

Followers

1,037

Following

13

Co-authors

6

Mentions

1

Public Views

Emeritus Professor of Respiratory Rehabilitation. University of Southampton
My blog is here https://anniebruton.wordpress.com/

I am a physiotherapist who transferred to academia and was awarded 3 NIHR Fellowships during my academic career. The most recent was an NIHR Senior Research Fellowship from 2013-2018 (http://www.nihr.ac.uk/funding/fellowship-programme.htm), which supported my respiratory research for 5 years (2013-18).

I retired from full-time academia in 2018.

less

The University of Sydney

Kevin E Yarasheski, PhD

Washington University in St. Louis

University of Leicester

Fernando Guimaraes

Universidade Federal do Rio de Janeiro (UFRJ)

Claude J SPICHER

McGill University

Kenneth Chapman

University of Toronto

Gazi University

Gustavo E N R I Q U E Zabert

Universidad Nacional del Comahue

Alejandro Videla

Universidad Austral

Magdalena Górska

Utrecht University

InterestsView All (9)

Uploads

Papers by Anne Bruton

Systematic review and meta-analysis of digital interventions for patient self-management support for asthma

Systematic review protocol registration

Can breathing pattern parameters be differentiated between healthy and severe asthma patients

European Respiratory Journal, Sep 1, 2012

The test re-test reliability of specific breathing pattern elements in sitting and supine positions

Physiotherapy, May 1, 2015

Background: Driving is a very important mode of mobility and it is associated with independence, ... more Background: Driving is a very important mode of mobility and it is associated with independence, self-esteem, and high quality of life. Impaired driving ability is common in persons with Multiple Sclerosis (MS), with failure rates on fitness-to-drive evaluations varying between 19% and 42%. The major concern for those who fail is "what help is available to help them return to driving?" An extensive review of the literature did not yield any driving-specific rehabilitation program for persons with MS. Purpose: The purpose of this study was therefore to determine the potential of using a simulator-based program to improve driving-related skills in persons with relapsingremitting MS whose disease severity was rated as being between 1 and 7 according to the Expanded Disability Status Scale (EDSS). Methods: Thirty-six participants (age 46 ± 11 years; 30 women) each received 5 hours of individualized training in a high fidelity driving simulator. The individualized training program focused on the specific driving difficulties that participants exhibited during an on-road driving test. Six other participants (age 48 ± 13 years; 5 women) did not receive training because of issues with simulation sickness. Data of performance on a driving evaluation before and after training were compared between those who received training and those who did not. Results: No significant differences were observed between the groups before and after training. However, 4 of the 7 participants in the training group who failed the road test at pre-training passed at post-training, while the only participant in the group that did not receive training who failed at pre-training still failed post-training. The training group also improved on a visual and two cognitive tests, and reported less fatigue after training. The improvements were most pronounced among those with an EDSS score between 3 and 7. Conclusion(s): This study demonstrates the potential of using a simulator to improve driving-related visual, cognitive, and on-road skills in individuals with relapsing-remitting MS, particularly those with an EDSS score >3. Implications: This is the first study to show that it is feasible to offer MS patients a meaningful rehabilitation program that is capable of improving some driving-related visual and

Adherence to pulmonary rehabilitation: A qualitative study

Respiratory Medicine, Oct 1, 2006

Objectives: To explore the experiences of chronic obstructive pulmonary disease (COPD) patients i... more Objectives: To explore the experiences of chronic obstructive pulmonary disease (COPD) patients invited to join a pulmonary rehabilitation (PR) programme. PR has been shown to be an effective non-pharmacological intervention; however uptake and completion of programmes is frequently low. Design: Qualitative study using semi-structured interviews Participants: Twenty COPD patients aged 45-85 years, referred for PR over a 2-year period. Results: In this group of patients the influence of the referring doctor was the key factor in leading patients to take up an invitation to attend a PR programme. Patients responded positively to doctors who imparted enthusiasm for, and belief in, the benefits of the intervention. Once started, ongoing adherence to the programme was positively influenced by a sense of group support, and increased self-confidence. Lack of social support at home and overcoming the effort of living with COPD in order to attend were cited as negative influences on continued adherence. Conclusions: This study has shown that the referring doctor plays a key role in the uptake of PR programmes. It suggests that a positive approach by doctors could increase the level of adherence to PR. Recognition and support in the area of social support for those living alone may also increase adherence. These simple, cost effective approaches may encourage more patients with COPD to participate in a therapeutic intervention which now has a strong evidence base.

Prioritising physiotherapy services: the development and implementation of a post-operative screening tool

Few respiratory physiotherapists now undertake pre-operative patient assessments, and not all pos... more Few respiratory physiotherapists now undertake pre-operative patient assessments, and not all post-operative patients will need physiotherapy. The objective of this project was to devise a safe screening tool (SPPOST) that could be applied post-operatively, which would prioritise surgical patients most likely to benefit from physiotherapy contact. The SPPOST was applied to 404 post-operative patients, screening out nearly half with no measurable detriment, thereby facilitating the targeting of higher risk patients.

Muscle Plasticity

Physiotherapy, Jul 1, 2002

All skeletal muscles have adaptive potential, which means that they are capable of modifying thei... more All skeletal muscles have adaptive potential, which means that they are capable of modifying their structure in response to environmental change. Increased and reduced activity are two of the common environmental changes that physiotherapists see in clinical practice (eg muscle training and detraining). The purpose of this article is to review the literature surrounding these two areas. Although many of the adaptations that occur in muscle as a result of increasing or reducing activity are reasonably well understood, there is still no consensus as to the best way either to promote or to prevent these adaptations. General principles for muscle training are accepted, but quantifying exercise prescription (eg in terms of duration, load or repetitions) is not standardised. One of the reasons for this lack of standardisation is the individuality of each person's response to exercise, some of which may be explained by genetic factors. Recent studies have explored the effect of the angiotensin converting enzyme genotype on physical performance, with some conflicting results.

LATE-BREAKING ABSTRACT: The relationship between crackle characteristics and regional ventilation/perfusion ratio measured by SPECT/CT

Crackle lung sounds are believed to be generated by the reopening of abnormally closed airways wh... more Crackle lung sounds are believed to be generated by the reopening of abnormally closed airways which are found in many cardiopulmonary diseases. The mismatch of ventilation (V) and perfusion (Q) in the lung, as measured by the V/Q ratio, can represent the impairment of gas exchange under the condition of abnormal airway closure. The objective of this study was to explore any relationship between the characteristics of crackles measured by Computer Aided Lung Sound Analysis (CALSA) and regional V/Q ratio measured by Single Photon Emission Computed Tomography (SPECT), and hence the possibility of using crackles to indicate impaired gas exchange in the lungs. Twenty-four participants (7 COPD, 8 healthy smokers and 9 healthy non-smokers) were examined with simultaneous SPECT/CT ventilation and perfusion scans (GE Systems, Milwaukee, WI, USA). Lung sounds were recorded using a digital stethoscope (ThinkLabs ds32a, USA) connected to a laptop computer. The results showed that, after a Bonferroni correction, there was a significant correlation between crackle 2CD and V/Q ratio for both left lower lobe (LLL) (r=0.63, p=0.001) and right lower lobe (RLL) (r=0.68, p=0.0002).Additionally, the crackle 2CD at LLL and RLL were found to significantly predict the V/Q ratio at the LLL and RLL (adjusted R 2 =0.39 and 0.44, R 2 =0.37 and 0.47 respectively, p=0.001). These initial results indicate that crackle 2CD might be able to predict the mismatch of V/Q caused by many pulmonary diseases, though a larger sample is needed to confirm it. This suggests that crackles could be used as an indicator of impairment of gas exchange.

Quantifiable Breathing Pattern Components Can Predict Asthma Control: an Observational Cross-sectional Study

Research Square (Research Square), Jan 25, 2021

Background: Breathing pattern disorders are frequently reported in uncontrolled asthma. At presen... more Background: Breathing pattern disorders are frequently reported in uncontrolled asthma. At present, this is primarily assessed by questionnaires, which are subjective. Objective measures of breathing pattern components can provide additional useful information about asthma control. This study examined whether respiratory timing parameters and thoracoabdominal (TA) motion measures could predict and classify levels of asthma control. Methods: 122 asthma patients at STEP 2-STEP 5 GINA asthma medication were enrolled. Asthma control was determined by the Asthma Control Questionnaire (ACQ7-item) and patients divided into 'well controlled' or 'uncontrolled' groups. Breathing pattern components (respiratory rate (RR), ratio of inspiration duration to expiration duration (Ti/Te), ratio of ribcage amplitude over abdominal amplitude during expiration phase (RCampe/ABampe), were measured using Structured Light Plethysmography (SLP) in a sitting position for 5-minutes. Breath-by-breath analysis was performed to extract mean values and withinsubject variability (measured by the Coefficient of Variance (CoV%). Binary multiple logistic regression was used to test whether breathing pattern components are predictive of asthma control. A post-hoc analysis determined the discriminant accuracy of any statistically significant predictive model. Results: Fifty-nine out of 122 asthma patients had an ACQ7-item < 0.75 (wellcontrolled asthma) with the rest being uncontrolled (n= 63). The absolute mean values of breathing pattern components did not predict asthma control (R 2 = 0.09) with only mean RR being a significant predictor (p < 0.01). The CoV% of the examined breathing components did predict asthma control (R 2 = 0.45) with all predictors having significant odds ratios (p < 0.01). The ROC curve showed that cutoff points > 7.40% for the COV% of the RR, > 21.66% for the CoV% of Ti/Te and > 18.78% for the CoV% of RCampe/ABampe indicated uncontrolled asthma. Conclusion: The within-subject variability of timing parameters and TA motion can be used to predict asthma control. Higher breathing pattern variability was associated with uncontrolled asthma suggesting that irregular resting breathing is an indicator of poor asthma control.

Reliability of computer aided lung sound analysis detecting crackles in bronchiectasis patients: a potential outcome measure for respiratory physiotherapy

... Subjects: R Medicine > R Medicine (General). Divisions: Faculty of Medicine, Health and Li... more

Does garment-embedded respiratory inductive plethysmography (RIP) show equivalent changes in respiratory parameters to a pneumotachograph (PNT)?

Lo, WL, Bruton, A., Barney, A. and Lewis, A (2010) Does garment-embedded respiratory inductive pl... more Lo, WL, Bruton, A., Barney, A. and Lewis, A (2010) Does garment-embedded respiratory inductive plethysmography (RIP) show equivalent changes in respiratory parameters to a pneumotachograph (PNT)? At European Respiratory Society Annual Congress, Barcelona, ES, 18 - 22 Sep 2010. ... Full text not available from this repository. ... RDF+N-Triples, RDF+N3, RDF+XML, Browse.

P51 Barriers And Facilitators To Effective Self-management Of Asthma - A Systematic Review And Thematic Synthesis

Thorax, Nov 10, 2014

but a high specificity of 93% and could be useful to exclude rather than identify the presence of... more but a high specificity of 93% and could be useful to exclude rather than identify the presence of sputum eosinophilia. Conclusion Combined testing using ACQ and BEos only identifies eosinophilia in 37% and can't replace induced sputum, but may be useful to exclude sputum eosinophilia and prospective study is warranted.

Resting mixed venous carbon dioxide levels in asthmatics and non-asthmatics: a pilot study investigating Buteyko’s theory

Clark, R. and Bruton, A. (2003) Resting mixed venous carbon dioxide levels in asthmatics and non-... more Clark, R. and Bruton, A. (2003) Resting mixed venous carbon dioxide levels in asthmatics and non-asthmatics: a pilot study investigating Buteyko's theory. In, 14th International World Congress in Physical Therapy, Barcelona, Spain, 08 - 10 Jun 2003. (Submitted). ... Full text not available from this repository. ... RDF+N-Triples, RDF+N3, RDF+XML, Browse.

Feasibility trial of a digital self-management intervention ‘My Breathing Matters’ to improve asthma-related quality of life for UK primary care patients with asthma

BMJ Open, Nov 1, 2019

Feasibility trial of a digital selfmanagement intervention 'My Breathing Matters' to improve asth... more

What factors influence adherence to portable oxygen systems in patients with Chronic Obstructive Pulmonary Disease (COPD)? A qualitative study

Login. ...

Breathing exercises delivered by DVD or face to face physiotherapy-acceptability to patients in the BREATHE study

Background: Breathing retraining exercises (BRE) are recommended in guidelines as adjuvant treatm... more Background: Breathing retraining exercises (BRE) are recommended in guidelines as adjuvant treatment for uncontrolled asthma, but are currently used infrequently. We developed a self-guided digital BRE programme delivered as DVD plus booklet (DVDB), and compared it with 3 sessions of face-to-face physiotherapy BRE plus booklet (FTF) Methods: Patient acceptability and experience were evaluated after 3 months by semi-structured qualitative interviews thematically analysed until data saturation achieved, and questionnaires sent to all (return rate: DVDB 244/261; FTF 132/132) Results: Qualitative sample: 11 women, 5 men (mean age 55 yrs), 8 from DVBD, 8 from FTF. BRE was viewed positively as patients found physiotherapist appointments motivational and liked the materials. Problems included finding time to practice and mastering techniques. Quantitative evaluation also showed positive engagement, with 95% of FTF attending at least 1 session and 93% attending all 3. 100% FTF and 98% DVDB reported practicing BRE to some extent. Experience of BRE components (stomach, nasal, slow breathing, breath hold, relaxation) was favourable with >50% spending 1/2 day or more practicing each. This led to increased awareness of breathing and development of new habits. Perceived benefits included increased breathing control, reduced rescue medication, feeling more relaxed, and improved quality of life. FTF participants spent significantly more time practicing, and reported greater enjoyment and engagement, with 93% rating the physio appointments 8/10 or higher. Conclusions BRE were acceptable and well received by both groups, although engagement and practice time were higher with FTF

Regional contributions of the ribcage and abdomen in healthy adults and patients with chronic respiratory disease during quiet breathing and speech

Background: While the regional contributions of the ribcage and abdomen during resting breathing ... more Background: While the regional contributions of the ribcage and abdomen during resting breathing have been shown to differ between health and disease, it is not known whether these differences can be detected during speech or if the type of speech influences the effect size of these differences. Aim: To compare the regional contributions of the ribcage and abdomen between healthy adults and patients with chronic respiratory disease during quiet breathing and speech tasks. Method: Breathing patterns were recorded non-invasively using Respiratory Inductive Plethysmography (RIP) from 29 healthy adults (mean age 66.9±8.14) and 20 age matched patients (mean age 69.7 ± 8.81) with chronic respiratory disease during two minute periods of quiet breathing, reading, conversation and counting. Offline analysis was performed using Matlab, where the contributions of the ribcage and abdomen during the breathing cycle (%RC; %AB) were extrapolated from the raw data. Results: On average, healthy adults were found to have a greater %RC and smaller %AB contribution in comparison to patients with chronic respiratory disease. These results were statistically significant during every breathing and speech task (p Conclusion: These findings suggest that a spontaneous speech task may be more useful for highlighting the differences between health and disease. If confirmed in larger samples, this has implications for monitoring respiratory health using breathing patterns during speech.

The stability of breathing pattern components over time in different body positions

Background: Elements of breathing pattern (BP) have potential to monitor respiratory health, or b... more Background: Elements of breathing pattern (BP) have potential to monitor respiratory health, or be used as outcome measures. Little published research has examined the stability of BP over time or in different body positions. Aim: To estimate the test-retest reliability of components of BP in sitting and supine positions. Methods: 46 healthy individuals (11 M) age (mean 31, SD 6.9) were recruited. Participants attended on 2 separate days a week apart. BP data were collected using Respiratory Inductive Plethysmography. BP was recorded for 15 minutes in sitting and 15 minutes in supine. After a break this was repeated to total 4 recordings. Participants were invited to return a week later to repeat the procedure. Group mean differences of BP components (inspiratory time, expiratory time, breathing cycle, respiratory rate, % of ribcage and abdomen contributions (RC/VT%, AB/VT%) were analysed within sessions, between sessions and between days using one way repeated measures ANOVA. Relative reliability was determined using intraclass correlation coefficient (ICC). Within subjects standard deviation (WSSD) was used to determine absolute reliability. 95% level of agreement (LA) was calculated to determine agreement between measures. Result: ANOVA and ICC results showed BP components to have good relative reliability. WSSD values were low to moderate suggesting good levels of absolute reliability. The 95% LA was narrow indicating acceptable agreement. Higher test re-test reliability was found for all components in sitting than supine. Conclusion: The BP components examined demonstrated good test re-test reliability in both sitting and supine positions in this sample of healthy participants.

Learning motivational interviewing (MI) for use in pulmonary rehabilitation (PR)

Background: MI is a potential method for improving PR engagement and adherence. The quality of MI... more Background: MI is a potential method for improving PR engagement and adherence. The quality of MI is known to influence outcomes, but the extent to which PR clinicians can develop skill in this complex counselling method has not been determined. Aim: To evaluate the impact of a tailored training package on MI skill amongst PR clinicians. Method: Eleven PR clinicians (7 physiotherapists, 3 nurses, 1 exercise specialist) participated in a 2-day workshop and 5 individualised coaching/feedback sessions scheduled over 10 weeks. MI skill was measured through MI Treatment Integrity coding (MITI 3.1.1) of audio-recorded PR consultations at baseline, post-workshop, post-coaching and at 4 months. Results: MI skill acquisition was variable. Mean MI skill increased and some aspects surpassed basic competency thresholds at 4 months, but no participants achieved all thresholds simultaneously. Training did not alter the relative frequency and depth of reflective listening sufficiently and some participants struggled to adjust to MI9s collaborative, evocative spirit. Observations of patient functioning often did not show the pattern of language that is predictive of change. These results may reflect a 9best-case9 scenario, since participants could choose which consultation to record. Mean time to complete training was 18 weeks (±8.26), with service demands commonly cited for the delay. Conclusion: Prior to widespread adoption of MI as part of PR, it is essential to ensure that those responsible for MI delivery can do so competently. Following the sub-optimal gains in skill observed an updated training package (including the 9PREAMP9 manual to guide the integration of MI into PR) is being evaluated.

The development of my breathing matters: A digital intervention to improve patient self-management of asthma

Background: It is estimated that appropriate early-intervention and self-management could prevent... more Background: It is estimated that appropriate early-intervention and self-management could prevent 70% of asthma-related hospital admissions. Patient education and self-management have been convincingly shown to improve clinical outcomes in asthma, and digital interventions have proved a cost-effective means by which to do this in other chronic health conditions. We used existing quantitative and a program of qualitative research to develop My Breathing Matters, an online self-management programme to improve a variety of asthma-related outcomes. Method: Our person-based approach to intervention development took an iterative approach, exploring patients9 perceptions of My Breathing Matters using thematic analysis of in-depth think-aloud studies, with modifications based on feedback. Findings: The age range of the patient group was 21 to 61, all with a positive diagnosis of asthma. My Breathing Matters was viewed positively by patients as a tool for patient self-management. Patients had positive perceptions of both pharmacological and non-pharmacological self-management techniques. Patients approved of digital interventions for self-management, including personalized tailoring in order to allow quick access of relevant content (such as an online Personalized Asthma Action Plan). Conclusions: This study provides important evidence that digital interventions are an acceptable and well-liked way to improve asthma-related outcomes. Further research will conduct a feasibility trial of the intervention, with process analyses of patient and primary care staff experiences, to inform a future Phase 3 trial.

Chronic obstructive pulmonary disease (COPD) patient experiences of pulmonary rehabilitation (PR): A longitudinal qualitative UK study

European Respiratory Journal, Sep 1, 2012

Systematic review and meta-analysis of digital interventions for patient self-management support for asthma

Systematic review protocol registration

Can breathing pattern parameters be differentiated between healthy and severe asthma patients

European Respiratory Journal, Sep 1, 2012

The test re-test reliability of specific breathing pattern elements in sitting and supine positions

Physiotherapy, May 1, 2015

Background: Driving is a very important mode of mobility and it is associated with independence, ... more Background: Driving is a very important mode of mobility and it is associated with independence, self-esteem, and high quality of life. Impaired driving ability is common in persons with Multiple Sclerosis (MS), with failure rates on fitness-to-drive evaluations varying between 19% and 42%. The major concern for those who fail is "what help is available to help them return to driving?" An extensive review of the literature did not yield any driving-specific rehabilitation program for persons with MS. Purpose: The purpose of this study was therefore to determine the potential of using a simulator-based program to improve driving-related skills in persons with relapsingremitting MS whose disease severity was rated as being between 1 and 7 according to the Expanded Disability Status Scale (EDSS). Methods: Thirty-six participants (age 46 ± 11 years; 30 women) each received 5 hours of individualized training in a high fidelity driving simulator. The individualized training program focused on the specific driving difficulties that participants exhibited during an on-road driving test. Six other participants (age 48 ± 13 years; 5 women) did not receive training because of issues with simulation sickness. Data of performance on a driving evaluation before and after training were compared between those who received training and those who did not. Results: No significant differences were observed between the groups before and after training. However, 4 of the 7 participants in the training group who failed the road test at pre-training passed at post-training, while the only participant in the group that did not receive training who failed at pre-training still failed post-training. The training group also improved on a visual and two cognitive tests, and reported less fatigue after training. The improvements were most pronounced among those with an EDSS score between 3 and 7. Conclusion(s): This study demonstrates the potential of using a simulator to improve driving-related visual, cognitive, and on-road skills in individuals with relapsing-remitting MS, particularly those with an EDSS score >3. Implications: This is the first study to show that it is feasible to offer MS patients a meaningful rehabilitation program that is capable of improving some driving-related visual and

Adherence to pulmonary rehabilitation: A qualitative study

Respiratory Medicine, Oct 1, 2006

Objectives: To explore the experiences of chronic obstructive pulmonary disease (COPD) patients i... more Objectives: To explore the experiences of chronic obstructive pulmonary disease (COPD) patients invited to join a pulmonary rehabilitation (PR) programme. PR has been shown to be an effective non-pharmacological intervention; however uptake and completion of programmes is frequently low. Design: Qualitative study using semi-structured interviews Participants: Twenty COPD patients aged 45-85 years, referred for PR over a 2-year period. Results: In this group of patients the influence of the referring doctor was the key factor in leading patients to take up an invitation to attend a PR programme. Patients responded positively to doctors who imparted enthusiasm for, and belief in, the benefits of the intervention. Once started, ongoing adherence to the programme was positively influenced by a sense of group support, and increased self-confidence. Lack of social support at home and overcoming the effort of living with COPD in order to attend were cited as negative influences on continued adherence. Conclusions: This study has shown that the referring doctor plays a key role in the uptake of PR programmes. It suggests that a positive approach by doctors could increase the level of adherence to PR. Recognition and support in the area of social support for those living alone may also increase adherence. These simple, cost effective approaches may encourage more patients with COPD to participate in a therapeutic intervention which now has a strong evidence base.

Prioritising physiotherapy services: the development and implementation of a post-operative screening tool

Few respiratory physiotherapists now undertake pre-operative patient assessments, and not all pos... more Few respiratory physiotherapists now undertake pre-operative patient assessments, and not all post-operative patients will need physiotherapy. The objective of this project was to devise a safe screening tool (SPPOST) that could be applied post-operatively, which would prioritise surgical patients most likely to benefit from physiotherapy contact. The SPPOST was applied to 404 post-operative patients, screening out nearly half with no measurable detriment, thereby facilitating the targeting of higher risk patients.

Muscle Plasticity

Physiotherapy, Jul 1, 2002

All skeletal muscles have adaptive potential, which means that they are capable of modifying thei... more All skeletal muscles have adaptive potential, which means that they are capable of modifying their structure in response to environmental change. Increased and reduced activity are two of the common environmental changes that physiotherapists see in clinical practice (eg muscle training and detraining). The purpose of this article is to review the literature surrounding these two areas. Although many of the adaptations that occur in muscle as a result of increasing or reducing activity are reasonably well understood, there is still no consensus as to the best way either to promote or to prevent these adaptations. General principles for muscle training are accepted, but quantifying exercise prescription (eg in terms of duration, load or repetitions) is not standardised. One of the reasons for this lack of standardisation is the individuality of each person's response to exercise, some of which may be explained by genetic factors. Recent studies have explored the effect of the angiotensin converting enzyme genotype on physical performance, with some conflicting results.

LATE-BREAKING ABSTRACT: The relationship between crackle characteristics and regional ventilation/perfusion ratio measured by SPECT/CT

Crackle lung sounds are believed to be generated by the reopening of abnormally closed airways wh... more Crackle lung sounds are believed to be generated by the reopening of abnormally closed airways which are found in many cardiopulmonary diseases. The mismatch of ventilation (V) and perfusion (Q) in the lung, as measured by the V/Q ratio, can represent the impairment of gas exchange under the condition of abnormal airway closure. The objective of this study was to explore any relationship between the characteristics of crackles measured by Computer Aided Lung Sound Analysis (CALSA) and regional V/Q ratio measured by Single Photon Emission Computed Tomography (SPECT), and hence the possibility of using crackles to indicate impaired gas exchange in the lungs. Twenty-four participants (7 COPD, 8 healthy smokers and 9 healthy non-smokers) were examined with simultaneous SPECT/CT ventilation and perfusion scans (GE Systems, Milwaukee, WI, USA). Lung sounds were recorded using a digital stethoscope (ThinkLabs ds32a, USA) connected to a laptop computer. The results showed that, after a Bonferroni correction, there was a significant correlation between crackle 2CD and V/Q ratio for both left lower lobe (LLL) (r=0.63, p=0.001) and right lower lobe (RLL) (r=0.68, p=0.0002).Additionally, the crackle 2CD at LLL and RLL were found to significantly predict the V/Q ratio at the LLL and RLL (adjusted R 2 =0.39 and 0.44, R 2 =0.37 and 0.47 respectively, p=0.001). These initial results indicate that crackle 2CD might be able to predict the mismatch of V/Q caused by many pulmonary diseases, though a larger sample is needed to confirm it. This suggests that crackles could be used as an indicator of impairment of gas exchange.

Quantifiable Breathing Pattern Components Can Predict Asthma Control: an Observational Cross-sectional Study

Research Square (Research Square), Jan 25, 2021

Background: Breathing pattern disorders are frequently reported in uncontrolled asthma. At presen... more Background: Breathing pattern disorders are frequently reported in uncontrolled asthma. At present, this is primarily assessed by questionnaires, which are subjective. Objective measures of breathing pattern components can provide additional useful information about asthma control. This study examined whether respiratory timing parameters and thoracoabdominal (TA) motion measures could predict and classify levels of asthma control. Methods: 122 asthma patients at STEP 2-STEP 5 GINA asthma medication were enrolled. Asthma control was determined by the Asthma Control Questionnaire (ACQ7-item) and patients divided into 'well controlled' or 'uncontrolled' groups. Breathing pattern components (respiratory rate (RR), ratio of inspiration duration to expiration duration (Ti/Te), ratio of ribcage amplitude over abdominal amplitude during expiration phase (RCampe/ABampe), were measured using Structured Light Plethysmography (SLP) in a sitting position for 5-minutes. Breath-by-breath analysis was performed to extract mean values and withinsubject variability (measured by the Coefficient of Variance (CoV%). Binary multiple logistic regression was used to test whether breathing pattern components are predictive of asthma control. A post-hoc analysis determined the discriminant accuracy of any statistically significant predictive model. Results: Fifty-nine out of 122 asthma patients had an ACQ7-item < 0.75 (wellcontrolled asthma) with the rest being uncontrolled (n= 63). The absolute mean values of breathing pattern components did not predict asthma control (R 2 = 0.09) with only mean RR being a significant predictor (p < 0.01). The CoV% of the examined breathing components did predict asthma control (R 2 = 0.45) with all predictors having significant odds ratios (p < 0.01). The ROC curve showed that cutoff points > 7.40% for the COV% of the RR, > 21.66% for the CoV% of Ti/Te and > 18.78% for the CoV% of RCampe/ABampe indicated uncontrolled asthma. Conclusion: The within-subject variability of timing parameters and TA motion can be used to predict asthma control. Higher breathing pattern variability was associated with uncontrolled asthma suggesting that irregular resting breathing is an indicator of poor asthma control.

Reliability of computer aided lung sound analysis detecting crackles in bronchiectasis patients: a potential outcome measure for respiratory physiotherapy

... Subjects: R Medicine > R Medicine (General). Divisions: Faculty of Medicine, Health and Li... more

Does garment-embedded respiratory inductive plethysmography (RIP) show equivalent changes in respiratory parameters to a pneumotachograph (PNT)?

Lo, WL, Bruton, A., Barney, A. and Lewis, A (2010) Does garment-embedded respiratory inductive pl... more Lo, WL, Bruton, A., Barney, A. and Lewis, A (2010) Does garment-embedded respiratory inductive plethysmography (RIP) show equivalent changes in respiratory parameters to a pneumotachograph (PNT)? At European Respiratory Society Annual Congress, Barcelona, ES, 18 - 22 Sep 2010. ... Full text not available from this repository. ... RDF+N-Triples, RDF+N3, RDF+XML, Browse.

P51 Barriers And Facilitators To Effective Self-management Of Asthma - A Systematic Review And Thematic Synthesis

Thorax, Nov 10, 2014

but a high specificity of 93% and could be useful to exclude rather than identify the presence of... more but a high specificity of 93% and could be useful to exclude rather than identify the presence of sputum eosinophilia. Conclusion Combined testing using ACQ and BEos only identifies eosinophilia in 37% and can't replace induced sputum, but may be useful to exclude sputum eosinophilia and prospective study is warranted.

Resting mixed venous carbon dioxide levels in asthmatics and non-asthmatics: a pilot study investigating Buteyko’s theory

Clark, R. and Bruton, A. (2003) Resting mixed venous carbon dioxide levels in asthmatics and non-... more Clark, R. and Bruton, A. (2003) Resting mixed venous carbon dioxide levels in asthmatics and non-asthmatics: a pilot study investigating Buteyko's theory. In, 14th International World Congress in Physical Therapy, Barcelona, Spain, 08 - 10 Jun 2003. (Submitted). ... Full text not available from this repository. ... RDF+N-Triples, RDF+N3, RDF+XML, Browse.

Feasibility trial of a digital self-management intervention ‘My Breathing Matters’ to improve asthma-related quality of life for UK primary care patients with asthma

BMJ Open, Nov 1, 2019

Feasibility trial of a digital selfmanagement intervention 'My Breathing Matters' to improve asth... more

What factors influence adherence to portable oxygen systems in patients with Chronic Obstructive Pulmonary Disease (COPD)? A qualitative study

Login. ...

Breathing exercises delivered by DVD or face to face physiotherapy-acceptability to patients in the BREATHE study

Background: Breathing retraining exercises (BRE) are recommended in guidelines as adjuvant treatm... more Background: Breathing retraining exercises (BRE) are recommended in guidelines as adjuvant treatment for uncontrolled asthma, but are currently used infrequently. We developed a self-guided digital BRE programme delivered as DVD plus booklet (DVDB), and compared it with 3 sessions of face-to-face physiotherapy BRE plus booklet (FTF) Methods: Patient acceptability and experience were evaluated after 3 months by semi-structured qualitative interviews thematically analysed until data saturation achieved, and questionnaires sent to all (return rate: DVDB 244/261; FTF 132/132) Results: Qualitative sample: 11 women, 5 men (mean age 55 yrs), 8 from DVBD, 8 from FTF. BRE was viewed positively as patients found physiotherapist appointments motivational and liked the materials. Problems included finding time to practice and mastering techniques. Quantitative evaluation also showed positive engagement, with 95% of FTF attending at least 1 session and 93% attending all 3. 100% FTF and 98% DVDB reported practicing BRE to some extent. Experience of BRE components (stomach, nasal, slow breathing, breath hold, relaxation) was favourable with >50% spending 1/2 day or more practicing each. This led to increased awareness of breathing and development of new habits. Perceived benefits included increased breathing control, reduced rescue medication, feeling more relaxed, and improved quality of life. FTF participants spent significantly more time practicing, and reported greater enjoyment and engagement, with 93% rating the physio appointments 8/10 or higher. Conclusions BRE were acceptable and well received by both groups, although engagement and practice time were higher with FTF

Regional contributions of the ribcage and abdomen in healthy adults and patients with chronic respiratory disease during quiet breathing and speech

Background: While the regional contributions of the ribcage and abdomen during resting breathing ... more Background: While the regional contributions of the ribcage and abdomen during resting breathing have been shown to differ between health and disease, it is not known whether these differences can be detected during speech or if the type of speech influences the effect size of these differences. Aim: To compare the regional contributions of the ribcage and abdomen between healthy adults and patients with chronic respiratory disease during quiet breathing and speech tasks. Method: Breathing patterns were recorded non-invasively using Respiratory Inductive Plethysmography (RIP) from 29 healthy adults (mean age 66.9±8.14) and 20 age matched patients (mean age 69.7 ± 8.81) with chronic respiratory disease during two minute periods of quiet breathing, reading, conversation and counting. Offline analysis was performed using Matlab, where the contributions of the ribcage and abdomen during the breathing cycle (%RC; %AB) were extrapolated from the raw data. Results: On average, healthy adults were found to have a greater %RC and smaller %AB contribution in comparison to patients with chronic respiratory disease. These results were statistically significant during every breathing and speech task (p Conclusion: These findings suggest that a spontaneous speech task may be more useful for highlighting the differences between health and disease. If confirmed in larger samples, this has implications for monitoring respiratory health using breathing patterns during speech.

The stability of breathing pattern components over time in different body positions

Background: Elements of breathing pattern (BP) have potential to monitor respiratory health, or b... more Background: Elements of breathing pattern (BP) have potential to monitor respiratory health, or be used as outcome measures. Little published research has examined the stability of BP over time or in different body positions. Aim: To estimate the test-retest reliability of components of BP in sitting and supine positions. Methods: 46 healthy individuals (11 M) age (mean 31, SD 6.9) were recruited. Participants attended on 2 separate days a week apart. BP data were collected using Respiratory Inductive Plethysmography. BP was recorded for 15 minutes in sitting and 15 minutes in supine. After a break this was repeated to total 4 recordings. Participants were invited to return a week later to repeat the procedure. Group mean differences of BP components (inspiratory time, expiratory time, breathing cycle, respiratory rate, % of ribcage and abdomen contributions (RC/VT%, AB/VT%) were analysed within sessions, between sessions and between days using one way repeated measures ANOVA. Relative reliability was determined using intraclass correlation coefficient (ICC). Within subjects standard deviation (WSSD) was used to determine absolute reliability. 95% level of agreement (LA) was calculated to determine agreement between measures. Result: ANOVA and ICC results showed BP components to have good relative reliability. WSSD values were low to moderate suggesting good levels of absolute reliability. The 95% LA was narrow indicating acceptable agreement. Higher test re-test reliability was found for all components in sitting than supine. Conclusion: The BP components examined demonstrated good test re-test reliability in both sitting and supine positions in this sample of healthy participants.

Learning motivational interviewing (MI) for use in pulmonary rehabilitation (PR)

Background: MI is a potential method for improving PR engagement and adherence. The quality of MI... more Background: MI is a potential method for improving PR engagement and adherence. The quality of MI is known to influence outcomes, but the extent to which PR clinicians can develop skill in this complex counselling method has not been determined. Aim: To evaluate the impact of a tailored training package on MI skill amongst PR clinicians. Method: Eleven PR clinicians (7 physiotherapists, 3 nurses, 1 exercise specialist) participated in a 2-day workshop and 5 individualised coaching/feedback sessions scheduled over 10 weeks. MI skill was measured through MI Treatment Integrity coding (MITI 3.1.1) of audio-recorded PR consultations at baseline, post-workshop, post-coaching and at 4 months. Results: MI skill acquisition was variable. Mean MI skill increased and some aspects surpassed basic competency thresholds at 4 months, but no participants achieved all thresholds simultaneously. Training did not alter the relative frequency and depth of reflective listening sufficiently and some participants struggled to adjust to MI9s collaborative, evocative spirit. Observations of patient functioning often did not show the pattern of language that is predictive of change. These results may reflect a 9best-case9 scenario, since participants could choose which consultation to record. Mean time to complete training was 18 weeks (±8.26), with service demands commonly cited for the delay. Conclusion: Prior to widespread adoption of MI as part of PR, it is essential to ensure that those responsible for MI delivery can do so competently. Following the sub-optimal gains in skill observed an updated training package (including the 9PREAMP9 manual to guide the integration of MI into PR) is being evaluated.

The development of my breathing matters: A digital intervention to improve patient self-management of asthma

Background: It is estimated that appropriate early-intervention and self-management could prevent... more Background: It is estimated that appropriate early-intervention and self-management could prevent 70% of asthma-related hospital admissions. Patient education and self-management have been convincingly shown to improve clinical outcomes in asthma, and digital interventions have proved a cost-effective means by which to do this in other chronic health conditions. We used existing quantitative and a program of qualitative research to develop My Breathing Matters, an online self-management programme to improve a variety of asthma-related outcomes. Method: Our person-based approach to intervention development took an iterative approach, exploring patients9 perceptions of My Breathing Matters using thematic analysis of in-depth think-aloud studies, with modifications based on feedback. Findings: The age range of the patient group was 21 to 61, all with a positive diagnosis of asthma. My Breathing Matters was viewed positively by patients as a tool for patient self-management. Patients had positive perceptions of both pharmacological and non-pharmacological self-management techniques. Patients approved of digital interventions for self-management, including personalized tailoring in order to allow quick access of relevant content (such as an online Personalized Asthma Action Plan). Conclusions: This study provides important evidence that digital interventions are an acceptable and well-liked way to improve asthma-related outcomes. Further research will conduct a feasibility trial of the intervention, with process analyses of patient and primary care staff experiences, to inform a future Phase 3 trial.

Chronic obstructive pulmonary disease (COPD) patient experiences of pulmonary rehabilitation (PR): A longitudinal qualitative UK study

European Respiratory Journal, Sep 1, 2012

Respiratory Management in Neurological Rehabilitation

pFad - Phonifier reborn

Pfad - The Proxy pFad of © 2024 Garber Painting. All rights reserved.

Note: This service is not intended for secure transactions such as banking, social media, email, or purchasing. Use at your own risk. We assume no liability whatsoever for broken pages.

Alternative Proxies:

Alternative Proxy