Applied Psychophysiology and Biofeedback

, Volume 41, Issue 1, pp 111–120 | Cite as

Reliability and Determinants of Self-Evaluation of Breathing Questionnaire (SEBQ) Score: A Symptoms-Based Measure of Dysfunctional Breathing

Article
First Online:
  • 342 Downloads

Abstract

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.

Keywords

Abnormal breathing pattern disorders Breathing dysfunction Breathing symptom questionnaire Hyperventilation Test–retest reliability Reproducibility 
This is a preview of subscription content, log in to check access.

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

Ethical approval was granted by the Unitec Research Ethics Committee (UREC 2010-1089).

References

  1. Barker, N., & Everard, M. L. (2015). Getting to grips with ‘dysfunctional breathing’. Paediatric Respiratory Reviews, 16(1), 53–61. doi: 10.1016/j.prrv.2014.10.001.CrossRefPubMedGoogle Scholar
  2. Bartley, J. (2011). Breathing and temporomandibular joint disease. Journal of Bodywork & Movement Therapies, 15(3), 291–297. doi: 10.1016/j.jbmt.2010.06.002.CrossRefGoogle Scholar
  3. Bolman, C., Lechner, L., & van Dijke, M. (2007). Question order in the assessment of misperception of physical activity. International Journal of Behavioral Nutrition & Physical Activity, 4, 42. doi: 10.1186/1479-5868-4-42.CrossRefGoogle Scholar
  4. Bradley, D. (2014). Physiotherapy in rehabilitation of breathing pattern disorders. In L. Chaitow, D. Bradley, & C. Gilbert (Eds.), Recognizing and treating breathing disorders: A multidisciplinary approach (pp. 185–202). Amsterdam: Elsevier.CrossRefGoogle Scholar
  5. Chadha, T. S., Lang, E., Birch, S., & Sackner, M. A. (1985). Respiratory drive in nonsmokers and smokers assessed by passive tilt and mouth occlusion pressure. Response to rebreathing carbon dioxide. Chest, 87(1), 6–10. doi: 10.1378/chest.87.1.6.PubMedGoogle Scholar
  6. Chaitow, L., Bradley, D., & Gilbert, C. (2014a). The structure and function of breathing. In L. Chaitow, D. Bradley, & C. Gilbert (Eds.), Recognizing and treating breathing disorders: A multidisciplinary approach (pp. 23–43). Amsterdam: Elsevier.CrossRefGoogle Scholar
  7. Chaitow, L., Bradley, D., & Gilbert, C. (2014b). What are breathing pattern disorders? In L. Chaitow, D. Bradley, & C. Gilbert (Eds.), Recognizing and treating breathing disorders: A multidisciplinary approach (2nd ed., pp. 1–10). Amsterdam: Elsevier.CrossRefGoogle Scholar
  8. Courtney, R., Cohen, M., & Reece, J. (2009). Comparison of the manual assessment of respiratory motion (MARM) and the Hi Lo breathing assessment in determining a simulated breathing pattern. International Journal of Osteopathic Medicine, 12(3), 86–91. doi: 10.1016/j.ijosm.2008.10.002.CrossRefGoogle Scholar
  9. Courtney, R., & Greenwood, K. (2009). Preliminary investigation of a measure of dysfunctional breathing symptoms: The Self Evaluation of Breathing Questionnaire (SEBQ). International Journal of Osteopathic Medicine, 12(4), 121–127. doi: 10.1016/j.ijosm.2009.02.001.CrossRefGoogle Scholar
  10. Courtney, R., Greenwood, K. M., & Cohen, M. (2011a). Relationships between measures of dysfunctional breathing in a population with concerns about their breathing. Journal of Bodywork & Movement Therapies, 15(1), 24–34. doi: 10.1016/j.jbmt.2010.06.004.CrossRefGoogle Scholar
  11. Courtney, R., & van Dixhoorn, J. (2014). Questionnaires and manual methods for assessing breathing dysfunction. In L. Chaitow, D. Bradley, & C. Gilbert (Eds.), Recognizing and treating breathing disorders: A multidisciplinary approach (2nd ed., pp. 137–146). Amsterdam: Elsevier.CrossRefGoogle Scholar
  12. Courtney, R., van Dixhoorn, J., Greenwood, K. M., & Anthonissen, E. L. M. (2011b). Medically unexplained dyspnea: Partly moderated by dysfunctional (thoracic dominant) breathing pattern. Journal of Asthma, 48(3), 259–265. doi: 10.3109/02770903.2011.554942.CrossRefPubMedGoogle Scholar
  13. Cowley, D. S., & Roy-Byrne, P. P. (1987). Hyperventilation and panic disorder. American Journal of Medicine, 83(5), 929–937. doi: 10.1016/0002-9343(87)90654-1.CrossRefPubMedGoogle Scholar
  14. David, P., Laval, D., Terrien, J., & Petitjean, M. (2012). Postural control and ventilatory drive during voluntary hyperventilation and carbon dioxide rebreathing. European Journal of Applied Physiology, 112(1), 145–154. doi: 10.1007/s00421-011-1954-8.CrossRefPubMedGoogle Scholar
  15. de Vet, H. C. W., Terwee, C. B., Knol, D. L., & Bouter, L. M. (2006). When to use agreement versus reliability measures. Journal of Clinical Epidemiology, 59(10), 1033–1039. doi: 10.1016/j.jclinepi.2005.10.015.CrossRefPubMedGoogle Scholar
  16. Field, A. (2009). Discovering statistics using SPSS (3rd ed.). London: Sage Publications.Google Scholar
  17. Freitas, D. A., Holloway, E. A., Bruno, S. S., Chaves, S. S. G., Fregonezi, A. F. G., & Mendonca, M. P. P. K. (2013). Breathing exercises for adults with asthma. Cochrane Database of Systematic Reviews., 10, CD001277. doi: 10.1002/14651858.CD001277.pub3.PubMedGoogle Scholar
  18. Hagman, C., Janson, C., & Emtner, M. (2008). A comparison between patients with dysfunctional breathing and patients with asthma. The Clinical Respiratory Journal, 2(2), 86–91. doi: 10.1111/j.1752-699X.2007.00036.x.CrossRefPubMedGoogle Scholar
  19. Han, J. N., Schepers, R., Stegen, K., Van den Bergh, O., & Van de Woestijne, K. P. (2000). Psychosomatic symptoms and breathing pattern. Journal of Psychosomatic Research, 49(5), 319–333. doi: 10.1016/S0022-3999(00)00165-3.CrossRefPubMedGoogle Scholar
  20. Hodges, P. W., Heijnen, I., & Gandevia, S. C. (2001). Postural activity of the diaphragm is reduced in humans when respiratory demand increases. Journal of Physiology, 537(Pt 3), 999–1008. doi: 10.1111/j.1469-7793.2001.00999.x.PubMedCentralCrossRefPubMedGoogle Scholar
  21. Holland, A. E., Hill, C. J., Jones, A. Y., & McDonald, C. F. (2012). Breathing exercises for chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews., 10, CD008250. doi: 10.1002/14651858.CD008250.pub2.PubMedGoogle Scholar
  22. Hopkins, W. G. (2009). A scale of magnitudes in a new view of statistics: Summarizing data: Simple statistics and effect statistics: Effect statistics. Retrieved from http://sportsci.org/resource/stats/index.html.
  23. Hopkins, W. G., Wilson, N. C., & Russell, D. G. (1991). Validation of the physical activity instrument for the Life in New Zealand national survey. American Journal of Epidemiology, 133(1), 73–82.PubMedGoogle Scholar
  24. Hornsveld, H. K., Garssen, B., Dop, M. J., van Spiegel, P. I., & de Haes, J. C. (1996). Double-blind placebo-controlled study of the hyperventilation provocation test and the validity of the hyperventilation syndrome. Lancet, 348(9021), 154–158. doi: 10.1016/S0140-6736(96)02024-7.CrossRefPubMedGoogle Scholar
  25. Hruska, R. J, Jr. (1997). Influences of dysfunctional respiratory mechanics on orofacial pain. Dental Clinics of North America, 41(2), 211–227.PubMedGoogle Scholar
  26. Hyland, M. E., Singh, S. J., Sodergren, S. C., & Morgan, M. P. (1998). Development of a shortened version of the Breathing Problems Questionnaire suitable for use in a pulmonary rehabilitation clinic: A purpose-specific, disease-specific questionnaire. Quality of Life Research, 7(3), 227–233.CrossRefPubMedGoogle Scholar
  27. Jones, M., Harvey, A., Marston, L., & O’Connell, N. E. (2013). Breathing exercises for dysfunctional breathing/hyperventilation syndrome in adults. Cochrane Database of Systematic Reviews., 5, CD009041. doi: 10.1002/14651858.CD009041.pub2.PubMedGoogle Scholar
  28. McArdle, W. D., Katch, F. I., & Katch, V. L. (2001). Exercise physiology: Energy, nutrition, and human performance (5th ed.). Philadelphia: Lippincott, Williams and Wilkins.Google Scholar
  29. McLaughlin, L. (2014). Capnography assessment. In L. Chaitow, D. Bradley, & C. Gilbert (Eds.), Recognizing and treating breathing disorders: A multidisciplinary approach (pp. 23–43). Amsterdam: Elsevier.Google Scholar
  30. Murugan, A. T., & Sharma, G. (2008). Obesity and respiratory diseases. Chronic Respiratory Disease, 5(4), 233–242. doi: 10.1177/1479972308096978.CrossRefPubMedGoogle Scholar
  31. Penninx, B. W. J. H., Nolen, W. A., Lamers, F., Zitman, F. G., Smit, J. H., Spinhoven, P., et al. (2011). Two-year course of depressive and anxiety disorders: Results from the Netherlands Study of Depression and Anxiety (NESDA). Journal of Affective Disorders, 133(1–2), 76–85. doi: 10.1016/j.jad.2011.03.027.CrossRefPubMedGoogle Scholar
  32. Schleifer, L. M., Ley, R., & Spalding, T. W. (2002). A hyperventilation theory of job stress and musculoskeletal disorders. American Journal of Industrial Medicine, 41(5), 420–432.CrossRefPubMedGoogle Scholar
  33. Smith, M. D., Russell, A., & Hodges, P. W. (2006). Disorders of breathing and continence have a stronger association with back pain than obesity and physical activity. Australian Journal of Physiotherapy, 52(1), 11–16. doi: 10.1016/S0004-9514(06)70057-5.CrossRefPubMedGoogle Scholar
  34. Smith, M. D., Russell, A., & Hodges, P. W. (2014). The relationship between incontinence, breathing disorders, gastrointestinal symptoms, and back pain in women: A longitudinal cohort study. Clinical Journal of Pain, 30(2), 162–167. doi: 10.1097/AJP.0b013e31828b10fe.PubMedGoogle Scholar
  35. Stanton, A. E., Vaughn, P., Carter, R., & Bucknall, C. E. (2008). An observational investigation of dysfunctional breathing and breathing control therapy in a problem asthma clinic. Journal of Asthma, 45(9), 758–765. doi: 10.1080/02770900802252093.CrossRefPubMedGoogle Scholar
  37. Thomas, M., McKinley, R. K., Freeman, E., & Foy, C. (2001). Prevalence of dysfunctional breathing in patients treated for asthma in primary care: Cross sectional survey. BMJ, 322(7294), 1098–1100. doi: 10.1136/bmj.322.7294.1098.PubMedCentralCrossRefPubMedGoogle Scholar
  38. Thomas, M., McKinley, R. K., Freeman, E., Foy, C., & Price, D. (2005). The prevalence of dysfunctional breathing in adults in the community with and without asthma. Primary Care Respiratory Journal, 14(2), 78–82. doi: 10.1016/j.pcrj.2004.10.007.CrossRefPubMedGoogle Scholar
  39. Urrutia, I., Capelastegui, A., Quintana, J. M., Muniozguren, N., Basagana, X., Sunyer, J., & Spanish Group of the European Community Respiratory Health. (2005). Smoking habit, respiratory symptoms and lung function in young adults. European Journal of Public Health, 15(2), 160–165. doi: 10.1093/eurpub/cki113.CrossRefPubMedGoogle Scholar
  40. van Dixhoorn, J., & Duivenvoorden, H. J. (1985). Efficacy of Nijmegen Questionnaire in recognition of the hyperventilation syndrome. Journal of Psychosomatic Research, 29(2), 199–206.CrossRefPubMedGoogle Scholar
  41. Warburton, C. J., & Jack, S. (2006). Can you diagnose hyperventilation? Chronic Respiratory Disease, 3(3), 113–115. doi: 10.1191/1479972306cd116ed.CrossRefPubMedGoogle Scholar
  42. Willemse, B. W. M., ten Hacken, N. H. T., Rutgers, B., Postma, D. S., & Timens, W. (2005). Association of current smoking with airway inflammation in chronic obstructive pulmonary disease and asymptomatic smokers. Respiratory Research, 6(1), 38. doi: 10.1186/1465-9921-6-38.PubMedCentralCrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Department of Community and Health Services: OsteopathyUnitec Institute of TechnologyAucklandNew Zealand
  2. 2.Department of General Practice and Primary Health CareUniversity of AucklandAucklandNew Zealand

Personalised recommendations