Breathing Pattern Assessment Tool
Original Editor - Lilian Ashraf
Top Contributors - Lilian Ashraf
Objective[edit | edit source]
Breathing Pattern Assessment Tool (BPAT) is a structured tool for diagnosis of breathing pattern disorders. Dysfunctional breathing is defined as an ‘alteration in the normal biomechanical pattern of breathing, that results in intermittent/chronic symptoms, which may be both respiratory and non-respiratory and a propensity to hyperventilation with subjective and psychological impact.[1]
Intended Population[edit | edit source]
BPAT was developed for diagnosis of breathing pattern disorders in patients with asthma.[2]
Method of Use[edit | edit source]
The patient should be at rest (have sat still for 5 minutes prior to assessment) in sitting with their back rested.
Count respiratory rate and observe breathing pattern for one minute. Score features of breathing in table below:
0 | 1 | 2 | |
Abdominal or upper chest movement:
Where is movement occurring in tidal volume breathing at rest? |
Abdominal
(Diaphragm level and below) |
Combination (Movement in both upper chest and abdomen) |
Apical
(Upper chest rises and falls with each breath) |
Inspiratory flow
Do they have increased inspiratory flow? This would be indicated by an audible breath IN through either nose or mouth and includes any type of wheeze. |
Silent | Audible | Loud |
Expiratory flow
Do they have increased expiratory flow? This would be indicated by an audible breath OUT through either nose or mouth and includes any type of wheeze. |
Silent | Audible | Loud |
Channel of inspiration and expiration
Are they breathing through their; nose, mouth or a combination of both during the minute assessed? |
Nose
(with their mouth closed throughout the minute assessed) |
Nose and mouth (During the minute some breaths are through their nose and some through their mouth) |
Mouth
(Breathing with mouth open throughout) |
Air hunger
During the minute assessed is the patient showing signs of air hunger. This includes yawning, sighing or taking a deeper breath than their tidal breaths? |
None | Once per minute | Twice or more times per minute |
Respiratory Rate
What is their respiratory rate in the minute assessed? TOTAL RR___________ |
12 or less | 13-25 | 25+ |
Rhythm
Are their breaths evenly spaced throughout the minute? Do they appear regular and rhythmical? |
Rhythmical | Erratic | |
Scoring | 0 | 1 | 2 |
Score for each column | |||
TOTAL
SCORE |
Evidence[edit | edit source]
BPD is prevalent in treatment-refractory asthma and heightens symptom perception and impairs quality of life. The BPAT provides a simple and rapid way to characterize BPD in treatment-refractory asthma. The assessment is easy to complete and can prompt need for physiotherapy assessment ± intervention to optimize respiratory symptom management.
Sensitivity analysis indicated that a BPAT score of ≥4 corresponded to a sensitivity of 0.92 and a specificity of 0.75 for diagnosis of BPD in this cohort.[2]
BPAT has high sensitivity and moderate specificity for BPD in patients with long COVID, with a sensitivity of 89.5% and specificity of 78.3% for diagnosing BPD in post-COVID breathlessness.[1]
References[edit | edit source]
- ↑ 1.0 1.1 Hylton H, Long A, Francis C, Taylor RR, Ricketts WM, Singh R, Pfeffer PE. Real-world use of the Breathing Pattern Assessment Tool in assessment of breathlessness post-COVID-19. Clinical Medicine. 2022 Jul;22(4):376.
- ↑ 2.0 2.1 Todd S, Walsted ES, Grillo L, Livingston R, Menzies‐Gow A, Hull JH. Novel assessment tool to detect breathing pattern disorder in patients with refractory asthma. Respirology. 2018 Mar;23(3):284-90.