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The Implications of Breathing Pattern Disorders on Movement Jena Hansen-Honeycu-, MS, LAT, ATC, PES Doctor of Athletic Training Program • BPD • Mechanics • Factors influencing breathing • Nervous system • Motor control • Assessment • Treatment Overview Doctor of Athletic Training Program “If breathing is not normalized no other motor pa-ern can be” Karl Lewit (Perri, 2007; CliSon Smith, 2011; Bradley, 2014) • A normal breath…(Kolar, 2013; Chaitow, 2004; Chaitow, 2014) • Not a disease • Extreme symptom hypervenZlaZon syndrome • 54% of general community members had a BPD (Perri & Halford,2004) • Plays a role in 75% of illnesses (Perri et al., 2004; Perri, 2007) What is a breathing pattern disorder? Doctor of Athletic Training Program h-p://www.physio-pedia.com/File:949_937_muscles-of-respiraZon.jpg/369pj8 Doctor of Athletic Training Program • Provides about 70-80 % of inhalaZon force (Chaitow et al., 2012) • Core Stability (Boyle, 2010) • 3 funcZons • Postural • Respiratory • Sphincter • Dynamic Neuromuscular StabilizaZon (DNS) uses breathing as foundaZon for all other movements • Aids in DigesZon • Breathing is context specific (Chaitow, 2014) • Biomechanical, biochemical, psychological • Posture, structure, culture, mouth breathing, movement pa-erns • Pain sZmulus • CondiZoned response to alter rate, volume, and pause (Ley, 1999) • IniZal vs. perpetuate (CliSon Smith, 2011) • Once pa-ern is established it can take on its own disorder Factors In?luencing Breathing • Lung disorders, allergies, exaggerated CO2, diet, medicaZons, hormones, exercise, alZtude, heat • RegulaZon of chemical state • O2 and CO2 (Chaitow, 2004; Chaitow, 2014; CliSon Smith, 2011) • CompensaZng (Chaitow, 2014) • Pathologies (diabetes, kidneys) • Asthma (similar s/s) 11/32 had HVS (Hammo, 1999; Miller, 2005) • Exercise increases demands (volume and rate)
• Psychological factors • Modern thinking a-empts to separate mind-body • Stress, anxiety, work stress, cultural beliefs, personality traits, emoZons, learned responses, pain (Courtney, 2011) • Fear condiZoning – amygdala (CliSon Smith, 2011; Chaitow, 2014) • ProtecZve, faster than voluntary responses • Breathing can correlate to anxiety states (Han et al., 1997) Psychological In?luences http://www.paulcheksblog.com/chek-totem-pole- part-8-the-limbicemotional-system/ • SNS • Stress response “Fight or flight” • Increase respiraZon • Increase HR/BP • Decrease digesZon • Release of CorZsol • PNS • RelaxaZon Response • Conscious input • Increase cardiac output, protecZve • Helps adjust to various demands (Perri, 2004; Chaitow, 2004) Autonomic Nervous System • Motor Control • Preprogramed pa-erns • Developmental Kinesiology • Breathing is the fundamental motor pa-ern
• Regulates intra-abdominal pressure (IAP) (Frank et al., 2013) • IniZates trunk stability • All muscles inserZng into thorax expand eccentrically with inhale • Abdominal drawing in maneuver (Boyle et al., 2010) • Pelvic floor • Transverse abdominus (Chaitow et al., 2012) Diaphragms role in stability Doctor of Athletic Training Program • FMS score and BPD (Bradley, 2014) • Used variety of tools for assessment • 75% FMS ≤ 14 – thoracic dominant BP (risk for injury) • 66.6 % FMS ≥ 15 – diaphragmaZc dominate BP (decrease risk for injury) • StaZsZcally significant (p value = .006) • SelecZve FuncZonal Movement Assessment(SFMA) and Breathing • Squat, Cervical Flexion, Toe touch, extension
Doctor of Athletic Training Program • Blowing up a Balloon, Postural RestoraZon InsZtute (Boyle et al., 2010) • Low Back Pain, high reoccurrence • BPD in cyclists (Vickery, 2007) • Control vs. experimental • Improved Zme, inhalaZon • Firefighters and yoga program (Cowan, 2010) • 6 week program improved FMS scores • Above 15, decreased risk for injury Breathing and Movement • Modified Manual Assessment of Respiratory MoZon (MARM) (Courtney, 2008; Bradley, 2014) • Hi- Lo • ObservaZon • PosiZon of rib cage • Hip flexion test (DNS) • Breath hold Zme • Assess • Seated • Standing • Supine • Prone • Various methods (Buteyko, Yoga, Dynamic Neuromuscular StabilizaZon, OpZmal Breathing, Primal Reflex Release Technique, PosiZonal Release Therapy, Mulligan MobilizaZons for ribs, Postural RestoraZon InsZtute) • Exercises • Preprogramed motor control pa-ern • Reflex triggering exercise (White, 2014) • Clamshell • End of natural exhale • Hold breath • Complete clam shell, up for 3, down for 3 • Legs close • Inhale through nose • 1x/5 regular breaths Treatment • Twist (White, 2014) • End of natural exhale hold breath • Twist for 6 seconds • Return to neutral • Inhale through nose • 1x/5 regular breaths • Goal: PaZent to feel what a normal breathing pa-ern is reflexively Treatment Questions?