LTB: 001 ABSTRACT

DIAGNOSING AND TREATING BREATHING PATTERN DISORDER IN A CHRONIC NECK PAIN PATIENT WITH A SPECIFIC EXERCISE PROGRAM: A CASE STUDY

ABSTRACT:

Study Design: Case study.

Objective: To evaluate the use of Nijmegen questionnaire along with manual assessment of respiratory motion (MARM) to diagnose breathing pattern disorder (BPD) in a patient with chronic neck pain (CNP) and to check the efficacy of a specified exercise program in treating BPD and CNP.

Background and purpose: Appropriate assessment and interventions for breathing patterns prior to assessment of the patient’s musculoskeletal complaint may be beneficial. There are a lot of studies highlighting the interplay of neck pain, posture and respiratory parameters; out of which, BPD is a lacking respiratory variable which needs a lot of attention on a regular physiotherapy assessment. The purpose of this case study is to demonstrate the integration of a BPD assessment into a standard clinical musculoskeletal examination and also to evaluate a suitable exercise program.

Case description: The patient was a 23-year-old male, working in an automobile industry for more than 5 years with a 3-year long history of chronic neck pain. He reported a diffuse pain with an average intensity of 8/10 on a numerical pain rating scale aggravated by his job and the worst discomfort while waking up in the morning. The patient also had paresthesia in hands and cold hands and feet. The patient also complained regarding general fatigue and confusion despite a good diet plan. The patient had already did a lot of investigations like MRI of C-spine, blood work etc which had no significant interpretations. The patient had also tried medications and even physiotherapy interventions like various electrotherapy modalities.

Methods and Measures: A detailed history collection was done and the subjective examination included the Nijmegen questionnaire and objective examination included regular musculoskeletal assessment along with MARM. The patient was then given diaphragmatic breathing exercises along with isometric neck exercises for 4 weeks daily. The outcome measures checked were NPRS, neck disability index (NDI) and Nijmegen questionnaire.

Conclusion: The patient was diagnosed with BPD according to the evaluation done by Nijmegen questionnaire and MARM. The specific exercise also proved effective in relieving both BPD and the chronic neck pain.

Key words: BPD, CNP, Nijmegen questionnaire