Physiotherapist check for breathing pattern problems

An Evaluation of Physiotherapy Assessment; A Mixed Methods Study to Evaluate the Physiotherapy Assessment of Breathing Pattern Disorder

This project will test whether a physiotherapist checklist called the BPAT can spot breathing pattern disorder and track changes after physiotherapy in people with breathlessness, asthma, or healthy volunteers.

Quick facts

• Study type: Observational
• Enrollment: 150 (estimated)
• Ages: 18 Years and up
• Sex: All
• Sponsor: Royal Brompton & Harefield NHS Foundation Trust (other)
• Locations: 1 site (London, London)
• Trial ID: NCT07543588 on ClinicalTrials.gov

What this trial studies

This observational project will test the measurement properties and clinical usefulness of the Breathing Pattern Assessment Tool (BPAT), a physiotherapist-completed checklist for identifying breathing pattern disorder (BPD). Adults with primary BPD, people with asthma, and healthy controls will be recruited at Royal Brompton Hospital (approximately 100 BPD, 25 asthma, 25 healthy). At the initial visit two physiotherapists will independently complete BPAT scores, and BPD patients will have a repeat assessment roughly 4 weeks later around routine physiotherapy treatment to measure change. BPAT scores will be compared with established breathlessness and breathing-symptom questionnaires to examine agreement, inter-rater reliability, and responsiveness over time.

Who should consider this trial

Good fit: Adults over 18 referred for unexplained breathlessness or suspected BPD, including those with primary BPD or BPD alongside asthma, who can attend outpatient physiotherapy sessions are the ideal candidates.

Not a fit: People with major respiratory or cardiac diseases (COPD, ILD, bronchiectasis, cystic fibrosis, structural heart disease), pregnant individuals, those unable to consent, or people already in pulmonary/cardiac rehabilitation or receiving specialist ENT therapy are excluded and unlikely to benefit.

Why it matters

Potential benefit: If successful, BPAT could give clinicians a simple, reliable way to identify BPD and monitor improvement after physiotherapy, helping tailor treatment and track progress.

How similar studies have performed: Some clinician-rated tools for dysfunctional breathing have shown promise in small studies, but robust validation of BPAT against patient-reported measures and inter-rater reliability remains limited, making this partly novel.

Eligibility criteria

Inclusion Criteria (Breathing Pattern Disorder group)

* Adults aged above 18 years
* Outpatient referrals for 'unexplained breathlessness' or possible breathing pattern disorder
* Primary BPD (no other significant respiratory or cardiology diagnosis)
* Secondary BPD (patients with a diagnosis of asthma)
* Able to complete up to four sessions of outpatient physiotherapy intervention Exclusion Criteria
* Patients with a respiratory diagnosis including COPD, ILD, Bronchiectasis and Cystic Fibrosis or structural heart disease
* Pregnancy
* Unable to give informed consent
* Anyone currently participating in pulmonary/cardiac rehabilitation
* Anyone receiving specialist ENT speech and language therapy for Upper airway symptoms

Where this trial is running

London, London

• Royal Brompton Hospital — London, London, United Kingdom (RECRUITING)

Study contacts

• Principal investigator: Lizzie JF Grillo, BSc MSc — Royal Brompton and Harefield Hospital
• Study coordinator: Lizzie Grillo JF Clinical Specialist Physiotherapist, BSc MSc

Conditions: Breathing Pattern Disorder, Breathlessness, Physiotherapy, Assessment