Does virtual breathing pattern retraining improve breathlessness in patients with post COVID syndrome?

Introduction: British Thoracic Society (BTS) guidelines recommend assessment of breathing pattern disorder (BPD) for ongoing breathlessness post COVID-19 infection. Breathing pattern retraining (BPR) has been shown to improve breathlessness arising from BPD. Aim: Ascertain percentage of people with BPD in a post-COVID clinic cohort. To determine if virtual BPR improves breathlessness in patients with BPD following COVID-19 infection. Method:: Data was collected from patients completing a systematic MDT assessment in a post-COVID clinic. Breathlessness (Dyspnoea 12- D12) and breathing pattern (Brompton Breathing Pattern Assessment Tool - BPAT) were assessed by the clinic Physiotherapist and on completion of BPR. Those with MDT diagnosis of BPD were referred for physiotherapy led virtual BPR. A Wilcoxon Sign Rank test was used to compare pre and post treatment data. The effect sizes were presented as a Hedge’s G statistic. Effect sizes are classified as: small > 0.2; moderate > 0.5; large > 0.8. Results: 55 of 293 patients were diagnosed with BPD (18.8%). Data for 17 patients who completed virtual BPR were analysed. Mean number of days since symptoms onset was 61.88 (SD 19.72). Patients completed a mean of 3.74 (SD 1.19) BPR sessions. Improvement in D12 was statistically significant (median pre 18, post 5, (z=-3.62, p=0.000)). The effect size was large: Hedge’s G=1.84. Improvement in BPAT was statistically significant (median BPAT pre 4 post 1, (z=-3.66, p=0.000)). The effect size was large: Hedge’s G=3.19. Conclusion: BPD is prevalent post COVID. Virtual BPR improves breathing pattern and breathlessness.