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Updated: Aug 6, 2026

Investigation into Deep Breathing through Measurement of Ventilatory Parameters and Observation of Breathing Patterns
Published on: September 16, 2019
Retrospective Study Exploring Changes in Respiratory Rate and Tidal Volume During Exercise Testing in Patients With
William Durbin1, Karla Foster2, Elliot Brown1
1Department of Pediatrics, University of Cincinnati School of Medicine, Cincinnati, OH,USA.
Purpose:
Dysfunctional breathing contributes to exercise intolerance (EI) but is difficult to diagnose. We developed a novel approach to evaluate the ventilatory response during cardiopulmonary exercise tests (CPET), measuring the average change in respiratory rate (RR) relative to the change in tidal volume (Vt). We hypothesized that this RR:Vt slope ratio will uncover unique ventilatory responses among different groups of patients experiencing EI.
Methods:
An exploratory retrospective review was conducted on CPET for patients with EI from January 2017 to July 2024. Demographics, spirometry, CPET, and auscultatory findings of stridor during exercise were compared among patients with an elevated RR:Vt to patients with a lower RR:Vt ratio with and without stridor.
Results:
CPET from 65 patients, mean age 14.8 (9-20) years, were compared among those with an elevated RR:Vt ratio (21 patients, ratio 43.0) and patients with a lower RR:Vt ratio with stridor (19 patients, ratio 22.6) and without stridor (25 patients, ratio 22.1). Patients with an elevated RR:Vt were younger with reduced Vt and minute ventilation expansion at peak exercise with no differences in peak oxygen uptake.
Conclusion:
Groups of patients with EI exhibit a higher RR:Vt ratio, reflecting an altered breathing pattern that may be consistent with dysfunctional breathing.
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