Restrictive Ventilatory Patterns in Residents of Continuing Care Retirement Communities.
Christine R Kovach, Murad H Taani, Crystal-Rae Evans and 2 others
PMID 30270778WHAT IT FOUND
52% of older residents in continuing care retirement communities had restrictive breathing patterns.
Dementia, kyphosis, lower muscle strength, and breathing distress were linked to these patterns. The study cannot show whether these factors cause or result from restrictive breathing.
Key findings
01Restrictive ventilatory patterns were found in 34 of 65 participants (52%), and 33 of these were judged moderate or severe.
02The statistical model was significant, and participants with restrictive ventilatory patterns were more likely to have dementia, dyspnea, kyphosis, and lower muscle strength.
03Ambulation differed between groups: 80% of nonambulatory participants had a restrictive ventilatory pattern, and 38% of ambulatory participants did.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for RNs
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What it does not show
The design was cross-sectional, so it cannot show temporal or causal direction. The final sample of 65 was below the calculated minimum of 69. Twenty-three residents with severe dementia could not complete testing, so restrictive breathing patterns in dementia were likely underestimated. The average age was 87, but spirometry reference values only included adults up to age 85. The sample was convenience based and mostly White and highly educated. Smoking history was self-reported and may be inaccurate. Grip strength was used as a proxy rather than direct inspiratory muscle strength. Ambulation was from record review or staff report. The study did not test an intervention.
Declared interests
The authors declared no potential conflicts of interest. The study was funded by Bader Philanthropies and the Jewish Home Foundation; the funder named was Jewish Home and Care Center Foundation.
The easy way to misread this
Do not conclude that correcting kyphosis, improving strength, or treating dementia will reduce restrictive breathing patterns. The study is cross-sectional and only reports associations, so it cannot show that any factor caused the breathing pattern or that treatment would change it.