Background/Objectives: The Nijmegen Questionnaire (NQ) has been a prevalent screening tool for dysfunctional breathing for the past 40 years. Until recently, the validity of the NQ has been established for the general population with hyperventilation syndrome (HVS) and for individuals with asthma, but not for people with COPD. The aim of the study was to examine the validity and reliability of the NQ in individuals with COPD. Methods: Construct, convergent, divergent and discriminant validity as well as internal consistency reliability were examined in a sample of 84 people with stable COPD. Results: A three-factor solution with 16 items and 74.70% of explained variability was extracted through principal component analysis. High internal consistency (Cronbach alpha = 0.94) of the 16 NQ items was found. Significant differences were found between COPD individuals with and without DB (p < 0.001) and among people of all COPD levels of severity (p < 0.001). The value “>23” was found to detect the presence of DB, with 95.92% sensitivity and 94.29% specificity. Significant correlations were found between the total NQ score with BODE index (r = 0.81), Borg dyspnea scale (r = 0.47) and CAT (r = 0.49). The prevalence of DB for the specific sample was found to be 58.3%. Conclusions: The present study provided the first validity and reliability evidence for the NQ for people with stable COPD.

Background: Self-efficacy is associated with functional capacity and quality of life in Chronic Obstructive Pulmonary Disease (COPD) patients. Aims and Objectives: The present study was designed to examine the validity and reliability of the General Self-Efficacy scale (GSE) responses in Greek patients with COPD. Methods: The GSE scale (n=50) was examined for construct and criterion validity as well as internal consistency. Results: Principal Components Analysis (PCA) revealed a two (2) factors solution (action self-efficacy and coping self-efficacy with eigen values 1.65 and 5.31 respectively) and with 69.67% total variability. Higher GSE scores were found in the following groups: a) smokers versus non-smokers (p<0.001), b) patients without visiting the emergency department versus patients with 1-2 visits in the last year (p<0.001), c) patients with regular follow-up versus patients with follow-up only in deterioration of symptoms (p<0.001), and d) among patients of the four quarters of the BODE index (F=2.89, p=0.04). Concurrent validity testing showed low to moderate high correlations for the GSE score with the 3 Minute Chair Rise Test (3CRT) (r=0.29, p<0.01) and the 6 Minute Walk Distance Test (6MWDT) (r=0.66, p<0.01), while negative correlations were found for the GSE score with age (r=-0.28, p<0.01) and the BODE index (r=-0.28, p<0.05). Further, multiple linear regression analysis showed that the 6MWDT was the predictor variable (Beta=0.72, p<0.001) of the GSE for the specific sample of COPD patients. The GSE showed high internal consistency (Cronbach9 s alpha=0.89). Conclusions: The GSE provided validity and reliability evidence for the specific Greek sample with COPD.

Background Chronic Obstructive Pulmonary Disease (COPD) is associated with increased fracture risk due to systemic inflammation, physical inactivity, and corticosteroid use. Pulmonary Rehabilitation (PR) improves physical function and quality of life in Chronic Obstructive Pulmonary Disease (COPD), but its effect on fracture risk remains unexplored. Objective To evaluate the effect of a PR program on the 10-year fracture risk (FRAX score), Bone Mineral Density (BMD), and secondary outcomes in COPD patients. Methods 10 patients with stable COPD, aged 55–80 years, will be enrolled in a single-centre, randomized controlled trial. Participants will be randomized to a PR group (exercise, dietary counselling, respiratory physiotherapy and standard medical care) or a control group (standard medical care). Outcomes will include the scores of the Fracture Risk Assessment Tool (FRAX®), the Bone Mineral Density-BMD (via DEXA), the BODE index [Body Mass Index-BMI, Airflow Obstruction (FEV1% pred), Dyspnoea (MRC sale), and exercise capacity (6MWT), the COPD Assessment Test (CAT), the Nijmegen Questionnaire-NQ, and the Borg dyspnoea scale, assessed at baseline and at 12 months. Statistical analysis will use 2×2 ANOVA repeated measures with Bonferroni adjustment. Anticipated Results PR is expected to reduce FRAX scores, improve BMD, mitigate mortality index, dysfunctional breathing patterns, and the impact of COPD in the participants’ health and daily life compared to standard care. Conclusion This trial will provide novel insights into PR’s role in fracture prevention for COPD patients, addressing a critical gap in holistic disease management. Trial registration: Australian New Zealand Clinical Trials Registry (ANZCTR). Trial id: ACTRN12623001282673, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=384352&showOriginal=true&isReview=true Date submitted: 9/07/2023 Date registered: 8/12/2023 Protocol version: 28/10/2024

Background The prevalence of respiratory disorders and abnormal breathing pattern caused by inspiratory muscle weakness is increasing among patients with chronic heart failure (CHF) leading to a decline in functional status. The study aims to evaluate the effect of inspiratory muscle training (IMT) on dysfunctional breathing and functional ability in patients with CHF. Methods Patients with stable heart failure (n = 22), who meet the inclusion criteria will be randomly assigned to two groups and receive 20 treatment sessions: (a) the experimental group (IMT & diaphragmatic breathing (DB), n = 11), and (b) the control group (DB, n = 11). Evaluation of treatment outcomes will be conducted at the beginning (week 0), and at the end (week 4) of the intervention. The main outcomes include dysfunctional breathing (Hi Lo test), diaphragm thickness (diaphragmatic ultrasonography) and functional ability (6MWT). Maximal inspiratory pressure (MIP), functional dyspnea (MRC) and quality of life (SF-12 v2) will be assessed as secondary outcomes. Discussion The study protocol aims to examine the effectiveness of IMT on dysfunctional breathing and functional ability in patients with CHF. IMT is a low-cost intervention that might improve the breathing pattern, diaphragm function, functional ability and overall quality of life in patients with CHF. Conclusion This trial will investigate the effects of IMT on breathing pattern, diaphragm function and functional ability in patients with CHF, aiming to address a significant gap in respiratory management of breathing disorders. Trial Registration: Clinical Trials gov, Trial id: NCT07104357 https://register.clinicaltrials.gov/prs/beta/studies/S000FZMT00000081/recordSummary

Background: Self-efficacy is associated with asthma control and quality of life in asthma patients. Aims and Objectives: The present study was designed to examine the validity and reliability of the General Self-Efficacy scale (GSE) responses in Greek adults with asthma. Methods: The GSE (n=50) was examined through construct validity (factor analysis and differences between groups), criterion validity (concurrent and predictive validity) as well as internal consistency reliability. Results: Principal component analysis (PCA) revealed a two-factor solution (action self-efficacy and coping self-efficacy with eigen values 4.13 and 1.94 respectively) and 60.70% of explained variability. The GSE showed high internal consistency (Cronbach’s alpha=0.84). Higher GSE scores were found in the following groups: patients with controlled versus uncontrolled asthma (p<0.001), patients without versus with hyperventilation (p<0.001) and patients with mild versus moderate and severe asthma (p<0.001). Concurrent validity testing showed moderate to high positive correlations for the GSE score with Forced Expiratory Volume in 199 (FEV₁%) (r=0.49, p<0.01), 6 Minute Walk Distance Test (6MWDT) (r=0.80, p<0.01), and Asthma Control Test (ACT) (r=0.81, p<0.01), while low to high negative correlations were found for the GSE score with age (r=-0.29, p<0.05), Nijmegen Questionnaire (NQ) (r=-0.75, p<0.01), and Borg scale as well (r=-0.77, p<0.01). Further, multiple linear regression analysis showed that the 6MWDT was the predictor variable (Beta=0.56, p<0.001) of the GSE for the specific sample of asthma patients. Conclusions: The GSE provided validity and reliability evidence for the specific Greek sample with asthma.