Assessing dysfunctional breathing: comparison of Manual Assessment of Respiratory Motion (MARM) and Respiratory Induction Plethysmography (Lifeshirt).



Rosalba Courtney*

Jan Van Dixhoorn**

Marc Cohen*


* School of Health Sciences, RMIT University, Melbourne, Australia

** Centre for Breathing Therapy, Amersfoort, The Netherlands


Background: Breathing Pattern disturbances (BPD) such as abnormalities in thoraco- abdominal co-ordination and thoracic dominance in breathing are an important aspect of dysfunctional breathing. BPD are associated with symptoms such as dyspnea [1, 2] and are considered to play a role in etiology of chronic back and neck pain [3-5].  Two methods of assessment are compared. Measurements with Respiratory Induction Plethysmography (RIP or Lifeshirt) are compared to a simple manual assessment technique, MARM, which assesses the distribution of thoraco-abdominal breathing movement [6]

Method: 12 Yoga teachers were directed to make a series of combinations of 2 breathing (thoracic and abdominal) and 3 postural changes (sitting slump, normal and upright). 2 examiners assessed their breathing using the MARM while simultaneous measurements with RIP were done.

Results: High levels of inter examiner agreement of MARM were found (r=.844, p< .001) lower but still considerable agreement was found between examiners and RIP measures (r=.597, p<.001). Statistical analysis of repeated measures using MANOVA indicated that MARM was able to differentiate between thoracic and abdominal breathing patterns within subjects (F(1)=12,88, p<0.005),  RIP was not able to make these differentiations.


Conclusion: This  study replicates earlier findings on  reliability of MARM. It confirms that MARM appears to be a reliable tool for assessing breathing pattern. When used by trained examiners on trained subjects it appears more sensitive than RIP in differentiating between thoracic and abdominal breathing pattern.


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