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Breathing Basics - Part 2: Assessment

Updated: May 10

Breathing assessment should always precede HRV biofeedback because dysfunctional breathing can frustrate training success. Clinicians may also find that correcting breathing mechanics can aid neurofeedback training.

Overbreathing may be the most common breathing problem. Its expulsion of CO2 can produce a spectrum of medical and psychological symptoms (Khazan, 2020).

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Waiting Room Assessment

Assessment should begin in the waiting room to observe breathing behaviors without reactivity and continue in the clinic. For example, a client's respiration rate may increase by more than 5 bpm after attaching breathing sensors. Graphic © tsyhun/

waiting room

Reception staff should covertly observe respiration rate, thoracic breathing, shoulder movement, gasping, sighing, yawning, and breath-holding. Graphic © Pixel-Shot/


Clinical Assessment

1. Watch for restrictive clothing that could interfere with abdominal expansion and the downward movement of the diaphragm muscle. Graphic © kbrowne41/

tight jeans

2. Look for a posture that could also restrict the abdomen. Graphic © Marcin Balcerzak/

bad posture

Restrictive clothing and poor ergonomics can increase respiration rates beyond a client's resonance frequency, lowering HRV.

3. Check for reverse breathing, in which the abdomen contracts during inhalation.

This breathing pattern can result in respiration rates that exceed the resonance frequency. In the screen capture below, the pink tracing shows instantaneous heart rate (HR), and the violet tracing shows respirometer expansion and contraction.