The stress management process/Assessment of breathing pattern

Instructing your client
Your client's breathing pattern is best assessed when they are first lying on the table. By this stage their breathing will have had a chance to settle to it's normal rhythm if they needed to rush to get to the session.

Ask your client to lie on their back to start. This allows you to clearly observe and palpate any movements of the chest and abdomen.

Palpation of the breathing pattern
Begin by placing your hands over the ribs and the upper abdomen allowing the body to go through three or more cycles. Relaxed breathing should result in a slight rounding of the upper abdomen and lateral movement of the lower ribs during inhale. The upper abdomen should also fill up like a small balloon as the client inhales. Breathing should begin in the upper abdomen and spread upwards into the ribcage. Excessive movement in the shoulders or upper chest, lack of movement in the upper abdomen, or breathing spreading downwards into the abdomen indicates a likely breath pattern disorder. Breath retraining is advisable.

Assessing the breathing rhythm
While the breathing pattern is being palpated, the rhythm of the breath should also be assessed. The average adult should breathe 14-18 times per minute. Over a 20 second period, they should breathe between 5-6 times (an analogue clock is useful for this). If your client is breathing much faster than this, then breath retraining is also advisable. The normal rate of breathing for children is faster than it is for adults.

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