Abstract
Motor control is a key component in injury prevention. Loss of motor control involves failure to
control joints, commonly because of incoordination of the agonist-antagonist muscle co-activation.
Three subsystems work together to maintain spinal stability: The central nervous subsystem
(control), the osteoligamentous subsystem (passive), and the muscle subsystem (active).
There is evidence that the effects of breathing pattern disorders, such as hyperventilation, result
in a variety of negative psychological, biochemical, neurological and biomechanical influences
and interferences, capable of modifying each of these three subsystems. Breathing pattern
disorders (the extreme form of which is hyperventilation), automatically increase levels of anxiety
and apprehension, which may be sufficient to alter motor control and to markedly influence balance
control. Hyperventilation results in respiratory alkalosis, leading to reduced oxygenation of tissues
(including the brain), smooth muscle constriction, heightened pain perception, speeding up of
spinal reflexes, increased excitability of the corticospinal system, hyperirritability of motor and
sensory axons, changes in serum calcium and magnesium levels, and encouragement of the
development of myofascial trigger points – all or any of which, in one way or another, are capable
of modifying normal motor control of skeletal musculature.
Diaphragmatic and transversus abdominis tone are key features in provision of core stability,
however it has been noted that reduction in the support offered to the spine, by the muscles of
the torso, may occur if there is both a load challenge to the low back, combined with a breathing
challenge. It has been demonstrated that, after approximately 60 seconds of hypercapneoa, the
postural (tonic) and phasic functions of both the diaphragm and transversus abdominis are reduced
or absent. Smooth muscle cells, now known to be widely embedded in connective tissues (including
spinal discs, and lumbar fascia) constrict during periods of respiratory alkalosis, with as yet
undetermined effects on joint stability and fascial tone. Breathing rehabilitation offers the potential
for reducing the negative influences resulting from breathing pattern disorders.
Keywords: breathing pattern disorder, hyperventilation, respiratory alkalosis, motor control,
musculoskeletal pain

Breathing pattern disorders, motor control, and low back pain