Breathlessness and brain power: KITE scientist explores link between respiratory muscles and coordination

Dr. Darlene Reid is helping patients with chronic respiratory conditions reimagine their lives with small improvements

Rifling a wrist shot over the goalie’s shoulder. Grabbing a cup of coffee. 

Both require brain power to activate the muscles and limbs to move and coordinate. 

But for an individual with acute or chronic respiratory conditions experiencing breathlessness, picking up that coffee mug can use similar focus and energy as an athlete perfecting their skill. 

It takes brain power to optimize physical activity … it takes brain power for coordination. 

This is something that fascinates Dr. W. Darlene Reid, a research scientist at The KITE Research Institute. With years of experience as a physical therapist, her long history of studying limb muscles led her to focus on understanding respiratory muscles and conditions, and how patients are impacted physically and cognitively.  

“I see a lot of parallels between the physiology of athletes and the altered physiology of patients with chronic respiratory conditions,” she says. “When patients are doing daily activities that we take for granted, they’re actually working to maximal capacity.” 

Dr. Reid says her journey into the field was a natural progression.  

“I did a lot of sports in high school. In fact, what I remember most is what the gym looks like, not the library!” she says with a laugh. “When I first broke my leg, it was a physical therapist who helped me improve my function and mobility, causing me to think about the profession in a natural way.” 

She went on to obtain her Bachelor of Medical Rehabilitation at the University of Manitoba, where she wrote a research paper on respiratory muscles, an early indicator of her work to come. 

“I got interested in this because, as a physical therapist, I worked with people with chronic and acute respiratory conditions in the intensive care unit, on the wards and as outpatients,” shares Dr Reid with compassion in her voice. “I saw what a difference it made for them just to be able to walk to the store and buy a newspaper. That’s why I’ve worked in this area, and that’s pretty much why I’ve stayed in this area.”   

“Examining respiratory muscle performance in patients with acute and chronic disease has led me into further research into breathlessness and how it impacts the mind and body coordination,” she says. 

After completing her PhD at the University of British Columbia, Dr. Reid joined its faculty as a professor in the Department of Physical Therapy. She was there until 2014 when she relocated to Ontario. She began her tenure as chair of the Department of Physical Therapy at the University of Toronto in January 2015.  

“I came here because of the research,” shares Dr. Reid. “I thought it would be great, and … it’s phenomenal. The density of research, the proximity of the health facilities, and the opportunities to network and collaborate are phenomenal.” 

It’s clear that collaboration and mentoring are two things Dr. Reid feels passionate about. “I still get excited working with research trainees,” she says smiling. “Watching them think, helping them understand and pointing in a particular direction and watching them run … that, to me, is very exciting.” 

At KITE, Dr. Reid has an integrated physiology lab where she and her colleagues examine very particular aspects of the respiratory muscles and how motor control is impacted. When someone is healthy, they can be in the lab for intensive studies for hours. But with Dr. Reid’s research, her patients are far from full health, so she ensures they are in and out of the lab within an hour and a half at the most.  

With the use of non-invasive tools like functional near-infrared spectroscopy (fNIRS) and electromyography (EMG), they can see a patient’s brain activity and muscle activity by assessing the changes in blood flow and metabolism when asked to do a simple task like squeeze a ball or reach up and touch their nose. This allows Dr. Reid’s team to examine the capacity of muscles in people with acute or chronic lung disorders like exacerbations of the interstitial lung disease (ILD). 

“Thinking about how the brain drives muscle activity will hopefully help improve the ability for people to do physical activities or to get weaned off mechanical ventilators earlier,” she says. “For people with considerable disability without energy to do an extra rehabilitation regimen, a small improvement, if it’s targeted in the right way, can make a huge difference in their life.”  

This is what motivates Dr. Reid in her continued research and work as an integrated physiologist: Helping patients with chronic respiratory conditions reimagine their lives with small improvements. She has worked on different kinds of research but always returns to respiratory muscles. 

“For me, it was very important to see the connection of my research to how it might improve the life of a person with either chronic respiratory disease or acute respiratory disease.” 

Recently, Dr. Reid has been zeroing in on breathlessness, known as dyspnea, a symptom caused by lung disorders like chronic obstructive pulmonary disease (COPD) and ILD. On a mission toward understanding how it affects patients cognitively and impacts their physical coordination, she hopes her research will produce a better appreciation of breathlessness in people suffering from lung disorders. Dr. Reid says she dreams for more than just awareness, but to also find ways to reduce the distressful sensation people feel and find ways to make physical activities easier despite breathlessness.  

So, what does this kind of research look like? In the lab, individuals are attached to fNIRS tools to monitor brain activity as they do simple activities like spell words backwards or walk back and forth – things many of us take for granted and do without thinking. Dr. Reid shares that in older individuals, neural activity decreased over just a 30-metre walk, showing that they didn’t need to really think about what they were doing. It came naturally without much effort. But for patients with COPD who experience breathlessness, their neural activity plateaued while doing the same exercises, showing evidence that it takes a lot more cognitive effort to perform routine activities. 

For patients, research gives credibility to the difficulties they experience and helps clinicians understand their reality. It guides rehabilitation plans to build endurance, both physically and cognitively.  

“By understanding the interaction between the mind, physical ability, and the capacity to accomplish a task,” says Dr. Reid, “patients can be encouraged to simplify or set up routines that help them manage a fuller life, maintaining a level of independence.” 

At KITE, being surrounded by people who think about rehabilitation has pushed Dr. Reid to think about her research in a different way. Now she focuses on asking: How can we help patients with acute and chronic lung disease? How can we reimagine activities to help patients maintain their level of independence? 

Finding answers to these questions gets her fired up.  

“This work isn’t for everyone,” Dr. Reid laughs. “But for me, to do clinical research is very rewarding. I’ve been doing it a long, long time and I still want to do it.” 

KITE's partnership with Centennial College

KITEworks Magazine is an annual collaborative project between Centennial College's Professional Writing-Communications and Photography programs and KITE. The stories, experiences and photographs shared in this year's edition of the magazine give an unfiltered look into how KITE has reimagined rehabilitative care. Come and explore how KITE works!