Multidimensional breathlessness assessment during cardiopulmonary exercise testing in healthy adults.

Lewthwaite H; Jensen D;

European journal of applied physiology [Eur J Appl Physiol] 2020 Nov 03. Date of Electronic Publication: 2020 Nov 03.

Purpose: This study explored if healthy adults could discriminate between different breathlessness dimensions when rated immediately one after another (successively) during symptom-limited incremental cardiopulmonary cycle exercise testing (CPET) using multiple single-item rating scales.
Methods: Fifteen apparently healthy adults (60% male) aged 22 ± 2 years performed six incremental cycle CPETs separated by ≥ 48 h. During each CPET (at rest, every 2-min and at end exercise), participants rated different breathlessness sensations using the 0-10 modified Borg scale using one of six assessment protocols, randomized for order: (1) ‘BREATHLESS ALL ‘ = breathlessness sensory intensity (SI), breathlessness unpleasantness (UN), work/effort of breathing (SQ W/E ), and unsatisfied inspiration (SQ UI ) assessed; (2) SI and UN assessed; and (3-6) SI, UN, SQ W/E , and SQ UI each assessed alone. Physiological responses to CPET were also evaluated.
Results: Physiological and breathlessness responses to CPET were comparable across the six protocols, with the exception of SI rated lower at the highest submaximal power output (220 ± 56 watts) during the BREATHLESS ALL protocol (0-10 Borg units 4.2 ± 1.7) compared to SI + UN (5.2 ± 2.1, p = 0.03) and SI alone (5.1 ± 1.9, p = 0.04) protocols. Ratings of SI and SQ W/E were not significantly different when assessed in the same protocol, and were significantly higher than UN and SQ UI , which were comparable.
Conclusion: In healthy younger adults, use of two separate single-item rating scales to assess breathlessness during CPET is feasible and enables the distinct sensory intensity and affective dimensions of exertional breathlessness to be assessed.