Source: Annual Congress 2002 - Physiotherapy: assessment and outcome in healthy subjects and patients with chronic lung disease
Disease area: Airway diseases

Abstract

Pulmonary rehabilitation (PRP) improves exercise tolerance (ET) and quality of life (QoL) and these improvements are accompanied by a reduction in dyspnoea. However as dyspnoea is a subjective sensation it is difficult to measure. This study evaluates the validity of 2 frequently used measurements of dyspnoea - the Borg score and the dyspnoea component of the Chronic Respiratory Disease questionnaire (D-CRDQ) following PRP. 129 patients with COPD (mean FEV1 43.7% pred.) were re-assessed on completion of an 8-week PRP and again at 1 year. As expected there was an overall improvement in ET, as measured by the treadmill endurance test (TET) (p<.001) and in QoL (as measured by the CRDQ - p<.001, St. George's Respiratory questionnaire - p<.001, and the Hospital Anxiety and Depression scale - anxiety - <.001, depression p<.001). Dyspnoea was reduced as measured by the Borg score after the TET (p<.001)and by the D-CRDQ (p<.001). The TET is limited by factors other than dyspnoea, such as fatigue or desaturation of oxygen. 17% of the patients cited moderately severe or severe dyspnoea (Borg 4/5) as the reason for stopping the TET both at 8 weeks and 1 year post rehab. The remainder (83%) stopped because of fatigue. However, the D-CRDQ measures dyspnoea by the patient's responses to 5 questions relating to the effect of dyspnoea on normal daily activities as established at the first assessment.
In conclusion the Borg scale post TET is not a valid measurement to evaluate improvement in dyspnoea following rehab. The D-CRDQ gives a more reliable and valid comparison of changes in dyspnoea at different stages during PRP.

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Citations should be made in the following way:
M. C. Connor, J. P. Cullen, M. F. O'Driscoll, T. J. McDonnell (Dun Laoghaire, Elm Park, Ireland). An evaluation of the validity of two measurements of dyspnoea as outcomes of pulmonary rehabilitation in patients with chronic obstructive pulmonary disease (COPD). Eur Respir J 2002; 20: Suppl. 38, 1168

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