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A multidimensional assessment of dyspnoea in healthy adults during exercise

European Journal of Applied Physiology volume 120, pages 2533–2545 (2020)Cite this article

Abstract

Purpose

(1) To determine whether healthy humans can distinguish between the intensity and unpleasantness of exertional dyspnoea; (2) to evaluate the reliability of qualitative dyspnoea descriptors during exercise; and (3) to assess the reliability of the Multidimensional Dyspnoea Profile (MDP)

Methods

Forty-four healthy participants (24M:20F, 25 ± 5 years) completed maximal incremental cycling tests on three visits. During visit 1, participants rated the intensity and unpleasantness of dyspnoea simultaneously throughout exercise using the modified 0–10 category-ratio Borg scale. On visits 2 and 3, participants rated either the intensity or unpleasantness of dyspnoea alone at the same measurement times as visit 1. On all visits, participants selected qualitative descriptors throughout all exercise intensities from a list of 4, selected relevant qualitative descriptors from a list of 15 at peak exercise, and completed the MDP.

Results

Participants rated their dyspnoea intensity significantly higher for a given minute ventilation (\(\dot{V}_{E}\)) compared to dyspnoea unpleasantness (dyspnoea-\(\dot{V}_{E}\) slope: 0.08 ± 0.02 vs. 0.07 ± 0.03 Borg 0–10/L min−1, p < 0.001) during visit 1. The onset of intensity ratings occurred at a significantly lower work rate compared to unpleasantness ratings measured on the same exercise test (52 ± 41 vs. 91 ± 53 watts, p < 0.001). Dyspnoea intensity and unpleasantness remained significantly different for a given ventilation even when measured independently on separate exercise tests (p < 0.05). There was good-to-excellent reliability (ICC > 0.60) for the use of qualitative dyspnoea descriptors and the MDP to measure dyspnoea at peak exercise.

Conclusion

Exercise-induced dyspnoea in healthy adults can differ in the sensory and affective dimensions, and can be measured reliably using qualitative descriptors and the MDP.

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Fig. 1
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Data availability

The datasets generated during the current study are available from the corresponding author on reasonable request.

Code availability

The statistical code used in the study is available from the corresponding author on reasonable request.

Abbreviations

A:

Affective

BMI:

Body mass index

CI:

Confidence interval

EELV:

End-expiratory lung volume

EILV:

End-inspiratory lung volume

ESM:

Electronic supplementary material

F:

Female

F b :

Breathing frequency

FEV1 :

Forced expiratory volume in 1 s

FVC:

Forced vital capacity

HR:

Heart rate

IC:

Inspiratory capacity

ICC:

Intraclass correlation coefficient

M:

Male

MDP:

Multidimensional dyspnoea profile

RER:

Respiratory exchange ratio

SQ:

Sensory quality

\(\dot{V}{\text{CO}}_{2}\) :

Carbon dioxide production

\(\dot{V}_{E}\) :

Minute ventilation

\(\dot{V}{\text{O}}_{2}\) :

Oxygen consumption

V T :

Tidal volume

References

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Acknowledgements

We would like to thank Satvir Dhillon, Andrew Ramsook, Nafeez Syed, Cassandra Legault, Erin Little, Serena Midttun, Sydney Schnell, and Chelsey de la Rey for their assistance during data collection. We also thank all the participants for their time and willingness to volunteer for this study.

Funding

This work was funded by a Discovery Grant from the Natural Sciences and Engineering Research Council of Canada (NSERC). JZ was supported by an NSERC Undergraduate Student Research Award. MRS was supported by a postdoctoral fellowship from the Michael Smith Foundation for Health Research (MSFHR). JP was supported by a Scholar Award from the MSFHR. RAM was supported by an NSERC Postgraduate Doctoral Scholarship and a 4-year doctoral fellowship from The University of British Columbia. JAG was supported by a Canadian Institutes of Health Research Clinical Rehabilitation New Investigator Award and a Scholar Award from the MSFHR.

Author information

Author notes

  1. Julia Zhang and Michele R. Schaeffer have contributed equally to this study.

Authors and Affiliations

  1. Centre for Heart Lung Innovation, Providence Health Care Research Institute, The University of British Columbia, St. Paul’s Hospital, Vancouver, BC, Canada

    Julia Zhang, Michele R. Schaeffer, Reid A. Mitchell, Kyle G. Boyle, Olivia N. Hutchinson & Jordan A. Guenette

  2. School of Kinesiology, Faculty of Education, The University of British Columbia, Vancouver, BC, Canada

    Julia Zhang & Jordan A. Guenette

  3. Department of Physical Therapy, Faculty of Medicine, The University of British Columbia, Vancouver, BC, Canada

    Michele R. Schaeffer, Reid A. Mitchell, Kyle G. Boyle & Jordan A. Guenette

  4. Department of Biomedical Physiology and Kinesiology, Faculty of Science, Simon Fraser University, Burnaby, BC, Canada

    Olivia N. Hutchinson

  5. Centre for Health Evaluation and Outcome Sciences, Providence Health Care Research Institute, St. Paul’s Hospital, The University of British Columbia, Vancouver, BC, Canada

    Joseph H. Puyat

Authors
  1. Julia Zhang
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  3. Reid A. Mitchell
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Contributions

MRS and JAG conceived and designed the research. JZ, MRS, RAM, KGB, and ONH conducted the experiments. JZ and MRS analyzed the data. JHP wrote the statistical code. All authors contributed to drafting and critically revising the manuscript. All authors read and approved the manuscript.

Corresponding author

Correspondence to Jordan A. Guenette.

Ethics declarations

Conflict of interest

No conflict of interest, financial or otherwise, are declared by the authors. The findings of this study are presented clearly, honestly, and without fabrication, falsification, or inappropriate data manipulation.

Ethics approval

All experimental protocols were approved by the University of British Columbia and Providence Health Care Research Institute Ethics Board. The study was performed in accordance with all the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments.

Consent to participate

All participants provided written, informed consent for their participation in the study.

Consent for publication

All participants provided written, informed consent for the publication of the data generated during the study.

Additional information

Communicated by Susan Hopkins.

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Zhang, J., Schaeffer, M.R., Mitchell, R.A. et al. A multidimensional assessment of dyspnoea in healthy adults during exercise. Eur J Appl Physiol 120, 2533–2545 (2020). https://doi.org/10.1007/s00421-020-04479-2

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  • DOI: https://doi.org/10.1007/s00421-020-04479-2

Keywords

  • Sensory
  • Affective
  • Descriptors
  • Multidimensional dyspnoea profile
  • Reliability