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A multidimensional assessment of dyspnoea in healthy adults during exercise



(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)


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.


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.


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
Fig. 2

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.





Body mass index


Confidence interval


End-expiratory lung volume


End-inspiratory lung volume


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F b :

Breathing frequency

FEV1 :

Forced expiratory volume in 1 s


Forced vital capacity


Heart rate


Inspiratory capacity


Intraclass correlation coefficient




Multidimensional dyspnoea profile


Respiratory exchange ratio


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


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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.


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.

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Authors and Affiliations



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.

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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.

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

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

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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).

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