The Measurement of Dyspnea

Mahler, Donald A.; Weinberg, David H.; Wells, Carolyn K.; Feinstein, Alvan R.

doi:10.1378/chest.85.6.751

Cited by 1,148 publications

(227 citation statements)

References 21 publications

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“…Although the combination of FCS and tiotropium was significantly more active in inducing improvements in FEV 1 than the single treatments alone, we did not observe a similar trend in use of rescue medication and changes in VAS scores. We have measured changes in dyspnea from A c c e p t e d m a n u s c r i p t baseline with VAS because it is simpler and easier to determine than other dyspnea measurements, it permits a subjective rating of this symptom [23] and, moreover, its reproducibility is maintained over intervals when memory for the score given is unlikely to be an important factor [24]. We must highlight, in any case, that we do not know how the observed changes in VAS scores of dyspnea were clinically significant.…”

Section: Discussionmentioning

confidence: 99%

A pilot study to assess the effects of combining fluticasone propionate/salmeterol and tiotropium on the airflow obstruction of patients with severe-to-very severe COPD

Cazzola

Andò

Santus

et al. 2007

Pulmonary Pharmacology & Therapeutics

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A c c e p t e d m a n u s c r i p t AbstractThe aim of this pilot study was to explore the relative efficacy in terms of improvement in symptoms and lung function of combining fluticasone propionate/salmeterol combination (FSC) and tiotropium in patients with severe-to-very severe stable COPD. Ninety patients were randomized to receive 3 months of treatment in one of three treatment groups: (1) FSC 500/50 µg Diskus, 1 inhalation twice daily + placebo Handihaler 1 inhalation once-daily daily; (2) tiotropium 18 µg Handihaler, 1 inhalation once daily + placebo Diskus, 1 inhalation twice daily; (3) FSC 500/50 µg Diskus, 1 inhalation twice daily + tiotropium 18 µg Handihaler, 1 inhalation once-daily daily. Patients attended the clinic before and after 1 month, 2 months, and 3 months of treatment for evaluations of pulmonary function, and dyspnea, which was assessed using a visual analog scale (VAS). Also the supplemental salbutamol use was measured. Eighty-one patients completed the 3-month treatment period: 26 patients receiving FSC, 26 patients receiving tiotropium, and 29 patients receiving FSC + tiotropium. Patients were withdrawn for COPD exacerbation. Improvements in trough FEV 1 with all treatments medications were observed by the first month when trough FEV 1 had improved significantly above baseline by 74 mL (p < 0.05) in the tiotropium group, by 117 mL (p < 0.05) in the FSC group and by 115 mL (p < 0.05) in FSC + tiotropium group. At the end of the study, trough FEV1 had improved significantly above baseline by141 mL (p < 0.05) in the tiotropium group, by 140 mL (p < 0.05) in the FSC group and by 186 mL (p < 0.05) in FSC + tiotropium group. The difference between FSC and tiotropium appeared to decrease, that between FSC and FSC + tiotropium appeared to increase and that between tiotropium and FSC + tiotropium remained almost similar with study duration. Our results suggest that adding FSC and tiotropium may provide benefits in symptomatic patients with severe-to-very severe stable COPD.

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Section: Discussionmentioning

confidence: 99%

A pilot study to assess the effects of combining fluticasone propionate/salmeterol and tiotropium on the airflow obstruction of patients with severe-to-very severe COPD

Cazzola

Andò

Santus

et al. 2007

Pulmonary Pharmacology & Therapeutics

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“…(23) A avaliação da dispnéia nas AVDs expressa melhor a percepção dos pacientes, pois avalia suas atividades do dia-a-dia. (24) Existem dois instrumentos para medir a dispnéia durante as AVDs: o Transitional Dyspnea Index / Baseline Dyspnea Index (23) e o domínio dispnéia no CRQ. (25) Dentre eles, o domínio dispnéia do CRQ é considerado o melhor instrumento, pois quantifica, individualmente, as atividades com maior desencadeamento de mais dispnéia e sofre menor interferência por parte do entrevistador.…”

Section: Discussionunclassified

“…(25) Dentre eles, o domínio dispnéia do CRQ é considerado o melhor instrumento, pois quantifica, individualmente, as atividades com maior desencadeamento de mais dispnéia e sofre menor interferência por parte do entrevistador. (24,25) Outro fator que justificou nossa utilização do CRQ foi o fato de que este questionário é o mais empregado nos estudos de reabilitação pulmonar. (7,8) No presente trabalho foi observado que o grupo tratado apresentou pior qualidade de vida avaliada pelo SGRQ antes do início do estudo.…”

Section: Discussionunclassified

Efeitos de programa de exercícios físicos direcionado ao aumento da mobilidade torácica em pacientes portadores de doença pulmonar obstrutiva crônica

2003

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Efeitos de programa de exercícios físicos direcionado ao aumento da mobilidade torácica em pacientes portadores de DPOC Introdução: A doença pulmonar obstrutiva crônica acarreta prejuízos na mecânica pulmonar e musculatura periférica. O treinamento físico dos pacientes com doença pulmonar obstrutiva crôni-ca é geralmente voltado à melhora das condições aeróbias e são raros os programas que abordam especificamente as alterações da caixa e musculatura torácicas.Objetivo: Avaliar o efeito de um programa de exercícios físicos direcionados ao aumento da mobilidade da caixa torácica sobre a capacidade funcional e psicossocial de pacientes portadores de doença pulmonar obstrutiva crônica moderada e grave. Método:Foram estudados 30 pacientes portadores de doença pulmonar obstrutiva crônica moderada e grave, divididos aleatoriamente em dois grupos: controle (GC) e tratado (GT). O GC foi submetido a um programa de educação e o GT foi submetido ao mesmo programa educacional e a um programa de exercícios físicos objetivando o aumento da mobilidade torácica. Os efeitos dos programas foram avaliados pela espirometria, mobilidade torácica, qualidade de vida, níveis de ansiedade e depressão e teste da caminhada de seis minutos (TC6).Resultados: Após dois meses de treinamento, somente o GT apresentou aumento na expansibilidade torácica (de 4,20 ± 0,58cm para 5,27 ± 0,58cm; p = 0,05) e no TC6 (de 469,73 ± 31,99m para 500,60 ± 27,38m; p = 0,01). Foi observado também que o GT apresentou melhora na qualidade de vida avaliada pelo St. George's Respiratory Questionnaire (SGRQ) e Chronic Respiratory Questionnaire (CRQ), bem como nos níveis de depressão após dois meses de tratamento. Não houve melhora da função pulmonar em nenhum dos dois grupos estudados. Conclusão:Exercícios direcionados ao aumento da mobilidade da caixa torácica melhoram a expansibilidade torácica, a qualidade de vida e a capacidade submáxima de exercício, bem como reduzem a dispnéia e os níveis de depressão nos pacientes portadores de doença pulmonar obstrutiva crônica. (J Pneumol 2003;29(5):287-94) 3. Doutor em Fisiologia.Endereço para correspondência -Elaine Paulin, Rua Marialva, 5.819, zona III -87502-100 -Umuarama, PR. Tel.: (44) 622-2652; e-mail: epaulin@unipar.brRecebido para publicação em 24/2/03. Aprovado, após revisão, em 11/6/03.

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“…16 The BDI index developed by Mahler et al 16 evaluates dyspnea based on three components that evoke dyspnea in activities of daily living, in symptomatic individuals. TDI measures changes in dyspnea severity from the baseline as established by the BDI.…”

Section: The Indirect Assessments Of Dyspneamentioning

confidence: 99%

“…TDI measures changes in dyspnea severity from the baseline as established by the BDI. 16 The limitation is few specific instructions included in the instrument.…”

Section: The Indirect Assessments Of Dyspneamentioning

confidence: 99%

Recent Advances in Assessment of Dyspnea

Kanezaki¹

2017

Pulm Res Respir Med Open J

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As pulmonary rehabilitation can provide various benefits on managing the symptoms of dyspnea, alleviating dyspnea represents a major goal in pulmonary rehabilitation. Dyspnea appears not to be just a single sensation, as it includes the three sensory quality of dyspnea; work/effort, air-hunger and chest tightness. In addition to sensation of dyspnea, complex emotions including anxiety, attention and fear can involve through processing of the limbic system. Recent studies emphasized the multidimensional nature of dyspnea in the sensory-perceptual (intensity and quality), affective distress and impact domains. This review focused on the underlying mechanism of dyspnea and recent advances in assessment in pulmonary rehabilitation in chronic obstructive pulmonary disease (COPD).

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The Measurement of Dyspnea

Cited by 1,148 publications

References 21 publications

A pilot study to assess the effects of combining fluticasone propionate/salmeterol and tiotropium on the airflow obstruction of patients with severe-to-very severe COPD

A pilot study to assess the effects of combining fluticasone propionate/salmeterol and tiotropium on the airflow obstruction of patients with severe-to-very severe COPD

Efeitos de programa de exercícios físicos direcionado ao aumento da mobilidade torácica em pacientes portadores de doença pulmonar obstrutiva crônica

Recent Advances in Assessment of Dyspnea

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