Measurement of Symptoms During Exercise
Shortness of Breath
Dyspnoea severity should be assessed before and after pulmonary rehabilitation as one of the primary goals of pulmonary rehabilitation is to reduce the patient’s perception of shortness of breath.
Modified Medical Research Council (MMRC) Dyspnoea Scale.
Modified Borg Dyspnoea Scale (0-10) – during exercise assessment
Dyspnoea is measured prior to and on completion of the walking test but, in patients with significant disease, it may also be required to record dyspnoea scores during the walking test.
See the Pulmonary Rehabilitation Toolkit for a description of the features of these tools.
Some health-related quality of life measures, such as the Chronic Respiratory Disease Questionnaire, also include dyspnoea as a component.
During aerobic and strength exercise sessions patients are asked to rate their perceived level of exertion – how hard they feel their body is working. Although this is a subjective measure, a person’s exertion rating can provide an estimate of the heart rate during physical activity.
Taking into account the presence of co-morbidities, patients are generally instructed to exercise at a moderate intensity. Self monitoring assists patients in adjusting their level of exercise intensity.
An example of a measure of perceived exertion is the Borg Rating of Perceived Exertion (RPE) Scale.
Oxygen Saturation (SpO2)
With the use of a pulse oximeter, oxygen saturation is recorded throughout the walking test. This may be placed hanging over the patients’ back, held in their hand or on their finger. The screen of the oximeter must be visible throughout the test.
It may also be necessary to repeat pulse oximetry at the home visit.