The Barthel index-dyspnea: a new two-dimensional dyspnea scale
1Division of Pulmonary Medicine, Department of Internal Medicine, 2Department of Critical Care Medicine, Chung Shan Medical University Hospital, 3School of Medicine, Chung Shan Medical University, Taichung, Taiwan, Republic of China
Clinical evaluation tools have been widely used in assessing the baseline status, treatment response, and prognosis for patients with chronic respiratory diseases and mostly for patients with chronic obstructive pulmonary disease (COPD).1 By factor analysis, multiple domains of disease entities involve dyspnea, psychological status, health-related quality of life, and sensation or perception of dyspnea,2 wherein dyspnea is commonly evaluated by dyspnea scales such as Medical Research Council (MRC), Baseline Dyspnea Index, Oxygen-Cost Diagram, St George Respiratory Questionnaire activity domain, and Chronic Respiratory Disease Questionnaire dyspnea domain (CRQ-dyspnea).2 These scales describe the subjects’ capability to perform at various levels of motor activity or functional status influenced or even limited by dyspnea. Indeed, exercise capacity is quantified; however, dyspnea is not. In our experience, the exertional dyspnea scales had better correlations with exercise performances (|r|=0.29–0.65) than dyspnea sensation intensity (|r|=0.06–0.55) and better correlation with walking (|r|=0.5–0.65) than peak exercise (|r|=0.29–0.39).
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