Asessing Shortness of Breath
A reduction in shortness of breath (i.e. dyspnoea) is a robust finding in pulmonary rehabilitation research.
A primary goal of pulmonary rehabilitation is to reduce the patient’s perception of shortness of breath.
Dyspnoea severity should be assessed before and after pulmonary rehabilitation (see Program Evaluation section).
There are a number of measurement tools available for assessing dyspnoea, including:
Some health-related quality of life measures also include dyspnoea as a component. For example, the Chronic Respiratory Disease Questionnaire includes a standardised dyspnoea measure.
Some measures of dyspnoea are useful for clinical assessment (e.g. the MMRC Scale) and can provide a baseline indication of the patient’s status. However, these scales are not particularly sensitive to interventions such as pulmonary rehabilitation.
Important features of two dyspnoea scales, which are valid, reliable and commonly used, are summarised in the table below.
Modified Medical Research Council (MMRC) Scale
Modified BORG Scale
– 5 point scale (0-4)
– 10 point scale (0-10)
– Rates dyspnoea according to different levels of activity
– Breathlessness during a particular task
– Lack of clear limits between grades
– Demonstrated sensitivity to treatment effect