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Assessing Breathlessness

Shortness of breath is one of the most common symptoms of people attending pulmonary rehabilitation. 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 PR (see Patient Re-Assessment 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 domain.

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 measure change with interventions such as PR.

Important features of two dyspnoea scales, which are valid, reliable and commonly used, are summarised in the table below.

Modified Medical Research Council (mMRC) Dyspnoea
Scale		 CRDQ Dyspnoea
Practical Considerations
  • 5 point scale (0-4)
  • Easy to administer
 Dyspnoea scale is individualised asking patients to quantify breathlessness during five activities they frequently undertake.
Domains Assessed Rates dyspnoea according to different levels of activity Dyspnoea.
Key Features/
Remarks
  • Lack of clear limits between levels
  • Very useful at baseline to provide a profile of a patient
  • Not very responsive for assessing change after an intervention such as PR
  • A change of one level is clinically significant
  • MMRC (0-4) used with BODE index*

The Toolkit

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Getting Started
Patient Assessment
Patient Assessment
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Patient Education
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Patient Re-assessment
Patient Re-Assessment
Additional Resources
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