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Effect of the trajectory of exertional breathlessness on symptom recall and anticipation : A randomized controlled trial

Elmberg, Viktor LU orcid and Ekström, Magnus LU orcid (2020) In PLoS ONE 15(9).
Abstract

Background Breathlessness is a major cause of physical limitation. Recalled breathlessness intensity may differ from experienced intensity and be influenced by the intensity trajectory including the ‘peak-end rule’. The primary aim was to test if adding two minutes of low intensity exercise at the end of an exercise test would change the recalled breathlessness. Secondary aims included to analyse the impact of the peak and end exertional breathlessness intensity on breathlessness recall. Methods Randomized controlled trial of 92 adults referred for exercise testing who were randomized (1:1), at test end, to 2 minutes of additional low intensity exercise (intervention; n = 47) or stopping at peak exertion (control; n = 45). Experienced... (More)

Background Breathlessness is a major cause of physical limitation. Recalled breathlessness intensity may differ from experienced intensity and be influenced by the intensity trajectory including the ‘peak-end rule’. The primary aim was to test if adding two minutes of low intensity exercise at the end of an exercise test would change the recalled breathlessness. Secondary aims included to analyse the impact of the peak and end exertional breathlessness intensity on breathlessness recall. Methods Randomized controlled trial of 92 adults referred for exercise testing who were randomized (1:1), at test end, to 2 minutes of additional low intensity exercise (intervention; n = 47) or stopping at peak exertion (control; n = 45). Experienced breathlessness during the test and recalled intensity (30 min after the test) was assessed using the Borg CR10 scale. Results Participants were aged a mean 59 years; 61% men; 79% reported a mMRC ≥1. There was no between-group difference in recalled breathlessness intensity, 5.51 ([95% CI] 5.00 to 6.01) vs. 5.73 (5.27 to 6.20; p = 0.52) in controls, even though the intervention group had a significantly lower end breathlessness (mean difference 0.96; 0.24 to 1.67; p = 0.009). Recalled exertional breathlessness was most strongly related to peak breathlessness (r2 = 0.43). When analyzed together, end breathlessness did not add any explanatory value above that of peak breathlessness. Conclusion Adding an episode of two minutes of lower exercise and breathlessness intensity at the end of an exercise test did not affect symptom recall, which was most strongly related to peak breathlessness intensity.

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author
and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
PLoS ONE
volume
15
issue
9
article number
e0238937
publisher
Public Library of Science (PLoS)
external identifiers
  • pmid:32915891
  • scopus:85090855038
ISSN
1932-6203
DOI
10.1371/journal.pone.0238937
project
Standardized measurements of breathlessness
language
English
LU publication?
yes
id
81afcce8-160e-45e2-8384-3e2723545c17
date added to LUP
2020-09-30 13:42:48
date last changed
2024-03-20 17:24:06
@article{81afcce8-160e-45e2-8384-3e2723545c17,
  abstract     = {{<p>Background Breathlessness is a major cause of physical limitation. Recalled breathlessness intensity may differ from experienced intensity and be influenced by the intensity trajectory including the ‘peak-end rule’. The primary aim was to test if adding two minutes of low intensity exercise at the end of an exercise test would change the recalled breathlessness. Secondary aims included to analyse the impact of the peak and end exertional breathlessness intensity on breathlessness recall. Methods Randomized controlled trial of 92 adults referred for exercise testing who were randomized (1:1), at test end, to 2 minutes of additional low intensity exercise (intervention; n = 47) or stopping at peak exertion (control; n = 45). Experienced breathlessness during the test and recalled intensity (30 min after the test) was assessed using the Borg CR10 scale. Results Participants were aged a mean 59 years; 61% men; 79% reported a mMRC ≥1. There was no between-group difference in recalled breathlessness intensity, 5.51 ([95% CI] 5.00 to 6.01) vs. 5.73 (5.27 to 6.20; p = 0.52) in controls, even though the intervention group had a significantly lower end breathlessness (mean difference 0.96; 0.24 to 1.67; p = 0.009). Recalled exertional breathlessness was most strongly related to peak breathlessness (r<sup>2</sup> = 0.43). When analyzed together, end breathlessness did not add any explanatory value above that of peak breathlessness. Conclusion Adding an episode of two minutes of lower exercise and breathlessness intensity at the end of an exercise test did not affect symptom recall, which was most strongly related to peak breathlessness intensity.</p>}},
  author       = {{Elmberg, Viktor and Ekström, Magnus}},
  issn         = {{1932-6203}},
  language     = {{eng}},
  number       = {{9}},
  publisher    = {{Public Library of Science (PLoS)}},
  series       = {{PLoS ONE}},
  title        = {{Effect of the trajectory of exertional breathlessness on symptom recall and anticipation : A randomized controlled trial}},
  url          = {{http://dx.doi.org/10.1371/journal.pone.0238937}},
  doi          = {{10.1371/journal.pone.0238937}},
  volume       = {{15}},
  year         = {{2020}},
}