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Reference equations for breathlessness during incremental cycle exercise testing

Elmberg, Viktor LU orcid ; Schiöler, Linus ; Lindow, Thomas ; Hedman, Kristofer ; Malinovschi, Andrei ; Lewthwaite, Hayley ; Jensen, Dennis ; Brudin, Lars and Ekström, Magnus LU orcid (2023) In ERJ open research 9(2).
Abstract

Background Exertional breathlessness is commonly assessed using incremental exercise testing (IET), but reference equations for breathlessness responses are lacking. We aimed to develop reference equations for breathlessness intensity during IET. Methods A retrospective, consecutive cohort study of adults undergoing IET was carried out in Sweden. Exclusion criteria included cardiac or respiratory disease, death or any of the aforementioned diagnoses within 1 year of the IET, morbid obesity, abnormally low exercise capacity, submaximal exertion or an abnormal exercise test. Probabilities for breathlessness intensity ratings (Borg CR10) during IET in relation to power output (%predWmax), age, sex, height and body mass were... (More)

Background Exertional breathlessness is commonly assessed using incremental exercise testing (IET), but reference equations for breathlessness responses are lacking. We aimed to develop reference equations for breathlessness intensity during IET. Methods A retrospective, consecutive cohort study of adults undergoing IET was carried out in Sweden. Exclusion criteria included cardiac or respiratory disease, death or any of the aforementioned diagnoses within 1 year of the IET, morbid obesity, abnormally low exercise capacity, submaximal exertion or an abnormal exercise test. Probabilities for breathlessness intensity ratings (Borg CR10) during IET in relation to power output (%predWmax), age, sex, height and body mass were analysed using marginal ordinal logistic regression. Reference equations for males and females were derived to predict the upper limit of normal (ULN) and the probability of different Borg CR10 intensity ratings. Results 2581 participants (43% female) aged 18–90 years were included. Mean breathlessness intensity was similar between sexes at peak exertion (6.7±1.5 versus 6.4±1.5 Borg CR10 units) and throughout exercise in relation to %predWmax. Final reference equations included age, height and %predWmax for males, whereas height was not included for females. The models showed a close fit to observed breathlessness intensity ratings across %predWmax values. Models using absolute W did not show superior fit. Scripts are provided for calculating the probability for different breathlessness intensity ratings and the ULN by %predWmax throughout IET. Conclusion We present the first reference equations for interpreting breathlessness intensity during incremental cycle exercise testing in males and females aged 18–90 years.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
ERJ open research
volume
9
issue
2
article number
00566-2022
publisher
European Respiratory Society
external identifiers
  • pmid:37057086
  • scopus:85156190375
ISSN
2312-0541
DOI
10.1183/23120541.00566-2022
language
English
LU publication?
yes
id
fd00879a-571e-4ab0-a617-0b52a6802a9d
date added to LUP
2023-08-14 08:41:41
date last changed
2024-04-20 00:29:26
@article{fd00879a-571e-4ab0-a617-0b52a6802a9d,
  abstract     = {{<p>Background Exertional breathlessness is commonly assessed using incremental exercise testing (IET), but reference equations for breathlessness responses are lacking. We aimed to develop reference equations for breathlessness intensity during IET. Methods A retrospective, consecutive cohort study of adults undergoing IET was carried out in Sweden. Exclusion criteria included cardiac or respiratory disease, death or any of the aforementioned diagnoses within 1 year of the IET, morbid obesity, abnormally low exercise capacity, submaximal exertion or an abnormal exercise test. Probabilities for breathlessness intensity ratings (Borg CR10) during IET in relation to power output (%predW<sub>max</sub>), age, sex, height and body mass were analysed using marginal ordinal logistic regression. Reference equations for males and females were derived to predict the upper limit of normal (ULN) and the probability of different Borg CR10 intensity ratings. Results 2581 participants (43% female) aged 18–90 years were included. Mean breathlessness intensity was similar between sexes at peak exertion (6.7±1.5 versus 6.4±1.5 Borg CR10 units) and throughout exercise in relation to %predW<sub>max</sub>. Final reference equations included age, height and %predW<sub>max</sub> for males, whereas height was not included for females. The models showed a close fit to observed breathlessness intensity ratings across %predW<sub>max</sub> values. Models using absolute W did not show superior fit. Scripts are provided for calculating the probability for different breathlessness intensity ratings and the ULN by %predW<sub>max</sub> throughout IET. Conclusion We present the first reference equations for interpreting breathlessness intensity during incremental cycle exercise testing in males and females aged 18–90 years.</p>}},
  author       = {{Elmberg, Viktor and Schiöler, Linus and Lindow, Thomas and Hedman, Kristofer and Malinovschi, Andrei and Lewthwaite, Hayley and Jensen, Dennis and Brudin, Lars and Ekström, Magnus}},
  issn         = {{2312-0541}},
  language     = {{eng}},
  month        = {{03}},
  number       = {{2}},
  publisher    = {{European Respiratory Society}},
  series       = {{ERJ open research}},
  title        = {{Reference equations for breathlessness during incremental cycle exercise testing}},
  url          = {{http://dx.doi.org/10.1183/23120541.00566-2022}},
  doi          = {{10.1183/23120541.00566-2022}},
  volume       = {{9}},
  year         = {{2023}},
}