Document Detail

Performance of a word labeled visual analog scale in determining the degree of dyspnea during exercise-induced bronchoconstriction in children and adolescents with asthma.
MedLine Citation:
PMID:  21085817     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: There is an indirect relationship between airway obstruction in asthma and the intensity of breathlessness (dyspnea). A word labeled visual analog dyspnea scale with a 0-3 score has been widely used for the assessment of the degree of bronchoconstriction, although the perception of such obstruction varies considerably. The objective of this study was to determine whether children and adolescents are able to perceive acute exercise-induced bronchoconstriction (EIB), as well as to measure the discriminatory power of a word labeled visual analog dyspnea scale in relation to the intensity of the EIB.
METHODS: A cross-sectional study involving 134 children and adolescents with asthma and submitted to a six-minute steady-state exercise test on a cycle ergometer. The intensity of dyspnea was determined using a word labeled visual analog dyspnea scale prior to each determination of FEV1. The scale is scored from 0 to 3, with a logical sequence of pictures, ranging from "no symptoms" to "severe dyspnea". Variables were determined at baseline, as well as at 5, 10, and 20 min after the exercise test. The accuracy of the dyspnea scale in identifying the degree of EIB was determined by means of ROC curves for the post-exercise fall in FEV1, using cut-off points of 10%, 20%, 30%, and 40%.
RESULTS: Of the patients selected, 111 finished the study, and 52 (46.8%) presented with EIB. The area under the ROC curve increased in direct proportion to increases in the degree of bronchoconstriction.
CONCLUSIONS: Among children and adolescents with asthma, the accuracy of this dyspnea scale improves as the post-exercise percentage fall in FEV1 increases. However, the predictive value of the scale is suboptimal when the percentage fall in FEV1 is lower.
Patrícia Bueno Lima; Ilka Lopes Santoro; Lilian Ballini Caetano; Anna Lúcia de Barros Cabral; Ana Luisa Godoy Fernandes
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Jornal brasileiro de pneumologia : publicaça̋o oficial da Sociedade Brasileira de Pneumologia e Tisilogia     Volume:  36     ISSN:  1806-3756     ISO Abbreviation:  J Bras Pneumol     Publication Date:    2010 Sep-Oct
Date Detail:
Created Date:  2010-11-18     Completed Date:  2011-10-27     Revised Date:  2013-09-26    
Medline Journal Info:
Nlm Unique ID:  101222274     Medline TA:  J Bras Pneumol     Country:  Brazil    
Other Details:
Languages:  eng; por     Pagination:  532-8     Citation Subset:  IM    
Department of Internal Medicine, Division of Pulmonology, Federal University of São Paulo, São Paulo, Brazil.
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MeSH Terms
Asthma / physiopathology*
Bronchial Provocation Tests*
Bronchoconstriction / physiology*
Dyspnea / physiopathology*
Exercise / physiology
Pain Measurement
Respiratory Function Tests
Severity of Illness Index

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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