A Reduction in the Use of Volunteered Descriptors of Air Hunger Is Associated With Increased Walking Distance in People With COPD
Open accessAbstract
BACKGROUND: This study investigated whether descriptors of breathlessness differed after participation in an 8 week pulmonary rehabilitation program and whether changes in sensory quality would be reflected in responsiveness to pulmonary rehabilitation. METHODS: People with COPD provided descriptors for their sensation of breathlessness before and after an 8 week pulmonary rehabilitation program. Primary outcomes for responsiveness to pulmonary rehabilitation were the 6 minute walk distance (6MWD) and the St George Respiratory questionnaire. Significant proportional shifts for sensory categories after rehabilitation were identified using the McNemar test. Random effects mixed modeling was used to determine significance of differences for primary outcomes between subjects modifying or not modifying descriptors of breathlessness. RESULTS: Of the 107 people referred to the pulmonary rehabilitation program, 94 met the spirometric criteria for COPD, with 58 having data for pre and post assessments (36 males, 71 ± 9 years old, percent of predicted FEV(1) 58 ± 24%). A significant proportion of subjects reduced descriptors of air hunger (P = .03, odds ratio 0.31, 95% CI 0.09-0.89) and depressed, regret, helpless (P = .04, odds ratio 0.36, 95% CI 0.10-1.05) following rehabilitation. Subjects reducing their use of descriptors of air hunger had greater improvements in the 6MWD after rehabilitation (P = .006, mean increase 46 m). CONCLUSIONS: The sensory quality of breathlessness was modified for approximately one third of subjects after pulmonary rehabilitation, with significant improvements in the 6MWD for subjects who reduced their use of descriptors of air hunger.
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Within the control group, a significant proportion of subjects reduced their use of volunteered descriptors in two categories: air hunger (P=.03) and depressed, regret, helpless (P=.04).
“whereas within the control group, a significant proportion of subjects reduced their use of volunteered descriptors in 2 volunteered language categories (air hunger [P ϭ .03]and depressed, regret, helpless [P ϭ .04];detailed tables are provided by Williams et al 7 ).”
From Cognitive behavioral therapy for management of dyspnea: A pilot study (2015) · cites this paper as [7]
The Changes in Language of Breathlessness section reports significant reductions in volunteered air-hunger (P=.03) and depressed/regret/helpless (P=.04) descriptors after pulmonary rehabilitation. But the Study Design section describes a pre-post study, not a control group; the cited results concern participants after rehabilitation. (LLM, conf=0.90)
Experimental — accuracy not yet measuredChanges in the perceptual experience of dyspnea after repeated exposure to exercise training may result from improvements in system efficiency and/or familiarity.
“Changes in the perceptual experience of dyspnea after repeated exposure to exercise training may result from improvements in system efficiency (less ventilatory effort for the same work load) and/or familiarity (reduced sensitivity to the sensation of breathlessness).7”
From Cognitive behavioral therapy for management of dyspnea: A pilot study (2015) · cites this paper as [7]
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- Authors
- Williams, M. T., Petkov, J., Olds, T. S., Cafarella, P., & Frith, P.
- Affiliations
- School of Health Sciences
- Applied Statistics Unit
- Health and Use of Time Group, Sansom Institute for Health Research, University of South Australia, Adelaide, South Australia, Australia.
- Department of Respiratory Medicine
- Repatriation General Hospital (AU)
- Venue
- Respiratory Care
- Publisher
- SAGE Publications
- Published
- 2012-09-01
- Volume
- 57
- Issue
- 9
- Pages
- 1431-1441
- ISSN
- 0020-1324 (ISSN-L)
- OpenAlex
- W2100538771
- Cited by
- 3
- References
- 62
- Citations by year
- 2023: 1 · 2019: 1 · 2015: 1
- FWCI
- 0.26
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Respiratory Care (publishedVersion)
- PubMed (publishedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Health Sciences › Medicine › Complementary and alternative medicine › Cardiovascular and exercise physiology
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Keywords
- chronic obstructive pulmonary disease, dyspnea, air hunger, pulmonary rehabilitation, 6-minute walk distance, St George's Respiratory Questionnaire
- MeSH terms
- Aged, Aged, 80 and over, Dyspnea, Exercise Test, Female, Forced Expiratory Volume, Humans, Language, Male, Middle Aged, Surveys and Questionnaires, Sensation, Verbal Behavior, Confidence Intervals, Odds Ratio, Walking, Exercise Tolerance, Pulmonary Disease, Chronic Obstructive
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