Incentive spirometry as a means to score breathlessness

Area of Science:

• Pulmonary Medicine
• Respiratory Physiology
• Clinical Assessment

Background:

• Perceived breathlessness significantly impacts asthma management.
• Objective and subjective measures are crucial for assessing asthma severity and disability.

Purpose of the Study:

• To develop and validate a simple, user-friendly method for scoring perceived dyspnea (POD) in asthma.
• To evaluate the test's ability to discriminate between asthma severity levels and normal subjects.

Main Methods:

• Developed a POD scoring method using an incentive spirometer (Triflo II) with repetitive inspiratory efforts.
• Tested 175 healthy subjects and 158 asthmatic patients across mild, moderate, and severe GINA-defined categories.
• Assessed reproducibility, bronchodilator responsiveness, and correlation with the 6-minute walking test (6MWT).

Main Results:

• The POD index showed significant differences across asthma severity groups (p<0.001).
• High intraclass correlation coefficients indicated good reproducibility.
• POD index changes correlated with bronchodilator response (%FEV1 change) and 6MWT performance.

Conclusions:

• The developed POD scoring method is a discriminative, reproducible, and responsive tool for assessing asthma.
• It shows potential for effectively and simply scoring disability and perceived dyspnea in asthma patients.
• This method offers a valuable addition to asthma assessment, complementing existing measures like the 6MWT.