Grant S, Aitchison T, Henderson E, Christie J, Zare S, McMurray J, Dargie H
Centre for Exercise Science and Medicine, Institute of Biomedical and Life Sciences, University of Glasgow, UK.
Chest. 1999 Nov;116(5):1208-17. doi: 10.1378/chest.116.5.1208.
To assess which subjective scale, the visual analogue scale (VAS), the Borg CR10 (Borg) scale, or the Likert scale (LS), if any, is decidedly more reproducible and sensitive to change in the assessment of symptoms.
Prospective clinical study.
Exercise laboratory.
Twenty-three physically active male subjects (mean +/- SD age of 30 +/- 4 years old) were recruited.
Each subject attended the exercise laboratory on four occasions at intervals of 1 week. Three subjective scales were used: (1) the VAS (continuous scale); (2) the Borg scale (12 fixed points); and (3) the Likert scale (LS; 5 fixed points). Four identical submaximal tests were given (2 min at 60% maximum oxygen uptake [VO(2)max] and 6 min at 70% VO(2)max). Two tests were undertaken to assess the reproducibility of scores that were obtained with each subjective scale. Two other tests were undertaken to assess the sensitivity of each scale to a change in symptom perception: a double-blind treatment with propranolol, 80 mg, (ie, active therapy; to increase the sensation of breathlessness and general fatigue during exercise) or matching placebo. The subjective scale scores were measured at 1 min 30 s, 5 min 30 s, and 7 min 15 s of exercise. Reproducibility was defined as the proportion of total variance (ie, between-subject plus within-subject variance) explained by the between-subject variance given as a percentage. Sensitivity was defined as the effect of the active drug therapy over the variation within subjects.
Overall, the VAS performed best in terms of reproducibility for breathlessness and general fatigue, with reproducibility coefficients as high as 78%. For sensitivity, the VAS was best for breathlessness (ratio, 2.7) and the Borg scale was most sensitive for general fatigue (ratio, 3.0). The relationships between the respective psychological and physiologic variables were reasonably stable throughout the testing procedure, with overall typical correlations of 0.73 to 0.82
This study suggests that subjective scales can reproducibly measure symptoms during steady-state exercise and can detect the effect of a drug intervention. The VAS and Borg scales appear to be the best subjective scales for this purpose.
评估视觉模拟量表（VAS）、博格CR10（Borg）量表或李克特量表（LS）这几种主观量表中，哪一种在症状评估中更具可重复性且对变化更敏感。
前瞻性临床研究。
运动实验室。
招募了23名身体活跃的男性受试者（平均年龄±标准差为30±4岁）。
每位受试者每隔1周前往运动实验室4次。使用了三种主观量表：（1）VAS（连续量表）；（2）Borg量表（12个固定点）；（3）李克特量表（LS；5个固定点）。进行了4次相同的次最大强度测试（在最大摄氧量[VO(2)max]的60%下进行2分钟，在VO(2)max的70%下进行6分钟）。进行了两项测试以评估每种主观量表所获分数的可重复性。还进行了另外两项测试以评估每种量表对症状感知变化的敏感性：用80毫克普萘洛尔进行双盲治疗（即活性治疗；以增加运动期间的呼吸急促和全身疲劳感）或匹配的安慰剂。在运动的1分30秒、5分30秒和7分15秒测量主观量表分数。可重复性定义为受试者间方差占总方差（即受试者间方差加受试者内方差）的比例，以百分比表示。敏感性定义为活性药物治疗对受试者内变化的影响。
总体而言，在呼吸急促和全身疲劳的可重复性方面，VAS表现最佳，可重复性系数高达78%。对于敏感性，VAS在呼吸急促方面最佳（比值为2.7），Borg量表在全身疲劳方面最敏感（比值为3.0）。在整个测试过程中，各自心理和生理变量之间的关系相当稳定，总体典型相关性为0.73至0.82。
本研究表明，主观量表能够可重复地测量稳态运动期间的症状，并能检测药物干预的效果。VAS和Borg量表似乎是用于此目的的最佳主观量表。
