Boer Lonneke M, Asijee Guus M, van Schayck Onno C P, Schermer Tjard R J
Department of Medical Psychology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
Prim Care Respir J. 2012 Jun;21(2):202-7. doi: 10.4104/pcrj.2012.00031.
In primary care, formal functional capacity testing is not always feasible. Guidelines for family practitioners suggest the use of dyspnoea scales to assess exercise tolerance in patients with chronic obstructive pulmonary disease (COPD).
To examine whether the use of activity-based dyspnoea scales can substitute for actual functional capacity testing.
128 subjects (49% at risk of COPD, 24% GOLD stage I, 17% GOLD stage II, 9% GOLD stage III) performed an Incremental Shuttle Walk Test (ISWT) and completed the Medical Research Council dyspnoea scale (MRC), Baseline Dyspnoea Index (BDI), Oxygen Cost Diagram (OCD), Clinical COPD Questionnaire (CCQ), and St George's Respiratory Questionnaire (SGRQ).
Analysis of variance showed that the relationship between the ISWT and the MRC dyspnoea scale was statistically significant but moderate (p < 0.001, R2 = 0.166). Correlations between the ISWT and the other dyspnoea scales were also moderate (correlation coefficients 0.34-0.42). Combining the dyspnoea scales in one analysis resulted in a proportion of explained variance of the ISWT of 21.4% (R2 = 0.214).
Dyspnoea scales cannot substitute for formal functional capacity testing. Authors of COPD guidelines should consider stating more specifically that the MRC and similar scales measure (self-reported) activity-related dyspnoea but cannot replace objectively measured functional capacity.
在初级保健中，正式的功能能力测试并不总是可行的。家庭医生指南建议使用呼吸困难量表来评估慢性阻塞性肺疾病（COPD）患者的运动耐量。
研究基于活动的呼吸困难量表是否可以替代实际的功能能力测试。
128名受试者（49%有患COPD的风险，24%为GOLD I级，17%为GOLD II级，9%为GOLD III级）进行了递增往返步行试验（ISWT），并完成了医学研究委员会呼吸困难量表（MRC）、基线呼吸困难指数（BDI）、氧耗图（OCD）、临床COPD问卷（CCQ）和圣乔治呼吸问卷（SGRQ）。
方差分析表明，ISWT与MRC呼吸困难量表之间的关系具有统计学意义，但为中度相关（p < 0.001，R2 = 0.166）。ISWT与其他呼吸困难量表之间的相关性也为中度（相关系数0.34 - 0.42）。在一项分析中综合使用呼吸困难量表，ISWT的可解释方差比例为21.4%（R2 = 0.214）。
呼吸困难量表不能替代正式的功能能力测试。COPD指南的作者应更明确地指出，MRC及类似量表测量的是（自我报告的）与活动相关的呼吸困难，但不能取代客观测量的功能能力。
