Abstract

Dyspnea reduction is a major objective of pulmonary rehabilitation (PR). To date, the effects of PR on this symptom are usually only assessed through the impact dimension (ID) on the daily lives of patients. However, dyspnea is a multidimensional construct with two additional affective (AD) and sensory (SD) dimensions. The aim of this study was to assess the relevance of evaluating AD and SD in addition to the usual evaluation of ID during a PR program. AD and SD were assessed with the Multidimensional Dyspnea Profile questionnaire (MDP) and ID with the modified Medical Research Council (mMRC) scale at the entry and the end of a 4-week inpatient PR. The study was a secondary analysis of the PERSADHE study (Caille et al. 2021). Data of 53 patients could be retrieved and analysed. At baseline, no significant correlation was observed between mMRC and MDP scores, indicating that the two tools provide distinct and complementary information. Regarding the PR response, 34% of patients (n=18) did not clinically improved their mMRC score and were classified as non-responders on ID, which is consistent with literature data. Nevertheless, 78% (n=14) of them did improved their AD or/and SD score. Finally, our results highlighted that 93% (n=49) of patients improved on at least one dyspnea dimension.Our results show that ID assessment is not enough and that the further evaluation of AD and SD allows a better understanding of dyspnea and its improvement during PR. Multidimensional comprehensive dyspnea assessment in PR is thus essential to better target, enrich and personalize care according to dyspnea characteristics in baseline and their evolution, opening up new therapeutic opportunities.