Continuous ratings of breathlessness during exercise by children and young adults with asthma and healthy controls

Although it is recommended and common practise for adults with respiratory disease to rate symptoms (e.g., dyspnea and/or leg discomfort) during exercise testing, there are no reports on whether children can rate their perception of breathlessness during exercise. Our aims were to evaluate the ability of children and young adults with asthma to continuously rate breathlessness on the 0-10 category-ratio (CR-10) scale with a computerized system during cycle ergometry, and to compare their results with those of healthy subjects. At an initial visit, subjects were familiarized with equipment and exercise protocol, and practised rating breathlessness while cycling. At a follow-up visit (2-4 days later), subjects performed incremental exercise and rated breathlessness using a computer system, mouse, and monitor. Changing the position of the mouse caused movement of a vertical bar located adjacent to the CR-10 scale to indicate the severity of breathlessness. Baseline characteristics of the 14 subjects with asthma (age, 15 3 years) and 33 healthy subjects (age, 16 2 years) were similar. The two groups had comparable levels of fitness as measured by peak oxygen consumption (VO2). Correlations between exercise physiologic variables (power production, VO2, and minute ventilation) and breathlessness ratings were > 0.90. Subjects reported progressively more ratings of breathlessness with increasing exercise intensities. There were no differences between groups for slopes, x-intercepts, and absolute thresholds relating physiologic variables and breathlessness. In conclusion, children and young adults with asthma as well as healthy individuals of comparable age successfully used the computerized system to rate breathlessness continuously during cycle ergometry. Both groups reported more ratings of breathlessness with this technique as exercise progressed.