LAUSR

Dyspnea, a major predictor of mortality and quality of life (QoL) in COPD, is essentially explored through its impact (e.g. via the mMRC scale). Many studies highlight two other major components: the sensory (SD) and affective (AD) dimension. Therefore, a multidimensional assessment of dyspnea is recommended in pulmonary rehabilitation (PR). However, studies having concomitantly investigated the SD and AD during PR are scarce. Our aim was thus to study 1) the effects of PR on the SD and AD of dyspnea and 2) the possible predictors of SD and AD response to PR. Seventy COPD patients admitted for a 4-week inpatient PR program were included. In addition to usual data, Multidimensional Dyspnea Profile questionnaire data were collected at the entrance (T1) and at the end (T2) of the PR. Stepwise regression analyses were performed to obtain predictive equations of SD and AD response. In baseline, the mean scores were 38 (± 10) for SD and 22 (± 14) for AD. Post-PR, the SD and AD scores improved significantly: -10.5 (effect size; d=0.81) and -9.5 (d=0.66) respectively. Thirty-seven percent of patients did not improve their scores (n=5 for SD, n=11 for AD and n=10 for both). QoL and AD at T1 predicted AD response (r=0.50, adjusted r2=0.21; standard error of the regression = 9.75). Overall, PR improves the SD and AD of dyspnea with a large and a medium effect size respectively. However, the analysis of individual responses shows that one third of patients does not improve in at least one of the two dimensions. Targeted intervention could be considered to enhance and maintain PR benefits for these patients.