Comparison of Scales Used to Quantitate the Sense of Effort to Breathe in Patients with Chronic Obstructive Pulmonary Disease

Several different scaling techniques, i.e., Borg category (BC) and visual analogue (VA) scales have been used to quantitate the intensity of the respiratory sensations elicited during exercise, but their relationship is unclear. Six subjects with stable chronic obstructive lung disease (FEV1 = 1.2 +/- 0.1 SE L) simultaneously rated the sense of effort to breathe with both BC and VA scales during progressive, maximal exercise tests performed three to five times on a cycle ergometer. The VA scores correlated linearly with minute ventilation in all subjects in all trials (r = 0.98 +/- 0.01), and when converted to common units (i.e., Z scores) correlated closely with simultaneous scores obtained using the Borg scale (r = 0.99 +/- 0.01). Furthermore, VA scores varied minimally over several trials. Coefficient of variation for the maximal VA scores was 6 +/- 1%, which was similar to the variation in maximal Borg score (i.e., 3 +/- 1%). We conclude that the visual analogue scale is reproducible and correlates closely with the Borg score when scaling the sense of effort to breathe during exercise in subjects with stable chronic obstructive pulmonary disease.