Relationships between Dyspnea Management Strategies and Activities of Daily Living in Patients with Chronic Lung Diseases

Abstract

Purpose: The purpose of this study was to investigate dyspnea management strategies and activities of daily living (ADL) in patients with chronic lung diseases.
Method: This study was a cross-sectional design. Sixty-four subjects with chronic lung disease were included. These subjects had more than Grade 2 of dyspnea on the Medical Research Council Dyspnea Scale (MRC). Subjects' characteristics, dyspnea management strategies, and ADL in patients with chronic lung diseases were investigated.
Results: Most subjects constantly used “moving at own pace” and “slow movements” as dyspnea management strategies. A cluster analysis for dyspnea management strategies identified four clusters: Cluster I (“moving at own pace” type), II (“adjusting movements” type), III (“adjusting breathing” type), and IV (“adjusting movements and breathing” type). Cluster IV subjects had a higher grade of dyspnea and lower ADL scores compared with subjects of the other three clusters. However Cluster IV subjects could perform their ADL almost independently and there was no significant difference in quadriceps force among the four clusters. Of MRC Grade 2 subjects (n=20), eleven subjects used “slow movements” (slow-moving subjects). The slow-moving subjects showed significantly lower ADL scores compared with the non slow-moving subjects.
Conclusion: If patients had a higher grade of dyspnea, various dyspnea management strategies such as “adjusting movements and breathing” would be useful for maintaining their ADL. However, patients' ADL may decrease if they limit themselves to dyspnea management strategies which are like “slow movements.”