Consistency of the language of breathlessness between recalled and experimentally induced breathlessness in adults who are obese

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Emerging evidence has suggested that the sensation of breathlessness includes domains for intensity, sensory quality (descriptors) and unpleasantness).The sensation of breathlessness differs between people with and without chronic medical conditions and is thought to reflect the different mechanisms initiating the sensation. While breathlessness is common in people who are overweight/ obese, to date, no previous study could be found which specifically describe the sensory quality of breathlessness in this population. It is unclear whether the sensation of breathlessness experienced by people who are overweight/obese is unpleasant and if so, does this unpleasant sensation encourage early cessation of physical activity. There is a difference in the sensory quality between recall and exercise-induced breathlessness in people with chronic pulmonary disease. This might be simply due to the difference in the context under which breathlessness was recalled or induced. However, influence of the memory, emotion, expectation, and other psychological factors could very well play a role. This uncontrolled pre-post design aims to determine whether the recalled sensation of breathlessness differs from the sensation induced by exercise in adults with overweight or obesity. Sixty people between the ages of 18 and 80 years with overweight /obesity (BMI kg/m2 >25) will be invited to participate in this study. Participants will be excluded if they have a prior diagnosis of heart disease, lung cancer, chronic obstructive pulmonary disease, memory or cognitive disorders or a visual disorder which limits the ability to interpret visual analogue scales. After height, body mass and body mass index have been assessed, participants will complete a structured interview for the sensation of breathlessness before and immediately after breathlessness in induced by a 2 minute step test. This interview includes assessment of breathlessness intensity (visual analogue scale), unpleasantness(visual analogue scale) and sensory quality (descriptors volunteered and selected from a pre-existing list of 15 breathlessness statements). Descriptive analysis (e.g. mean, standard deviation, frequency) are planned for age, gender, weight, height and BMI. Paired t-test will be performed between baseline and exercise-induced VAS scores to determine the degree of breathlessness induced by the 2-minute step test. The frequency of descriptors volunteered and endorsed by each subject will be allocated into sensory categories. Language data will then be converted to a binary form (subjects do or do not volunteer or endorse a particular language category). Within each sensory category, the difference between the recalled and exercise-induced language will be compared using McNemar’s test, with p < 0.05 regarded as significant.

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