Does the Dyspnea Challenge detect changes in exertional breathlessness?

The intervention for this study will be Pulmonary and Heart Failure exercise rehabilitation and what impact the exercise training has on exertional dyspnea in the COPD and Heart Failure populations. Participants will be required to attend two-three visits to be part of this study, one-two visits pre-rehabilitation (depending if all exercise testing can be completed in one visit, fatigue limited) and one visit post-rehabilitation. Participants will complete a two-minute treadmill exercise test called the Dyspnea Challenge to assess exertional dyspnea pre and post an exercise training intervention. During the Dyspnea Challenge participants will walk at 80% of the pre-rehabilitation six minute walk test speed and at a grade that generates an exertional dyspnea score of at least 3-4 using the modified Borg Scale. The Pre-rehabilitation testing will be completed within 1 week prior to the commencement of exercise training. Following the exercise-based rehabilitation participants will repeat the Dyspnea Challenge at the same pre-rehabilitation treadmill speed and grade, with the primary outcome being the change in the end exercise dyspnea measured using the modified Borg Scale. Post-rehabilitation testing will be completed within 1 week of completion of the exercise program. Exercise training: Once to twice weekly dependent on the program participants undertake; group-based, 8-10 week exercise-based rehabilitation program run in an outpatient setting. Different rehabilitation sites run different length programs, same goes for number of sessions attended each week by participants. Participants don't select how many sessions they attend a week or for how long the program runs for this is standard for each site for all participants. Exercise training will be supervised by a physiotherapist and will be individually prescribed for each participant. Individualised exercise programs will be prescribed for intensity based off pre-rehabilitation exercise tests i.e. 6MWT. Participants will be exercising at a moderate to high intensity which is set off their pre-rehabilitation exercise tests and is monitored throughout the program using the Borg RPE. The exercise interventions will include aerobic, anaerobic, strength, core conditioning and stretching components based on the individual participants exercise goals and physical abilities. Examples of exercises frequently included: treadmill walking, cycling, light upper and lower limb resistance exercises. The supervised exercise training session should take approx. 45-60 min to complete. Participants are encouraged to complete a similar home exercise program 3-4 times a week additional to the supervised sessions. Participants will be monitored so that HR during training will be less than 90% of peak 6MWT HR, SaO2> 85% and RPE <13. If required, supplemental oxygen will be provided during exercise sessions to maintain SpO2> 85%. The number of exercise sessions attended by each participant over the 8-10 week intervention will be recorded.