Critical outcomes in pulmonary rehabilitation: Assessment and evaluation of dyspnea and fatigue

Abstract—Dyspnea and fatigue, the two most common symp-toms experienced by patients with chronic obstructive pulmo-nary disease, are believed to result in decreased activity levels and poor quality of life. The primary measurable benefits of pulmonary rehabilitation to date have been a decrease in symp-toms (mainly dyspnea and fatigue) and an increase in exercise endurance. The precise means by which pulmonary rehabilita-tion improves these symptoms is not clear. The use of stan-dardized questionnaires to measure the changes associated with pulmonary rehabilitation is important if we are to under-stand the magnitude of improvement with the intervention and determine those who will benefit. This article reviews the mechanisms believed to contribute to these symptoms and the methods available for their measurement. Key words: symptoms; dyspnea; fatigue; chronic obstructive pulmonary disease (COPD); pulmonary rehabilitation, meas-urement, and assessment