title: Dalhousie Pictorial Scales Measuring Dyspnea and Perceived Exertion during Exercise for Children and Adolescents.
abstract: BACKGROUND
  Alternative scales to measure dyspnea and perceived exertion have been sought due to concerns regarding understanding and validity of any Borg scale in pediatric populations.
  
  
  OBJECTIVE
  To demonstrate content validity of Dalhousie Dyspnea and Perceived Exertion Scales developed for children and adolescents.
  
  
  METHODS
  We obtained ratings for dyspnea and perceived exertion using both Borg CR-10 and Dalhousie Scales during incremental cycle exercise in 100 children and adolescents, healthy or with respiratory disease. Content validity was determined by correlating perceived leg exertion rating versus heart rate or %peak work capacity and dyspnea rating versus ventilation expressed as %peak ventilation. The stimulus-perceptual response was modeled as a quadratic function with a delay term. Reproducibility, cross-modality usage, and language effects were assessed in a small group of Italian children during treadmill exercise.
  
  
  RESULTS
  Pictorial ratings of dyspnea and perceived exertion measured by both scale ratings rose as expected with increasing exercise intensity in children and adolescents, demonstrating excellent correlation between perceived leg exertion versus exercise intensity and dyspnea rating versus ventilation (median Spearman ρ ≥ 0.9) with either scale. There were no systematic differences in dyspnea or perceived exertion ratings between children with or without respiratory disease. Understandability and reproducibility of the Dalhousie scales was affirmed in Italian-speaking subjects performing treadmill exercise.
  
  
  CONCLUSIONS
  Dalhousie Dyspnea and Perceived Exertion Scales offer an alternative to the Borg scale for use during exercise in pediatric subjects. Children and adolescents exhibit large variation in patterns of ratings of dyspnea and perceived exertion in incremental exercise.
authors.affiliation: 1 Department of Pediatric and Adolescent Medicine.
authors.forename: Paolo T
authors.initials: PT
authors.lastname: Pianosi
authors.forename: Marianne
authors.initials: M
authors.lastname: Huebner
authors.forename: Zhen
authors.initials: Z
authors.lastname: Zhang
authors.forename: Attilio
authors.initials: A
authors.lastname: Turchetta
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: McGrath
mesh_terms: D000293:Adolescent; D002648:Child; D004417:Dyspnea / Q000175:diagnosis / Q000503:physiopathology*; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D010101:Oxygen Consumption / Q000502:physiology; D010465:Perception; D005082:Physical Exertion / Q000502:physiology*; D015203:Reproducibility of Results; D012720:Severity of Illness Index
keywords: pediatric; psychophysical function; rating scale