Comparison of laboratory- and field-based exercise tests for COPD: a systematic review

Abstract

Exercise tests are often used to evaluate the functional status of patients with COPD. However, to the best of our knowledge, a comprehensive systematic comparison of these tests has not been performed. We systematically reviewed studies reporting the repeatability and/or reproducibility of these tests, and studies comparing their sensitivity to therapeutic intervention. A systematic review identified primary manuscripts in English reporting relevant data on the following exercise tests: 6-minute walk test (6MWT) and 12-minute walk test, incremental and endurance shuttle walk tests (ISWT and ESWT, respectively), incremental and endurance cycle ergometer tests, and incremental and endurance treadmill tests. We identified 71 relevant studies. Good repeatability (for the 6MWT and ESWT) and reproducibility (for the 6MWT, 12-minute walk test, ISWT, ESWT, and incremental cycle ergometer test) were reported by most studies assessing these tests, providing patients were familiarized with them beforehand. The 6MWT, ISWT, and particularly the ESWT were reported to be sensitive to therapeutic intervention. Protocol variations (eg, track layout or supplemental oxygen use) affected performance significantly in several studies. This review shows that while the validity of several tests has been established, for others further study is required. Future work will assess the link between these tests, physiological mechanisms, and patient-reported measures.

Effects of heated and humidified high flow gases during high-intensity constant-load exercise on severe COPD patients with ventilatory limitation

“…Patients were asked to exercise on an "unloaded" cycle ergometer for up to 12 min, which is not the gold standard test to study the efficacy of a treatment [16]. Moreover oxygen was added to the mouthpiece at a certain predefined flow, which was kept constant during the test and the FiO 2 was measured only at rest.…”

Physiological Requirements to Perform the Glittre Activities of Daily Living Test by Subjects With Mild-to-Severe COPD

“…33,34 The shuttle test, despite less use than the 6MWT, also has the ability to measure physical capacity changes in COPD submitted to an intervention. 35 In addition, unsupported upper-limb tests could also describe the functionality of COPD patients 36 and could be taken alone or in conjunction with the 6MWT or shuttle test.…”

Effects of combined tiotropium/olodaterol on inspiratory capacity and exercise endurance in COPD

“…Improving dyspnoea and exercise tolerance are now recognised as important goals in the treatment of stable COPD [ 6 ], with the measurement of exercise endurance considered a valuable component of COPD assessment, particularly in response to treatment interventions [ 7 , 8 ]. Current trials of COPD treatments use a variety of exercise tests, such as the 6-min walk test, incremental and endurance shuttle walk tests, and cycle ergometry and treadmill tests [ 9 ]. In particular, constant work-rate cycle ergometry (CWRCE) is now often used in efficacy evaluations of long-acting bronchodilators because it allows a thorough evaluation of the physiological response during exercise and due to its documented responsiveness to treatment [ 8 , 10 ].…”