Estimation of Ventilatory Reserve by Stair Climbing

Pollock, Mark; Roa, Jairo; Benditt, Joshua O.; Celli, Bartolomé R.

doi:10.1378/chest.104.5.1378

Cited by 104 publications

(17 citation statements)

References 24 publications

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“…Limited expertise, equipment and costs are required, and it has been reported that stair climbing yields greater values of V̇O 2 than cycle ergometry [6, 7, 12]. Previous studies focused mainly on absolute height achieved as a surrogate marker of either V̇O 2 M A X or the risk for major post-operative complications.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies focused mainly on absolute height achieved as a surrogate marker of either V̇O 2 M A X or the risk for major post-operative complications. Pollock et al[ 7] were the first to evaluate the use of symptom-limited stair climbing as a simple method to estimate the V̇O 2 M A X in patients with chronic obstructive pulmonary disease. They studied 31 men who climbed stairs until they stopped at their symptom-limited maximum.…”

Section: Discussionmentioning

confidence: 99%

“…The first step, as well as 12-, 17- and 20-metre elevations were clearly demarcated. The latter values were anticipated to be meaningful elevation cut-offs, based on previous studies [7,8,9]. …”

Section: Methodsmentioning

confidence: 99%

“…All patients were equally encouraged to give their best effort. Tests were performed according to the American Thoracic Society guidelines [10] and were comparable to previous studies in this field [2, 3, 6, 7]. The V̇O 2 P E A K was accepted as the V̇O 2 M A X in cases where a clear plateau was not observed, provided that all other criteria for maximal exercise were met.…”

Section: Methodsmentioning

confidence: 99%

“…The last 2 decades have seen a revival of this modality. Recent studies [5,6,7,8,9] have proposed various targets reached during stair climbing as surrogate markers of either V̇O 2 M A X or post-operative complications. These studies were unfortunately not standardised, and have not as yet altered clinical practice.…”

Section: Introductionmentioning

confidence: 99%

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Stair Climbing in the Functional Assessment of Lung Resection Candidates

Koegelenberg

Diacon²,

Irani³

et al. 2008

Respiration

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Background: Algorithms for the pre-operative evaluation of lung resection candidates with impaired lung function invariably include maximum oxygen uptake (v̇O₂MAX) as a critical parameter of functional reserves, with a v̇O₂MAX ≧20 ml/kg/min generally considered sufficient for pneumonectomy. Stair climbing is a low-cost alternative to assess exercise capacity. Objectives: As stair climbing is not standardised, we aimed to compare the altitude reached and the speed of ascent with v̇O₂MAX measured by cycle ergometry. Methods: We prospectively enrolled 44 pulmonary resection candidates (mean age: 47.6 ± 12.5 years) with an FEV₁ <80%. Patients were asked to climb as high and as fast as they could, to a maximum elevation of 20 m. The altitude reached and the average speed of ascent were compared to v̇O₂MAX. Results: Forty-three patients reached a 20-metre elevation. Thirteen of them, as well as the patient who did not reach this height, had a v̇O₂MAX <20 ml/kg/min. There was a linear correlation between speed of ascent and v̇O₂MAX/kg (R² = 0.67), but not between altitude and v̇O₂MAX/kg. All 24 patients with a speed ≧15 m/min had a v̇O₂MAX ≧20 ml/kg/min. Thirty-nine of 40 patients with a speed ≧12 m/min had a v̇O₂MAX ≧15 ml/kg/min. Conclusions: The average speed of ascent during stair climbing was an accurate semiquantitative predictor of v̇O₂MAX/kg, whereas altitude was not. We were able to identify potential cut-off values for lobectomy or pneumonectomy. Pending validation with clinical endpoints, stair climbing may replace formal exercise testing at much lower costs in a large proportion of lung resection candidates.