Prospective validation of the endurance shuttle walking test in the context of bronchodilation in COPD

Abstract

This study focused on repeatability data and minimal important difference (MID) estimates of the endurance shuttle walking test (ESWT).255 chronic obstructive pulmonary disease patients (forced expiratory volume in 1 s 54.7¡13.2% predicted) completed four ESWTs at different times during the 8-week study: two under baseline conditions with tiotropium (1 week apart), one after a single dose and one after 4 weeks of either fluticasone propionate/salmeterol combination or placebo in addition to tiotropium. 97 patients performed all the tests with a portable metabolic system. Reproducibility of test performance and cardiorespiratory response was investigated with the data obtained on the first two ESWTs.The mean differences between the first two ESWT performances (-6.7¡72.2 s and -7.3¡113.1 m for endurance time and walking distance, respectively) were not statistically significant. The between-test end-exercise and isotime values for each cardiorespiratory parameter were not significantly different from each other. With the exception of arterial oxygen saturation by pulse oximetry, the repeatability of cardiorespiratory adaptations to ESWT was also confirmed with strong Pearson and intraclass correlation coefficients. Finally, changes of 56-61 s and 70-82 m in endurance time and distance walked, respectively, were perceived by patients.This study provides methodological information supporting the reliability of the ESWT and suggests MID estimates for this test.@ERSpublications This study provides a prospective validation of ESWT reliability and minimal important difference in COPD

Use of exercise testing in the evaluation of interventional efficacy: an official ERS statement

“…These ESWT changes represented 13-15% of baseline values. These figures were confirmed by the same authors in a multicentre trial including 255 patients in which changes of 56-61 s and 70-82 m in ESWT were perceived by the participants as relevant [194] (table 2).…”

“…Thus, coefficient of variations have been reported to range between 60% and 120% of the corresponding means [174,[194][195][196][197][198]. While no recommendation on how to adjust test duration has yet been proposed, it is reasonable to assume that the range of baseline test durations used for the CWRET is desirable (i.e.…”

“…15 s) and nonsignificant [194,201,202]. In a recent multicentre clinical trial involving 255 moderate-to-severe COPD patients, the mean±SD differences between the first two ESWT performances (−7±72 s and −7±113 m for endurance time and distance, respectively) were not statistically significant [194] (table 2).…”

Paediatrics: messages from Munich

“…In a separate study, E ngelkes et al . [25] found that LABA monotherapy was decreasing but, despite the guidelines, the prevalence remains at 1.44 per 100 per year. Although few studies have addressed clinical effectiveness in childhood asthma, research of this kind gives a major insight into the problem and may be complimentary to the results reported in randomised controlled trials.…”

Programas de rehabilitación respiratoria en pacientes con enfermedad pulmonar obstructiva crónica. Eficacia de distintas modalidades de enfrentamiento en el mantenimiento de los beneficios a largo plazo y la modificación del nivel de actividad física = Respiratory rehabilitation programs in patients with chronic obstructive pulmonary disease. Effectiveness of different modalities of training in maintaining long-term benefits and modifying the level of physical activity

“…En nuestro estudio, tanto la distancia como el tiempo alcanzados en el EST se duplicaron en relación al valor basal y superaron ampliamente la MCID (277,281). Estos resultados significan que los cambios obtenidos fueron percibidos como una mejoría clínica por los pacientes.…”