Relationship between field walking tests and incremental cycle ergometry in COPD

Luxton, Nia; Alison, Jennifer A.; Wu, Judy; Mackey, Martin

doi:10.1111/j.1440-1843.2008.01355.x

Cited by 125 publications

(136 citation statements)

References 31 publications

(47 reference statements)

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“…In a study by POULAIN et al [16], 28% of patients with COPD exhibited desaturation on 6MWT that was not observed on CPET. Other authors have reported similar findings [35,37,38]. The phenomenon was reproducible and not protocol dependent, emphasising the clinical interest of the 6MWT [16].…”

Section: Oxyhaemoglobin Saturationsupporting

confidence: 69%

An official systematic review of the European Respiratory Society/American Thoracic Society: measurement properties of field walking tests in chronic respiratory disease

Singh¹,

Puhan²,

et al. 2014

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This systematic review examined the measurement properties of the 6-min walk test (6MWT), incremental shuttle walk test (ISWT) and endurance shuttle walk test (ESWT) in adults with chronic respiratory disease.Studies that report the evaluation or use of the 6MWT, ISWT or ESWT were included. We searched electronic databases for studies published between January 2000 and September 2013.The 6-min walking distance (6MWD) is a reliable measure (intra-class correlation coefficients ranged from 0.82 to 0.99 in seven studies). There is a learning effect, with greater distance walked on the second test (pooled mean improvement of 26 m in 13 studies). Reliability was similar for ISWT and ESWT, with a learning effect also evident for ISWT (pooled mean improvement of 20 m in six studies). The 6MWD correlates more strongly with peak work capacity (r50.59-0.93) and physical activity (r50.40-0.85) than with respiratory function (r50.10-0.59). Methodological factors affecting 6MWD include track length, encouragement, supplemental oxygen and walking aids. Supplemental oxygen also affects ISWT and ESWT performance. Responsiveness was moderate to high for all tests, with greater responsiveness to interventions that included exercise training.The findings of this review demonstrate that the 6MWT, ISWT and ESWT are robust tests of functional exercise capacity in adults with chronic respiratory disease. OverviewThe aim of this systematic review was to examine the measurement properties for the 6-min walk test (6MWT), incremental shuttle walk test (ISWT) and endurance shuttle walk test (ESWT) in adults with chronic respiratory disease. A companion paper describes the standard operating procedures for the tests [1]. The key findings of this systematic review are as follows.1) The 6-min walking distance (6MWD) is a valid and reliable measure of exercise capacity for people with chronic lung disease. The 6MWD correlates more strongly with measures of peak work capacity and physical activity than with respiratory function or quality of life, which supports its conceptualisation as a test of functional exercise performance.2) The ISWT offers a different protocol to the 6MWT as it is incremental and externally paced. The ISWT is a valid and reliable measure of cardiopulmonary exercise capacity in chronic obstructive pulmonary disease (COPD), where there is a strong relationship between ISWT distance and peak oxygen uptake (V9O 2 peak) or work rate on a cardiopulmonary exercise test (CPET).3) A learning effect is observed for the 6MWT and the ISWT. The second test usually is the better compared with the first, but this is inconsistent.4) The ESWT is a test of endurance capacity. It is externally paced and is performed along the same course as the ISWT. Two tests do not appear to be necessary if the second test is conducted on the same day.5) Reference equations have been proposed for the 6MWD and the ISWT. Age, height and weight are included in most equations. The influence of race and ethnicity is unclear.6) The safety profile of ...

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Section: Oxyhaemoglobin Saturationsupporting

confidence: 69%

An official systematic review of the European Respiratory Society/American Thoracic Society: measurement properties of field walking tests in chronic respiratory disease

Singh¹,

Puhan²,

et al. 2014

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“…The 6MWD may reflect the maximum exercise capacity, as do peak work rate and ISWT. 26,27 On the other hand, ET measures the ability to sustain submaximal exercise capacity. 10 ET can improve even if there is no significant increase in maximum exercise capacity.…”

Section: Discussionmentioning

confidence: 99%

Endurance Time Is the Most Responsive Exercise Measurement in Idiopathic Pulmonary Fibrosis

et al. 2013

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BACKGROUND: Although pulmonary rehabilitation (PR) has been reported to improve exercise capacity in patients with idiopathic pulmonary fibrosis, it is unknown which exercise measurement is the most responsive for evaluation of PR efficacy. The purpose of this study was to compare the responsiveness of 5 exercise measurements by evaluating the efficacy of PR in subjects with idiopathic pulmonary fibrosis. METHODS: We conducted a prospective observational study in which 53 subjects with idiopathic pulmonary fibrosis were enrolled. The PR group underwent a 10-week out-patient PR program. The control group was observed without any additional intervention, including PR. Five exercise measurements (endurance time [ET], peak work rate, peak oxygen consumption [V O 2 ], 6-min walk distance, and incremental shuttle walk distance) were evaluated at baseline and after 10 weeks. The effect size was used for the assessment of responsiveness. RESULTS: In each group, 24 subjects completed the 5 measurements at baseline and after 10 weeks. The changes in ET (PR: 181.6%; control: ؊8.2%), peak V O 2 (PR: 7.6%; control: ؊5.4%), peak work rate (PR: 15.1%; control: ؊5.1%), 6-min walk distance (PR: 6.0%; control: ؊3.8%), and incremental shuttle walk distance (PR: 9.1%; control: ؊5.1%) were significantly different between the groups after 10 weeks (P < .05). In the PR group, ET showed the most striking improvement among the 5 measurements (P < .05), and its effect size was as large as 2.96, whereas those of the others were all < 0.5. CONCLUSIONS: ET is the most responsive exercise measurement for evaluating PR efficacy in patients with idiopathic pulmonary fibrosis.

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“…31 In addition, the correlation we observed between number of steps and peak work load in the cycling test (r ϭ 0.69) was similar to that reported in studies of peak work load in the 6-min walk test versus the shuttle test. 32,33 Therefore the number of steps climbed in the Chester step test can be representative of functional performance, and, when tests that require long corridors are unfeasible, step tests may be an alternative. However, further studies are needed to establish a better incremental pattern for patients with chronic respiratory diseases, once it has been demonstrated that variations of incremental size affect exercise time in patients with COPD.…”

Section: Discussionmentioning

confidence: 99%

Chester Step Test in Patients With COPD: Reliability and Correlation With Pulmonary Function Test Results

et al. 2011

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BACKGROUND:The 5-stage Chester step test assesses aerobic capacity in healthy subjects. It has not been tested in patients with COPD. OBJECTIVE: To determine the reliability of the Chester step test in patients with COPD and correlation with pulmonary function test and exercise test results. METHODS: Thirty-two patients (mean ؎ SD FEV 1 46 ؎ 15% of predicted) undertook 2 Chester step tests and two 6-min walk tests, on different days, in random order. A subgroup of 11 patients performed incremental cycle ergometry. RESULTS: Thirty-one patients performed stage 1 of the Chester step test. Nineteen patients performed stage 2 of the Chester step test. The number of steps was highly reproducible: 66 ؎ 41 steps vs 68 ؎ 41 steps. There was no difference in heart rate or S pO 2 between the 2 Chester step tests at the peak of exercise or at the end of each stage. There was a significant correlation between number of steps and FEV 1 (r ‫؍‬ 0.43, P ‫؍‬ .02), and 6-min walk distance (r ‫؍‬ 0.60, P ‫؍‬ .001). Heart rate increased according to advanced stages of the Chester step test, up to 81 ؎ 13% of predicted. There was a significant correlation between number of steps and peak heart rate (r ‫؍‬ 0.55, P ‫؍‬ .001). In the 11 patients who performed the incremental cycling test there was a significant correlation between number of steps and peak work load (r ‫؍‬ 0.69, P ‫؍‬ .02). In the 6 patients in whom oxygen uptake could be estimated from the Chester step test, oxygen uptake was higher than that measured at the peak of the cycling test (30.8 ؎ 5.1 mL/kg/min vs 17.4 ؎ 4.5 mL/kg/min, respectively, P ‫؍‬ .001). CONCLUSIONS: Despite being highly reproducible, the Chester step test had a very short duration in patients with COPD. The number of steps incremented in each stage seems to be too large for these patients. An adaptation of the Chester step test should be considered for patients with COPD.

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Relationship between field walking tests and incremental cycle ergometry in COPD

Abstract: The significant relationships found between the three exercise tests, and the regression equations predicting peak work rate on the CET from the 6MWT or the ISWT, may allow for the estimation of intensity of cycle exercise training from walk tests in COPD patients.

Cited by 125 publications

References 31 publications

An official systematic review of the European Respiratory Society/American Thoracic Society: measurement properties of field walking tests in chronic respiratory disease

An official systematic review of the European Respiratory Society/American Thoracic Society: measurement properties of field walking tests in chronic respiratory disease

Endurance Time Is the Most Responsive Exercise Measurement in Idiopathic Pulmonary Fibrosis

Chester Step Test in Patients With COPD: Reliability and Correlation With Pulmonary Function Test Results

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