Reliability and validity of 4-metre gait speed in COPD

Abstract

In community-dwelling older adults, usual gait speed over 4 m (4MGS) consistently predicts greater risk of adverse health outcomes. The aims of the present study were to assess the reliability of the 4MGS and the relationship with established health outcome measures in chronic obstructive pulmonary disease (COPD).Test-retest and interobserver reliability of the 4MGS were measured in 80 and 58 COPD patients, respectively. In 586 COPD patients, the 4MGS, as well as forced expiratory volume in 1 s (FEV1), the incremental shuttle walk (ISW), Medical Research Council (MRC) dyspnoea scale and St George's Respiratory Questionnaire (SGRQ) were measured. Participants were stratified according to ''slow'' (,0.8 m?s -1 ) or ''normal'' 4MGS (o0.8 m?s -1 ). Intra-class correlation coefficients for test-retest and interobserver reliability were 0.97 and 0.99, respectively. There was a significant positive correlation between 4MGS with ISW (r50.78; p,0.001) and a negative correlation with MRC dyspnoea scale and SGRQ (r5 -0.55 and -0.44; p,0.001 for both). COPD patients with slow 4MGS had significantly reduced ISW and higher MRC dyspnoea scale and SGRQ than those with preserved walking speed, despite similar FEV1 % predicted.The 4MGS is reliable in COPD, correlates with exercise capacity, dyspnoea and health-related quality of life, and has potential as a simple assessment tool in COPD. @ERSpublications The 4-metre gait speed test is reliable and valid as a simple assessment tool in chronic obstructive pulmonary disease

Determinants of Gait Speed in COPD

“…Th is sim ple measure may provide guidance on the need to perform a 6MWT, trigger discussion regarding referral for pulmonary rehabilitation, or help the clinician in overall patient assessment. We extend the fi ndings of a recent report 12 stating the association between gait speed and the shuttle walk test as a measure of exercise capacity by investigating the determinants of gait speed and evaluating a more comprehensive set of variables believed to infl uence gait speed, including objectively measured physical activity and one of the most commonly implemented measures of exercise capacity, the 6MWT. Th e value of 6MWT in daily offi ce care of COPD, and for that matter in cardiopulmonary disease, is unquestionable.…”

“…Although gait speed has been associated with exercise capacity in COPD as measured by the shuttle test, 12 knowledge gaps still exist regarding the association of gait speed with numerous clinically meaningful factors in COPD. Th e relationship between gait speed and daily physical activity level, general perception of health, cognitive function, mindfulness, and mood states is yet to be determined.…”

Measuring Gait Speed in the Out-Patient Clinic: Methodology and Feasibility

“…Recent studies have shown a link between gait speed and exercise capacity for patients with COPD. 12,13 However, those studies did not evaluate the several commonly described gait speed protocols and have not established the effect of distance walked, pace, or timing methods on the reliability and reproducibility of gait speed results in patients with COPD. Prior studies using fast pace 14,15 have not investigated the commonly used distances (4 and 10 meters) or the possible timing systems.…”

Neural respiratory drive and cardiac function in patients with obesity hypoventilation syndrome following initiation of non-invasive ventilation

“…Blood tests included the full blood count, the renal profile, thyroid stimulating hormone (TSH), N-terminal pro-brain natriuretic peptide (NT-proBNP), glucose and a radial artery blood gas (ABG) analysis. At baseline, a nocturnal transcutaneous oximetry and capnography (TCM TOSCA, Radiometer Medical ApS, Bronshoj/Denmark) and a walking test (4-metre gait speed) were performed (32). EMGpara and TTE were measured prior to NIV setup.…”