Six-minute walking versus shuttle walking: responsiveness to bronchodilation in chronic obstructive pulmonary disease

Pepin, Véronique; Brodeur, Jean‐Marc; Lacasse, Yves; Milot, Julie; Leblanc, Pierre; Whittom, François; Maltais, François

doi:10.1136/thx.2006.065540

Cited by 117 publications

(172 citation statements)

References 34 publications

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“…This is probably due to the differences between these two exercise modalities. In comparison with cycling, walking has been shown to be less fatiguing and to produce less lactate at similar V9O 2 levels [19][20][21]. Hence, patients are able to exercise for longer periods.…”

Section: Discussionmentioning

confidence: 99%

Cardiopulmonary stress during exercise training in patients with COPD

Probst¹

2006

European Respiratory Journal

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Exercise training is an essential component of pulmonary rehabilitation. However, the cardiopulmonary stress imposed during different modalities of exercise training is not yet known.In the present study, the cardiopulmonary stress of a 12-week exercise training programme in 11 chronic obstructive pulmonary disease (COPD) patients (forced expiratory volume in one second 42¡12%pred, age 69¡6 yrs) was measured. Pulmonary gas exchange and cardiac frequency (fC) of three training sessions were measured with a portable metabolic system at the beginning, mid-term and end of the programme. Symptoms were assessed with Borg scores.The exercise intensity was compared with the recommendations for exercise training by the American College of Sports Medicine (ACSM). Training effects were significant (maximum change in work: 14¡11 Watts, 6-min walk test: 44¡36 m). Whole body exercises (cycling, walking and stair climbing) consistently resulted in higher cardiopulmonary stress (oxygen uptake (V9O 2 ), minute ventilation and fC) than arm cranking and resistance training. Dyspnoea was higher during cycling than resistance training. Patients exercised for .70% (.20 min) of the total exercise time at .40% of the V9O 2 reserve and fC reserve (''moderate'' intensity according to the ACSM) throughout the programme.The cardiopulmonary stress resistance training is lower than during whole-body exercise and results in fewer symptoms. In addition, exercise testing based on guidelines using a fixed percentage of baseline peak performance and symptom scores achieves and sustains training intensities recommended according to the American College of Sports Medicine.

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Section: Discussionmentioning

confidence: 99%

Cardiopulmonary stress during exercise training in patients with COPD

Probst¹

2006

European Respiratory Journal

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“…The randomness of this variability suggests that it was not related to a learning effect, as confirmed by the Bland-Altman plot. The issue about intraindividual variability in exercise performance was previously discussed for the ESWT [12,[19][20][21], but also for constant work-rate cycling exercise [22]. REVILL et al [21] reported greater variability in ESWT performance with longer endurance time.…”

Section: Reproducibility Of Eswt Performancementioning

confidence: 99%

“…As such, measuring the endurance to constant load exercise has been an important objective of several clinical trials evaluating the impact of pharmacological or rehabilitative interventions in COPD [3][4][5]. In this context, the endurance shuttle walking test (ESWT) is gaining acceptance due to its minimal requirement for equipment, low cost and ease of administration [6], and to its responsiveness and sensitivity to interventions, at least in single centre studies [7][8][9][10][11][12]. With the advancement of portable cardiopulmonary monitoring, it is also possible to obtain a thorough physiological assessment during the ESWT.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2014

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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

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“…A large rehabilitation study reported mean changes of 75.9 m [281]. In a large group of patients with COPD, the SWT was sensitive to the administration of formoterol and ipratopium bromide [283,284]. The endurance SWT (ESWT) seems more sensitive to change after a course of rehabilitation than the ISWT.…”

Section: Walking Testsmentioning

confidence: 99%

Recommendations on the use of exercise testing in clinical practice

Palange¹,

Ward²,

Carlsen³

et al. 2006

European Respiratory Journal

549

390

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Evidence-based recommendations on the clinical use of cardiopulmonary exercise testing (CPET) in lung and heart disease are presented, with reference to the assessment of exercise intolerance, prognostic assessment and the evaluation of therapeutic interventions (e.g. drugs, supplemental oxygen, exercise training). A commonly used grading system for recommendations in evidence-based guidelines was applied, with the grade of recommendation ranging from A, the highest, to D, the lowest.For symptom-limited incremental exercise, CPET indices, such as peak O 2 uptake (V9O 2 ), V9O 2 at lactate threshold, the slope of the ventilation-CO 2 output relationship and the presence of arterial O 2 desaturation, have all been shown to have power in prognostic evaluation. In addition, for assessment of interventions, the tolerable duration of symptom-limited high-intensity constant-load exercise often provides greater sensitivity to discriminate change than the classical incremental test. Field-testing paradigms (e.g. timed and shuttle walking tests) also prove valuable.In turn, these considerations allow the resolution of practical questions that often confront the clinician, such as: 1) ''When should an evaluation of exercise intolerance be sought?''; 2) ''Which particular form of test should be asked for?''; and 3) ''What cluster of variables should be selected when evaluating prognosis for a particular disease or the effect of a particular intervention?''

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Six-minute walking versus shuttle walking: responsiveness to bronchodilation in chronic obstructive pulmonary disease

Cited by 117 publications

References 34 publications

Cardiopulmonary stress during exercise training in patients with COPD

Cardiopulmonary stress during exercise training in patients with COPD

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

Recommendations on the use of exercise testing in clinical practice

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