Stair Climbing in the Functional Assessment of Lung Resection Candidates

Abstract

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.

Measuring Health-Related Physical Fitness in Physiotherapy Practice: Reliability, Validity, and Feasibility of Clinical Field Tests and a Patient-Reported Measure

“…5,9,10,12,28,32,34,41,42 Patients seen by physiotherapists in outpatient clinics vary in terms of diagnosis and disease severity, and instruments for measuring physical fitness must, therefore, be applicable across diagnostic groups, age, gender, and physical fitness levels. The aim of this study was to examine reliability, validity, and feasibility of a core set of clinical field tests and a patient-reported measure reflecting health-related physical fitness in patients with a variety of MSCs.…”

Surgical risk tests related to cardiopulmonary postoperative complications: comparison between upper abdominal and thoracic surgery

“…Exercise tests can be those of maximal effort such as ergospirometry that measures the oxygen consumption (VO 2 ) 5 or submaximal effort such as stair-climbing test (SCT) [6][7][8][9][10][11][12][13][14][15] and six-minute walk test (6MWT) 9,16 .…”

Comparison of Two Stair Climbing Protocols for Smokers

“…However, studies to date have been limited by heterogeneity of stair climbing protocols and inadequate control of confounding factors [9,[17][18][19][20]. This study overcame some of these limitations.…”

“…Thus, stair climbing can provide economical aerobic training without specialized equipment [17][18][19][20] and has been recommended to alleviate America's and Europe's obesity epidemic [1,6,9,17]. However, studies to date have been limited by heterogeneity of stair climbing protocols and inadequate control of confounding factors [9,[17][18][19][20].…”