The 6-minute stepper test and the sit-to-stand test predict complications after major pulmonary resection via minimally invasive surgery: a prospective inception cohort study

Boujibar, Fairuz; Gillibert, André; Bonnevie, Tristan; Rinieri, Philippe; Montagne, François; Selim, Jean; Cuvelier, A.; Gravier, Francis‐Edouard; Baste, Jean-Marc

doi:10.1016/j.jphys.2022.03.001

Cited by 10 publications

(14 citation statements)

References 24 publications

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“…In addition, a significant improvement in 5STS was found after the HBEP, indicating better lower limb functional strength. This is consistent with the findings of Coats et al (2013), who observed an improvement in hamstring strength following home-based exercise training [26] and is of clinical importance since poor preoperative performance in the sit-to-stand test increases the risk of complications after lung cancer resection [81].…”

Section: Discussionsupporting

confidence: 89%

Home-Based Preoperative Exercise Training for Lung Cancer Patients Undergoing Surgery: A Feasibility Trial

Machado

Pimenta

Garcia

et al. 2023

JCM

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Background: Clinical guidelines recommend prehabilitation with exercise training to optimize recovery after lung cancer surgery. However, the lack of access to facility-based exercise programs is a major barrier to routine participation. This study aimed to assess the feasibility of a home-based exercise intervention before lung cancer resection. Methods: We conducted a prospective, two-site feasibility study, including patients scheduled for lung cancer surgery. Exercise prescription involved aerobic and resistance training with telephone-based supervision. The primary endpoint was overall feasibility (recruitment rate, retention rate, intervention adherence and acceptability). Secondary endpoints included safety and effects on health-related quality of life (HRQOL) and physical performance, evaluated at baseline, after the exercise intervention and 4–5 weeks after surgery. Results: Over three months, 15 patients were eligible, and all agreed to participate (recruitment rate: 100%). A total of 14 patients completed the exercise intervention, and 12 patients were evaluated postoperatively (retention rate: 80%). The median length of the exercise intervention was 3 weeks. Patients performed an aerobic and resistance training volume higher than prescribed (median adherence rates of 104% and 111%, respectively). A total of nine adverse events occurred during the intervention (Grade 1, n = 8; Grade 2, n = 1), the most common being shoulder pain. After the exercise intervention, significant improvements were observed in the HRQOL summary score (mean difference, 2.9; 95% confidence interval [CI], from 0.9 to 4.8; p = 0.049) and the five-times sit-to-stand test score (median difference, −1.5; 95% CI, from −2.1 to −0.9; p = 0.001). After surgery, no significant effects on HRQOL and physical performance were observed. Conclusion: A short-term preoperative home-based exercise intervention is feasible before lung cancer resection and may enhance accessibility to prehabilitation. Clinical effectiveness should be investigated in future studies.

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Section: Discussionsupporting

confidence: 89%

Home-Based Preoperative Exercise Training for Lung Cancer Patients Undergoing Surgery: A Feasibility Trial

Machado

Pimenta

Garcia

et al. 2023

JCM

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“…After multivariable analysis no significant association between sarcopenia and increased time for the 4 m walking test or sit to stand test was found. This is surprising as both walking and sit to stand tests are often used to determine sarcopenia and physical frailty preoperatively 21,22 . Although the outcomes of these tests can be influenced by a multitude of factors in the postoperative period, further investigation is required to determine whether these tests are indeed a valid surrogate metric for objectively defined muscle mass.…”

Section: Discussionmentioning

confidence: 99%

Validity of computed tomography defined body composition as a prognostic factor for functional outcome after kidney transplantation

Swaab,

Quint,

Westenberg

et al. 2023

J cachexia sarcopenia muscle

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BackgroundThe prevalence of sarcopenia is markedly higher in kidney transplant candidates than in the general population. It is a syndrome characterized by progressive and generalized loss of skeletal muscle mass and strength, which increases the risk of adverse postoperative outcomes.MethodsWe studied the impact of computed tomography defined preoperative sarcopenia, defined as a skeletal muscle index below age and gender specific cut‐off values, on postoperative physical functional outcomes (grip strength, 4‐m walking test, timed up and go, and sit to stand) at 6 months follow up.ResultsA total of 107 patients transplanted between 2015 and 2019 were included in this single‐centre study. Mean age was 60.3 (±13.1), and 68.2% of patients were male. Ten patients (9.4%) were identified as sarcopenic. Sarcopenic patients were younger (55.6 (±15.1) vs. 60.8 (±12.9) years), more likely to be female (60.0% vs. 28.9%), and had an increased dialysis vintage (19 [2.5–32.8] vs. 9 [0.0–21.0] months) in comparison with their non‐sarcopenic counterparts. In univariate analysis, they had a significantly lower body mass index and skeletal muscle area (P ≤ 0.001). In multivariate regression analysis, skeletal muscle index was significantly associated with grip strength (β = 0.690, R2 = 0.232) and timed up and go performance (β = −0.070, R2 = 0.154).ConclusionsWe identified a significant association between sarcopenia existing pre‐transplantation and poorer 6 months post‐transplantation physical functioning with respect to hand grip strength and timed up and go tests in kidney transplant recipients. These results could be used to preoperatively identify patients with an increased risk of poor postoperative physical functional outcome, allowing for preoperative interventions to mitigate these risks.

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“…Among the 14 included studies, 12 studies reported that the American Thoracic Society guideline was used to perform the 6-min step test, and two studies did not report which recommendations were used during the test. 44,48 Although all studies reported that the test duration was 6 min, only five studies (36%) 37,38,40,46,47 reported the other two criteria in accordance with the test recommendations. Two studies (14%) 41,42 did not use a 20-cm step and 9 studies (64%) either did not allow upper limb support (five studies; 36%), 22,36,39,42,45,49 or did not provide information related to upper limb support (four studies; 28%).…”

Section: Characteristics Of Included Trialsmentioning

confidence: 99%

“…Seventeen papers failed to meet the inclusion criteria (see Supplemental Material for a summary of the excluded papers), leaving 15 papers to be included. 22,27,[36][37][38][39][40][41][42][43][44][45][46][47][48] Two papers 22,36 had the same sample and were, therefore, reported as a single study (Figure 3). Therefore, 14 studies were analyzed in this systematic review.…”

Section: Flow Of Trials Through the Reviewmentioning

confidence: 99%

“…The mean age of the participants ranged from 35 to 68 years old across studies. Five studies included participants with chronic obstructive pulmonary disease, 22,36,[37][38][39][40] three studies included participants with obesity, [41][42][43] two studies included participants with obstructive sleep apnea, 44,45 and the remaining four studies included participants with pulmonary resection, 46 stroke, 47 heart failure, 27 and cardiac diseases 48 (Table 1).…”

Section: Characteristics Of Included Trialsmentioning

confidence: 99%

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Procedures and measurement properties of the 6-min step test: A systematic review with clinical recommendations

Boening,

Scianni,

Martins

et al. 2024

Clin Rehabil

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Objective To provide information regarding the procedures, safety, tolerability, and measurement properties of the 6-min step test. Data sources MEDLINE, EMBASE, CINAHL, and SPORTDiscus (from inception until January 2024). Review methods Studies that examined adults with acute or chronic diseases, and outcomes related to procedures, safety, tolerability, or measurement properties of the 6-min step test were included. Outcome data were summarized and combined in meta-analyses. The quality of included studies was assessed by the Consensus-based Standards for the selection of health Measurement Instruments checklist, and the quality of evidence was determined according to the Grading of Recommendations Assessment, Development, and Evaluation system. Results Fourteen studies, involving 847 participants, were included. All studies performed the 6-min step test in 6 min; however, some studies varied the step height and the use of upper limb support. The test appears to be safe and well tolerated by individuals. Moderate- to high-quality evidence demonstrated appropriate results for test-retest reliability (4 studies; Intraclass correlation coefficient 0.96; 95% CI 0.91–0.98; n = 125), criterion validity (4 studies; r = 0.53; 95% CI 0.30–0.71; n = 307), and construct validity (4 studies; r = 0.63; 95% CI 0.52–0.73; n = 233). Conclusion This review provides recommendations for applying the 6-min step test in clinical and research settings. No adverse events were reported, and the test appears to be well tolerated. Adequate results were found for test-retest reliability, criterion validity, and construct validity. Review Registration PROSPERO (CRD42022347744).

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The 6-minute stepper test and the sit-to-stand test predict complications after major pulmonary resection via minimally invasive surgery: a prospective inception cohort study

Cited by 10 publications

References 24 publications

Home-Based Preoperative Exercise Training for Lung Cancer Patients Undergoing Surgery: A Feasibility Trial

Home-Based Preoperative Exercise Training for Lung Cancer Patients Undergoing Surgery: A Feasibility Trial

Validity of computed tomography defined body composition as a prognostic factor for functional outcome after kidney transplantation

Procedures and measurement properties of the 6-min step test: A systematic review with clinical recommendations

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