The Short-term Effect of a Rollator on Functional Exercise Capacity Among Individuals With Severe COPD

Solway, Sherra; Brooks, Dina; Lau, Louis; Goldstein, Roger

doi:10.1378/chest.122.1.56

Cited by 82 publications

(42 citation statements)

References 31 publications

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“…Given the impact of encouragement on 6MWD [33] and the use of encouraged tests in the generation of reference equations [1], it is recommended that standardised phrases of encouragement are used (see later section on the testing protocol for 6MWT). Provision of supplemental oxygen [26][27][28][29], method for carrying the supplemental oxygen [31,32] and use of wheeled walkers [20][21][22][23][24][25] also have an important impact on 6MWD. These factors must be kept constant on repeat testing.…”

Section: Methodological Factors Affecting Test Performancementioning

confidence: 99%

An official European Respiratory Society/American Thoracic Society technical standard: field walking tests in chronic respiratory disease

Holland¹,

Spruit²,

Troosters³

et al. 2014

Eur Respir J

1,835

1,555

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Field walking tests are commonly employed to evaluate exercise capacity, assess prognosis and evaluate treatment response in chronic respiratory diseases. In recent years, there has been a wealth of new literature pertinent to the conduct of the 6-min walk test (6MWT), and a growing evidence base describing the incremental and endurance shuttle walk tests (ISWT and ESWT, respectively). The aim of this document is to describe the standard operating procedures for the 6MWT, ISWT and ESWT, which can be consistently employed by clinicians and researchers.The Technical Standard was developed by a multidisciplinary and international group of clinicians and researchers with expertise in the application of field walking tests. The procedures are underpinned by a concurrent systematic review of literature relevant to measurement properties and test conduct in adults with chronic respiratory disease.Current data confirm that the 6MWT, ISWT and ESWT are valid, reliable and responsive to change with some interventions. However, results are sensitive to small changes in methodology. It is important that two tests are conducted for the 6MWT and ISWT.This Technical Standard for field walking tests reflects current evidence regarding procedures that should be used to achieve robust results. OverviewThe aim of this Technical Standard is to document the standard operating procedures for the 6-min walk test (6MWT), incremental shuttle walk test (ISWT) and endurance shuttle walk test (ESWT) in adults with chronic respiratory disease. The testing procedures were developed by a multinational and multidisciplinary group of experts in field exercise testing, informed by a systematic review of the measurement properties and interpretation of the 6MWT, ISWT and ESWT in adults with chronic respiratory disease [1].The key findings of the Technical Standard are as follows.1) The 6-min walking distance (6MWD), ISWT and ESWT demonstrate good construct validity. Strong relationships with measures of exercise performance and physical activity support their conceptualisation as tests of functional exercise performance.2) A lower 6MWD is strongly associated with increased risk of hospitalisation and mortality in people with chronic respiratory disease, with a small number of studies suggesting a similar relationship for the ISWT.3) The 6MWD, ISWT and ESWT exhibit good test-retest reliability; however, there is strong evidence of a learning effect for the 6MWT and ISWT. Two tests should be performed when the 6MWT or ISWT are used to measure change over time.4) The 6MWD, ISWT and ESWT are responsive to treatment effects in people with chronic respiratory disease; however, most studies have evaluated responsiveness to rehabilitation and fewer data are available to confirm responsiveness to other interventions.5) The 6MWD and ISWT elicit a peak oxygen uptake (V9O 2 peak) that is similar to that during a cardiopulmonary exercise test (CPET). As a result, the contraindications and precautions for field testing should be consistent with those ...

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Section: Methodological Factors Affecting Test Performancementioning

confidence: 99%

An official European Respiratory Society/American Thoracic Society technical standard: field walking tests in chronic respiratory disease

Holland¹,

Spruit²,

Troosters³

et al. 2014

Eur Respir J

1,835

1,555

View full text Add to dashboard Cite

show abstract

“…Six studies investigated the effect of a walking aid on 6MWD in people with COPD [90][91][92][93][94][95]. In all five studies investigating the effect of rollators, there was an improvement in 6MWD, ranging 2-46 m or 1-14% (weighted mean 6.2% improvement).…”

Section: Walking Aidmentioning

confidence: 99%

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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“…The reduction in dyspnoea perceived with pursed-lip breathing seems to relate to a slowing of the respiratory rate, which, in people with expiratory airflow obstruction, allows for more complete lung emptying during expiration and less pulmonary hyperinflation [44][45][46]. Finally, the use of a rollator allows people to fix their upper limbs during ambulation and reduces their dyspnoea [47], presumably by facilitating use of the accessory muscles of respiration and minimising reliance on the diaphragm during inspiration. Fixing the upper limbs on a rollator has been shown to confer significant increases in maximum voluntary ventilation [48,49].…”

Section: Managing Acute Dyspnoeamentioning

confidence: 99%

The importance of components of pulmonary rehabilitation, other than exercise training, in COPD

Hill¹,

Vogiatzis²,

Burtin³

2013

European Respiratory Review

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Comprehensive pulmonary rehabilitation is an important component in the clinical management of people with chronic obstructive pulmonary disease (COPD). Although supervised exercise training is considered the cornerstone of effective pulmonary rehabilitation, there are many other components that should be considered to manage the impairments and symptom burden, as well as the psychosocial and lifestyle changes imposed by COPD. These include approaches designed to: 1) facilitate smoking cessation; 2) optimise pharmacotherapy; 3) assist with early identification and treatment of acute exacerbations; 4) manage acute dyspnoea; 5) increase physical activity; 6) improve body composition; 7) promote mental health; 8) facilitate advance care planning; and 9) establish social support networks. This article will describe these approaches, which may be incorporated within pulmonary rehabilitation, to optimise effective chronic disease self-management. @ERSpublications This paper describes several components of comprehensive pulmonary rehabilitation, other than simply exercise training http://ow.ly/mMNRp Pulmonary rehabilitation for chronic obstructive pulmonary diseaseChronic obstructive pulmonary disease (COPD) is characterised by persistent airflow limitation due to chronic inflammation within the airways and lung in response to noxious particles or gases [1]. People with this condition are limited by dyspnoea and have impaired exercise capacity and health-related quality of life [1]. The prevalence of COPD amongst adults aged o40 years is ,10% [2], and increases to 21% in those with a significant smoking history who are visiting their family physician for any reason [3]. The natural course of COPD is punctuated with episodes of acute worsening, known as exacerbations, which contribute

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The Short-term Effect of a Rollator on Functional Exercise Capacity Among Individuals With Severe COPD

Cited by 82 publications

References 31 publications

An official European Respiratory Society/American Thoracic Society technical standard: field walking tests in chronic respiratory disease

An official European Respiratory Society/American Thoracic Society technical standard: 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

The importance of components of pulmonary rehabilitation, other than exercise training, in COPD

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