Abstract
Objective
To analyze the reliability, validity, and determinants of the incremental shuttle
walk test (ISWT) in adults with noncystic fibrosis bronchiectasis.
Design
Cross-sectional study.
Setting
Outpatient clinic.
Participants
Subjects (N=75; 26 men) underwent, on different days, cardiopulmonary exercise testing
(CPET) and 2 ISWTs, 30 minutes apart. The number of steps in daily life was recorded.
Concurrent validity was tested by the relation between distance walked with peak load
and oxygen consumption (o2).
Interventions
None.
Main Outcome Measures
Distance walked (m) was compared between the first and second ISWTs; greatest distance
walked was correlated with peak load and Vo2peak obtained from CPET, steps per day, and dyspnea evaluated by the Medical Research
Council (MRC) scale; and desaturation was compared between CPET and the ISWT.
Results
Distance walked was equivalent between the first ISWT (441±152m) and the second ISWT
(445±153m) with an excellent intraclass correlation coefficient (.995; 95% confidence
interval, .99–.997). There were significant correlations between distance walked and
peak load (r=.82), o2 (r=.72), steps per day (r=.61), and the MRC scale (r=−.69). Age, body mass index, sex, forced vital capacity (% predicted), dyspnea, and
steps per day explained 70% of the variation in distance walked (m) and 60% of the
variance when expressed as percent predicted. Higher desaturation was observed during
the ISWT (−4%±4%) than cycling (−2±3%) (P<.001).
Conclusions
The ISWT is reliable, represents functional capacity, and induces greater desaturation
than cycling. Age, body composition, pulmonary function, dyspnea, and physical activity
in daily life are determinants of the distance walked on the ISWT.
Keywords
List of abbreviations:
BMI (body mass index), CF (cystic fibrosis), CI (confidence interval), COPD (chronic obstructive pulmonary disease), CPET (cardiopulmonary exercise testing), FVC (forced vital capacity), ISWT (incremental shuttle walk test), MRC (Medical Research Council), 6MWT (6-minute walk test), Spo2 (oxyhemoglobin saturation), V˙o2 (oxygen consumption), Vo2peak (oxygen uptake at the peak of CPET)To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Archives of Physical Medicine and RehabilitationAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Clinical, pathophysiologic and microbiologic characterization of bronchiectasis in an aging cohort.Chest. 1995; 108: 955-956
- Outcome in adult bronchiectasis.COPD. 2005; 2: 27-34
- Lung diffusing capacity in adult bronchiectasis: a longitudinal study.Respir Care. 2010; 55: 1686-1692
- Non-cystic fibrosis bronchiectasis.Interact Cardiovasc Thorac Surg. 2011; 13: 619-625
- Characterization of the onset and presenting clinical features of adult bronchiectasis.Respir Med. 2006; 100: 2183-2189
- How should we measure function in patients with chronic heart and lung disease?.J Chronic Dis. 1985; 38: 517-524
- 6-minute walk testing is more sensitive than maximal incremental cycle testing for detecting oxygen desaturation in patients with COPD.Chest. 2003; 123: 1401-1407
- Physiological responses to incremental and self-paced exercise in COPD: a comparison of three tests.Chest. 2004; 126: 766-773
- Relationship between psychological well-being and lung health status in patients with bronchiectasis.Resp Med. 2002; 96: 686-692
- Validation of the St. George's respiratory questionnaire in bronchiectasis.Am J Respir Crit Care Med. 1997; 156: 536-541
- Exercise training and inspiratory muscle training in patients with bronchiectasis.Thorax. 2005; 60: 943-948
- The effects of pulmonary rehabilitation in patients with non-cystic fibrosis bronchiectasis: protocol for a randomised controlled trial.BMC Pulm Med. 2010; 10: 5
- Development of a shuttle walking test of disability in patients with chronic airways obstruction.Thorax. 1992; 47: 1019-1024
- Reliability, repeatability, and sensitivity of the modified shuttle test in adult cystic fibrosis.Chest. 2000; 117: 1666-1671
- Shuttle walking test: a new approach for evaluating patients with pacemakers.Heart. 1996; 75: 414-418
- The shuttle walking test: a reproducible method for evaluating the impact of shortness of breath on functional capacity in patients with advanced cancer.Thorax. 2001; 56: 146-150
- Six-minute walk, maximal exercise tests: reproducibility in fibrotic interstitial pneumonia.Am J Respir Crit Care Med. 2005; 171: 1150-1157
- Pulmonary Rehabilitation: Joint ACCP/AACVPR Evidence-Based Clinical Practice Guidelines.Chest. 2007; 131: 4S-42S
- Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease.Thorax. 1999; 54: 581-586
- Prediction of metabolic and cardiopulmonary responses to maximum cycle ergometry: a randomised study.Eur Respir J. 1999; 14: 1304-1313
- Predictors of oxygen desaturation during submaximal exercise in 8,000 patients.Chest. 2001; 120: 88-92
- A comparison of the visual analogue scale and modified Borg scale for the measurement of dyspnoea during exercise.Clin Sci. 1989; 76: 277-282
- Reference values for the incremental shuttle walking test.Respir Med. 2012; 106: 243-248
- How many days of pedometer monitoring predict weekly physical activity in adults?.Prev Med. 2005; 40: 293-298
- Reference equations for the six-minute walk test in healthy adults.Am J Respir Crit Care Med. 1998; 158: 1384-1387
- Validity and reliability of the modified shuttle walk test in patients with chronic obstructive pulmonary disease.Arch Phys Med Rehabil. 2006; 87: 918-922
- Reproducibility of 6-minute walking test in patients with COPD.Eur Respir J. 2011; 38: 261-267
- Comparison of oxygen uptake during a conventional treadmill test and shuttle walking test in chronic airflow limitation.Eur Respir J. 1994; 7: 2016-2020
- Validity of a modified shuttle test in adult cystic fibrosis.Thorax. 1999; 54: 437-439
- Evaluation of a new motion sensor in patients with chronic obstructive pulmonary disease.Arch Phys Med Rehabil. 2012; 93: 2319-2325
- Characteristics of physical activities in daily life in chronic obstructive pulmonary disease.Am J Respir Crit Care Med. 2005; 171: 972-977
- The incremental shuttle walking test in older brazilian adults.Respiration. 2011; 81: 223-228
- Clinical determinants of the 6-Minute Walk Test in bronchiectasis.Respir Med. 2009; 103: 780-785
- Skeletal muscle weakness, exercise tolerance and physical activity in adults with cystic fibrosis.Eur Respir J. 2009; 33: 99-106
- Tidal expiratory flow limitation, dyspnoea and exercise capacity in patients with bilateral bronchiectasis.Eur Respir J. 2003; 21: 743-748
- Arterial oxygen desaturation during treadmill and bicycle exercise in patients with chronic obstructive airways disease.Clin Sci. 1985; 68: 327-332
- Ventilatory and metabolic adaptations to walking and cycling in patients with COPD.J Appl Physiol (1985). 2000; 88: 1715-1720
Article info
Publication history
Published online: December 19, 2013
Footnotes
No commercial party having a direct financial interest in the results of the research supporting this article has conferred or will confer a benefit on the authors or on any organization with which the authors are associated.
Identification
Copyright
© 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
