Abstract
Objectives
To evaluate the characteristics and available evidence on the measurement properties
of the gait speed (GS) test, timed Up and Go test (TUG), sit-to-stand (STS) test,
and step test; to investigate their relation with clinical outcomes in chronic obstructive
pulmonary disease (COPD); and to provide recommendations for clinical practice and
future research.
Data Sources
Studies were systematically identified from a literature search using PubMed, PEDro,
CINAHL, and Cochrane Library databases and the reference lists of the included articles.
Study Selection
Studies including ≥1 of these 4 lower limb functional tests (GS test, TUG, STS test,
and step test) as an outcome in patients with COPD were selected. No limits were applied
for language and study design.
Data Extraction
Two researchers independently performed data extraction and, by using the COnsensus-based
standards for the Selection of health status measurement INstruments, assessed the
quality of those studies that described measurement properties.
Data Synthesis
Forty-two articles met the selection criteria. GS test, STS test, and step test are
valid, reproducible, and responsive tests, especially the 4-meter GS, 5-repetition
STS test, and 6-minute step test (6MST). The TUG is reliable; however, studies on
other measurement properties of this test are lacking. Outcomes of these tests are
correlated with mortality, physical activity in daily life, exercise capacity, dyspnea,
and quality of life.
Conclusions
Simple and functional lower limb tests provide information about important clinical
outcomes in patients with COPD. The 4-meter GS, 5-repetition STS test, and 6MST are
tests with well-established psychometric properties, whereas the properties of the
TUG need to be studied further.
Keywords
List of abbreviations:
4MGS (4-meter gait speed), 5STS (5-repetition sit-to-stand test), 6MST (6-minute step test), 6MWT (6-minute walk test), COPD (chronic obstructive pulmonary disease), CST (Chester step test), GS (gait speed), IST (incremental step test), PADL (physical activity in daily life), STS (sit-to-stand), TUG (timed Up and Go test)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
- An official American Thoracic Society/European Respiratory Society statement: update on limb muscle dysfunction in chronic obstructive pulmonary disease.Am J Respir Crit Care Med. 2014; 189: e15-62
- Mechanisms and measures of exercise intolerance in chronic obstructive pulmonary disease.Clin Chest Med. 2000; 21: 693-704
- Recommendations on the use of exercise testing in clinical practice.Eur Respir J. 2007; 29: 185-209
- Functional assessment of chronic obstructive pulmonary disease.J Am Acad Nurse Pract. 2011; 23: 161-167
- An official European Respiratory Society/American Thoracic Society technical standard: field walking tests in chronic respiratory disease.Eur Respir J. 2014; 44: 1428-1446
- Functional status measurement in COPD: a review of available methods and their feasibility in primary care.Prim Care Respir J. 2011; 20: 269-275
- The five-repetition sit-to-stand test as a functional outcome measure in COPD.Thorax. 2013; 68: 1015-1020
- Reliability and validity of 4-metre gait speed in COPD.Eur Respir J. 2013; 42: 333-340
- Performance, ventilation, and oxygen consumption in three different types of exercise test in patients with chronic obstructive lung disease.Thorax. 1985; 40: 581-586
- Chester step test in patients with COPD: reliability and correlation with pulmonary function test results.Respir Care. 2011; 56: 995-1001
- How should we measure arm exercise capacity in patients with COPD? A systematic review.Chest. 2012; 141: 111-120
- The COSMIN checklist for assessing the methodological quality of studies on measurement properties of health status measurement instruments: an international Delphi study.Qual Life Res. 2010; 19: 539-549
- Foundations of clinical research: applications to practice.3rd ed. Prentice Hall, New Jersey2009
- The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration.PLoS Med. 2009; 6: e1000100
- Factors to inform clinicians about the end of life in severe chronic obstructive pulmonary disease.J Pain Symptom Manage. 2013; 46: 491-499
- The effect of pulmonary rehabilitation on critical walk speed in patients with COPD: a comparison with self-paced walks.Chest. 2012; 141: 413-419
- Associations of the Stair Climb Power Test with muscle strength and functional performance in people with chronic obstructive pulmonary disease: a cross-sectional study.Phys Ther. 2010; 90: 1774-1782
- Associations between isokinetic muscle strength, high-level functional performance, and physiological parameters in patients with chronic obstructive pulmonary disease.Int. 2012; 7: 537-542
- Deficits in muscle strength, mass, quality, and mobility in people with chronic obstructive pulmonary disease.J Cardiopulm Rehabil Prev. 2011; 31: 120-124
- Reductions in functional balance, coordination, and mobility measures among patients with stable chronic obstructive pulmonary disease.J Cardiopulm Rehabil. 2004; 24: 274-280
- Examination of the difference in balance ability across the disease stages of male chronic obstructive pulmonary disease patients.Rigakuryoho Kagaku. 2011; 26: 215-219
- Step test and sit-to-stand test: behavior of metabolic, ventilatory and cardiovascular responses in patients with COPD.Fisioter Mov. 2012; 25: 105-115
- Validation of functional fitness tests as surrogates for strength measurement in frail, older adults with chronic obstructive pulmonary disease.Am J Phys Med Rehabil. 2009; 88 (quiz 584-6, 590): 579-583
- Measuring walking speed in COPD: test-retest reliability of the 30-metre walk test and comparison with the 6-minute walk test.Prim Care Respir J. 2011; 20: 434-440
- Physical activity level and its clinical correlates in chronic obstructive pulmonary disease: a cross-sectional study.Respir Res. 2013; 14: 128
- Correlations between gait speed, 6-minute walk distance, physical activity, and self-efficacy in patients with severe chronic lung disease.Respir Care. 2013; 58: 2113-2119
- Measuring gait speed in the out-patient clinic: methodology and feasibility.Respir Care. 2014; 59: 531-537
- Determinants of gait speed in COPD.Chest. 2014; 146: 104-110
- The 4-metre gait speed in COPD: responsiveness and minimal clinically important difference.Eur Respir J. 2014; 43: 1298-1305
- Impairments in balance discriminate fallers from non-fallers in COPD.Respir Med. 2009; 103: 1885-1891
- Global functioning of COPD patients with and without functional balance impairment: an exploratory analysis based on the ICF framework.COPD. 2015; 12: 207-216
- Within-day test-retest reliability of the Timed Up & Go test in patients with advanced chronic organ failure.Arch Phys Med Rehabil. 2013; 94: 2131-2138
- Determinants of 1-year changes in disease-specific health status in patients with advanced chronic obstructive pulmonary disease: a 1-year observational study.Int J Nurs Pract. 2014; 2014: 12265
- Functional balance in older adults with chronic obstructive pulmonary disease.J Aging Phys Act. 2014; 22: 357-363
- A simple semipaced 3-minute chair rise test for routine exercise tolerance testing in COPD.Int J Chron Obstruct Pulmon Dis. 2014; 9: 1009-1019
- Neurophysiological comparison between the sit-to-stand test with the 6-minute walk test in individuals with COPD.Electromyogr Clin Neurophysiol. 2010; 50: 47-53
- Comparison of the sit-to-stand test with 6 min walk test in patients with chronic obstructive pulmonary disease.Respir Med. 2007; 101: 286-293
- Simple functional performance tests and mortality in COPD.Eur Respir J. 2013; 42: 956-963
- Association between peripheral muscle strength, exercise performance, and physical activity in daily life in patients with chronic obstructive pulmonary disease.Multidiscip Respir Med. 2014; 9: 37
- Relationship of BODE Index to functional tests in chronic obstructive pulmonary disease.Clinics (Sao Paulo). 2009; 64: 983-988
- Neurophysiological aspects and their relationship to clinical and functional impairment in patients with chronic obstructive pulmonary disease.Clinics. 2011; 66: 125-129
- Predicting daily physical activity in patients with chronic obstructive pulmonary disease.PLoS One. 2012; 7: 2
- Impaired postural control reduces sit-to-stand-to-sit performance in individuals with chronic obstructive pulmonary disease.PLoS One. 2014; 9: 2014
- Comparison of cardiopulmonary responses during 2 incremental step tests in subjects with COPD.Respir Care. 2012; 57: 1920-1926
- Reproducibility of cadence-free 6-minute step test in subjects with COPD.Respir Care. 2014; 59: 538-542
- A symptom-limited incremental step test determines maximum physiological responses in patients with chronic obstructive pulmonary disease.Respir Med. 2013; 107: 1993-1999
- Chester step test: assessment of functional capacity and magnitude of cardiorespiratory response in patients with COPD and healthy subjects.Braz J Phys Ther. 2013; 17: 227-235
- Responsiveness of the six-minute step test to a physical training program in patients with COPD.J Bras Pneumol. 2012; 38: 579-587
- Paced-walk and step tests to assess exertional dyspnea in COPD.COPD. 2009; 6: 330-339
- Validity of the six-minute step test of free cadence in patients with chronic obstructive pulmonary disease.Braz J Phys Ther. 2014; 18: 228-236
- Tolerance tests to the exercise in a hospital physical therapy program in the exacerbation of the chronic obstructive pulmonary disease.Fisioter Mov. 2006; 19: 119-126
- Oxygen uptake, minute ventilation and oxygenation in the step test and walk test in subjects with COPD.Reabilitar. 2005; 7: 4-9
- Comparative study between six minute walk test and six minute step test in chronic obstructive pulmonary disease patients.Arq Med ABC. 2008; 32: S47-50
- Quantitative 15 steps exercise oximetry as a marker of disease severity in patients with chronic obstructive pulmonary disease.Isr Med Assoc J. 1999; 1: 165-168
- Assessment of functional capacity in patients with chronic obstructive pulmonary disease: correlation between cardiopulmonary exercise, 6 minute walk and 15 step exercise oximetry test.Isr Med Assoc J. 2006; 8: 460-463
- Gait speed as a measure of functional status in COPD patients.Int J Chron Obstruct Pulmon Dis. 2014; 9: 1315-1320
- The use of step tests for the assessment of exercise capacity in healthy subjects and in patients with chronic lung disease.J Bras Pneumol. 2012; 38: 116-124
Article info
Publication history
Published online: August 05, 2015
Footnotes
Supported by Coordination for the Improvement of Higher Education Personnel, Brazil (grant nos. 1374490 and 1538669); Araucaria Foundation, Paraná, Brazil (grant no. 36322/2012-21); and National Counsel of Technological and Scientific Development, Brazil (grant no. 304326/2014-3).
Disclosures: none.
Identification
Copyright
© 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.
