Comparing Various Exercise Tests for Assessing the Response to Pulmonary Rehabilitation in Patients With COPD

Mador, M. Jeffery; Modi, Kush

doi:10.1097/hcr.0000000000000154

Cited by 14 publications

(7 citation statements)

References 32 publications

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“…Assessment of exercise tolerance at the start of PR is also necessary to formulate the exercise prescription. Several methods of exercise assessment are validated for use in PR, and are responsive to the PR intervention . CPET evaluates the integrated cardiovascular, ventilatory and musculoskeletal response to exercise.…”

Section: Patient Assessment and Outcomes Measurement In Prmentioning

confidence: 99%

“…Repeat (second) walk tests improve validity and precision of test performance, hence second walks should be performed when used in PR programmes . Changes in exercise capacity following PR do not necessarily correlate with changes in QOL, and changes in one exercise test do not always correlate with improvements in others …”

Section: Patient Assessment and Outcomes Measurement In Prmentioning

confidence: 99%

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Patient assessment and selection for pulmonary rehabilitation

Rochester

2019

Respirology

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Pulmonary rehabilitation (PR) is beneficial for people with several forms of chronic respiratory disease. Given the existing limitations on availability of PR services, it is important to identify participants who are most likely to benefit from it. Identification of criteria for patient referral to PR is challenging, as chronic respiratory diseases and their medical and psychosocial co‐morbidities place a complex and multifaceted burden on patients. Although research studies have attempted to identify key parameters predictive of ‘responsiveness to PR’, to date no firm physiological, psychosocial or other criteria exist by which optimal patient candidacy can be determined. Moreover, individual factors do not reliably predict successful multidimensional PR outcomes. In general, individuals who remain symptomatic with dyspnoea, fatigue and exercise intolerance; who have difficulty performing activities of daily living (ADL); and who are having difficulty coping with or managing their disease despite optimized pharmacological therapy are potential candidates for PR. Patient assessment and outcome measurement are core essential features of PR. To be considered as a PR programme, rehabilitation programmes must demonstrate, at a minimum, assessment and outcome measurement in regard to exercise capacity, dyspnoea and health‐related quality of life. Additional parameters, including physical activity, nutritional status, tobacco use status, patient knowledge and self‐efficacy, performance of ADL, fatigue, disease exacerbations, hospitalizations and other urgent healthcare utilization, and behavioural outcomes, including coping styles, patient satisfaction and programme metrics, are other relevant and important aspects of patient assessment and outcome measurement that should be considered and undertaken in PR, where feasible.

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Section: Patient Assessment and Outcomes Measurement In Prmentioning

confidence: 99%

Section: Patient Assessment and Outcomes Measurement In Prmentioning

confidence: 99%

Patient assessment and selection for pulmonary rehabilitation

Rochester

2019

Respirology

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“…The 6MWT is reported as a valid and reliable field test and reflects performance of more activities of daily life [ 4 ]. A previous study found that changes in dyspnea grade, patient-reported outcomes, 6-min walk distance (6MWD), and cycle endurance time (constant work-rate test), after pulmonary rehabilitation, did not show synchronous responses in patients with COPD, suggesting the need for various tests to evaluate the response in exercise intolerance [ 29 ]. Therefore, we proposed that 6MWT, ISWT, and CPET be used complementary to each other to evaluate the exercise capacity of patients with COPD.…”

Section: Discussionmentioning

confidence: 99%

Stronger correlation of peak oxygen uptake with distance of incremental shuttle walk test than 6-min walk test in patients with COPD: a systematic review and meta-analysis

Chae

Lee

et al. 2022

BMC Pulm Med

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Background The 6-min walk test (6MWT) and incremental shuttle walk test (ISWT) are valid and reliable measures to assess exercise capacity of patients with chronic obstructive pulmonary disease (COPD). However, the comparison of correlation between peak oxygen uptake (peak VO2) and 6MWT or ISWT distance has not been investigated. We aimed to investigate the correlation between peak VO2 and 6MWT and ISWT distances in COPD patients through a meta-analysis. Methods We systematically searched MEDLINE, Scopus, Embase, and the Cochrane Library up to June, 2020 for studies comparing the correlation of peak VO2 with either 6MWT or ISWT in COPD patients. Meta-analysis was performed with R software using a fixed-effect model. We compared the correlation coefficient and measured the heterogeneity using I2 statistics. Results We identified 12 studies involving 746 patients. Meta-analysis showed a significant correlation between peak VO2 and 6MWT and ISWT distances (6MWT: r = 0.65, 95% CI 0.61–0.70; ISWT: r = 0.81, 95% CI 0.74–0.85; p < 0.0001). The heterogeneity was lower in ISWT than in 6MWT (6MWT: I2 = 56%, p = 0.02; ISWT: I2 = 0%, p = 0.71). Subgroup analysis showed a higher correlation coefficient in the low exercise capacity group than in the high exercise capacity group in both field tests. Conclusions 6MWT and ISWT significantly correlated with peak VO2. Our findings suggest that ISWT has a stronger correlation with peak VO2 than 6MWT. The exercise capacity in COPD patients may affect the strength of the relationship between peak VO2 and walking distance in both field tests, suggesting the importance of using various exercise tests. Trial registration CRD 42020200139 at crd.york.ac.uk/prospero/

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“…Field tests are routinely used to evaluate the functional benefits following a PR program in patients with chronic lung disease,10 such as the 6-minute walk test (6MWT)11–14 or the incremental shuttle walking test 15. In clinical practice, the 6-minute stepper test (6MST) has been recently proposed as a convenient method to evaluate exercise tolerance because the test can be easily implemented, is inexpensive and feasible to be performed at medical offices or patients’ homes 16–19.…”

Section: Introductionmentioning

confidence: 99%

Relationships between heart rate target determined in different exercise testing in COPD patients to prescribed with individualized exercise training

Fabre¹,

Chéhère²,

Bart³

et al. 2017

COPD

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BackgroundIt has been scientifically proven that pulmonary rehabilitation improves exercise tolerance and facilitates the carrying out of daily physical activities. To optimize the physical and physiological benefits, it is necessary to individualize the training intensity for each patient. The aim of this study is to compare the heart rate (HR) responses to three exercise modalities measuring aerobic fitness in chronic obstructive pulmonary disease patients, in order to easily prescribe individual target HRs for endurance training.Patients and methodFifty COPD patients (mean age: 60.1±8.5 years) were included in the study. Each patient carried out a cardiopulmonary exercise test, a 6-minute walk test (6MWT) and a 6-minute stepper test (6MST). During these tests, HR was recorded continuously. After the cardiopulmonary exercise test, the HR was noted at the ventilatory threshold (VT) and at the end of the two exercise field tests (6MWTpeak and 6MSTpeak). The values of the HR during the last 3 minutes of both field tests were averaged (6MWT456 and 6MST456). Finally, the HR at 60% of the HR reserve was calculated with the values of the HR measured during 6MWT and 6MST (HRr60%walk, HRr60%step).ResultsThe HRs measured during the 6MST were significantly higher than those measured during the 6MWT. The HRr60%step was not significantly different from 6MWT456 and 6MWTpeak HR (P=0.51; P=0.48). A significant correlation was observed between 6MWT456 and 6MWTpeak (r=0.58). The 6MWT456 and 6MWTpeak HR were correlated with HRr60%step (r=0.68 and r=0.62). The VT could be determined in 28 patients. The HRVT was not different from 6MWT456, 6MWTpeak, and HRr60%step (P=0.57, P=0.41 and P=0.88) and was correlated to 6MWT456, 6MWTpeak, and HRr60%step (r=0.45, r=0.40, r=0.48).ConclusionAn individualized target HR for endurance training can be prescribed from the HR measured during routine tests, such as 6MWT or 6MST.

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Comparing Various Exercise Tests for Assessing the Response to Pulmonary Rehabilitation in Patients With COPD

Cited by 14 publications

References 32 publications

Patient assessment and selection for pulmonary rehabilitation

Patient assessment and selection for pulmonary rehabilitation

Stronger correlation of peak oxygen uptake with distance of incremental shuttle walk test than 6-min walk test in patients with COPD: a systematic review and meta-analysis

Relationships between heart rate target determined in different exercise testing in COPD patients to prescribed with individualized exercise training

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