Development of a Shuttle Walking Test of Disability in Patients with Chronic Airways Obstruction

Singh, Sukhdeep; Morgan, M.J.; Scott, Sasha M.; Walters, Doug; Hardman, Adrianne E.

doi:10.1097/00008483-199305000-00014

Cited by 208 publications

(295 citation statements)

References 2 publications

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“…As expected, the mean (SD) ISWT distance was higher in our patients with severe asthma compared to the studies among COPD and CHF patients with moderate to severe disease (302 (133) and 380 (190) m accordingly) . However, the average ISWT distance was lower in our study population compared to adults with obstructive sleep apnoea (OSA) with obesity, cystic fibrosis (CF) and the healthy population reported in other studies (580 (207), 754 (362) and 733 (183), respectively) .…”

Section: Discussionsupporting

confidence: 62%

“…The protocol used for ISWT in the OSA and CF studies differed from other studies in that patients were allowed to run as the speed on the ISWT increased. We adhered to the original protocol for performing ISWT as described by Singh et al, where ISWT was validated with walking only. This could explain why patients with CF had a slightly higher ISWT distance compared to healthy individuals and may also explain the better performance on ISWT among patients with OSA and CF compared to the patients with severe asthma in our study.…”

Section: Discussionmentioning

confidence: 99%

“…The modified ISWT is a 16‐level test with an incremental acceleration every minute . The participant walks around two cones 9 m apart with a shuttle distance of 10 m . Standard encouragement was provided at the start of a new level and if they were unable to maintain the required speed whereby the test was terminated if the correct speed was not achieved by the subsequent 10‐m shuttle.…”

Section: Methodsmentioning

confidence: 99%

“…These tests are laboratory based requiring specialized equipment and trained operators. The incremental shuttle walk test (ISWT), a simple and inexpensive field test, has been shown to be valid and repeatable in other chronic lung diseases and has been used extensively to assess changes in exercise capacity after an intervention . However, the ISWT may have a ceiling effect due to the flat nature of the course, walking rather than running, and the changes in gait pattern with the turns at either end of the 10‐m course which may be relevant for some patients with severe asthma who have a high body mass index (BMI).…”

Section: Introductionmentioning

confidence: 99%

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Understanding the measurement properties of the incremental shuttle walk test in patients with severe asthma

et al. 2019

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Background and objective:We investigated the repeatability and validity of the incremental shuttle walk test (ISWT) distance compared to peak oxygen uptake (VO 2pk ) during maximal incremental cycle ergometer (ICE) and treadmill (ITM) tests in adults with severe asthma. Methods: Adults with severe asthma, Medical Research Council (MRC) dyspnoea ≥2, were recruited from specialists caring for patients with severe asthma. All participants performed three ISWT (familiarization and two subsequent tests on the same day), an ICE and an ITM in a randomized order, on separate days, to intolerance with expiratory gas analysis. Results: A total of 50 patients (32 females, mean (SD), age: 54 (13) years, forced expiratory volume in 1 s (FEV 1 ): 1.9 (0.8) L and body mass index (BMI): 32 (6) kg/m 2 ) completed all five tests. The mean (SD) ISWT distance for each test was 400 (156), 418 (142) and 438 (157) m (P = 0.001), respectively. There was a strong correlation between the ISWT distance with VO 2pk derived from ITM (r = 0.74, P < 0.001) and ICE (r = 0.75, P < 0.001). Conclusion: There was a small increase in the mean ISWT distance on sequential testing. In clinical practice, the coefficient of repeatability and heteroscedasticity need to be considered when assessing whether a true change has occurred within an individual patient. The ISWT has validity compared to VO 2pk on both ICE and ITM, but they are not interchangeable.

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Section: Discussionsupporting

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Understanding the measurement properties of the incremental shuttle walk test in patients with severe asthma

et al. 2019

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“…The pace is set at 85% of the maximal pace achieved on an incremental shuttle test. The ESWT is well validated for measuring exercise capacity in COPD populations with good repeatability . In IPF and sarcoidosis patients, distance walked during ESWT correlates well with resting oxyhaemoglobin saturation on pulse oximetry (SpO 2 ), DLCO and peak VO 2 as measured with CPET .…”

Section: Tests For Investigating Exercise Performancementioning

confidence: 91%

Exercise pathophysiology and the role of oxygen therapy in idiopathic interstitial pneumonia

et al. 2015

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Exercise limitation is a common feature in idiopathic interstitial pneumonia (IIP). There are multiple contributing pathophysiological mechanisms, including ventilatory mechanical limitation, impaired gas exchange, pulmonary vascular insufficiency and peripheral muscle dysfunction. Progressive exertional dyspnoea and functional incapacity impact significantly on quality of life. Exercise-induced desaturation is frequently observed and is predictive of poorer outcomes. Tests to assess the cardiorespiratory system under stress (e.g. cardiopulmonary exercise testing and the 6-min walk test) can provide important physiologic and prognostic information as adjuncts to resting measurements of lung function. Despite many advances in understanding disease mechanisms, therapies to improve exercise capacity, symptom burden and quality of life are lacking. Exercise training and supplemental oxygen are two potential interventions that require closer evaluation in patients with IIP.

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Left Atrial Radiofrequency Ablation During Mitral Valve Surgery for Continuous Atrial Fibrillation

Doukas¹,

Samani²,

Alexiou³

et al. 2005

JAMA

163

121

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Context Although left atrial radiofrequency ablation (RFA) is increasingly used for the treatment of chronic atrial fibrillation during mitral valve surgery, its efficacy to restore sinus rhythm and any resulting benefits have not been examined in the context of an adequately powered randomized trial. Objective To determine whether intraoperative RFA of the left atrium increases the long-term restoration of sinus rhythm and improves exercise capacity. Design, Setting, and Patients Randomized, double-blind trial performed in a single UK tertiary referral center with enrollment between December 2001 and November 2003. A total of 101 patients referred for mitral valve surgery with at least 6 months' history of uninterrupted atrial fibrillation were assessed for eligibility; 97 were enrolled. Patients were followed up for 12 months. Intervention Patients were randomly assigned to undergo mitral valve surgery and RFA of the left atrium (n=49) or mitral valve surgery alone (controls; n=48). Main Outcome Measures The primary outcome measure was presence of sinus rhythm at 12 months; secondary measures were patient functional status and exercise capacity (assessed by shuttle-walk test), left atrial contractility, and left atrial and left ventricular dimension and function and plasma levels of B-type natriuretic peptide. Results At 12 months, sinus rhythm was present in 20 (44.4%) of 45 RFA patients and in 2 (4.5%) of 44 controls (rate ratio, 9.8; 95% CI, 2.4-86.3; PϽ.001). Restoration of sinus rhythm in the RFA group was accompanied by a greater improvement in mean (SD) shuttle-walk distance compared with controls (ϩ94 [102] m vs ϩ48 [82] m; P=.003) and a greater reduction in the plasma level of B-type natriuretic peptide (−104 [87] fmol/mL vs −51 [82] fmol/mL; P=.03). Patients randomized to receive RFA had similar rates of postoperative complications and deaths as control patients. Conclusions Radiofrequency ablation of the left atrium during mitral valve surgery for continuous atrial fibrillation significantly increases the rate of sinus rhythm restoration 1 year postoperatively, improving patient exercise capacity. On the basis of its efficacy and safety, routine use of RFA of the left atrium during mitral valve surgery may be justified. Trial Registration ClinicalTrials.gov Identifier: NCT00238706.

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Development of a Shuttle Walking Test of Disability in Patients with Chronic Airways Obstruction

Cited by 208 publications

References 2 publications

Understanding the measurement properties of the incremental shuttle walk test in patients with severe asthma

Understanding the measurement properties of the incremental shuttle walk test in patients with severe asthma

Exercise pathophysiology and the role of oxygen therapy in idiopathic interstitial pneumonia

Left Atrial Radiofrequency Ablation During Mitral Valve Surgery for Continuous Atrial Fibrillation

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