Endurance shuttle walking test: responsiveness to salmeterol in COPD

Abstract

Few studies have shown that the endurance shuttle walking test (ESWT) is responsive to treatment in patients with chronic obstructive pulmonary disease (COPD). This exercise test needs to be further investigated because of its relevance for activity of daily living. The aim of the present study was to evaluate, in patients with COPD, the responsiveness of the ESWT in detecting improvement in walking performance after a single dose of salmeterol.In a randomised, double-blind, placebo-controlled crossover trial, 20 patients with COPD performed two ESWT at 80% of peak capacity 2.5 h after inhaling either a placebo or 50 mg of salmeterol. Cardiorespiratory parameters were monitored during each walking test. Inspiratory capacities and Borg ratings for dyspnoea were obtained every other minute throughout the tests.Compared with placebo, salmeterol produced a significant change in lung function and a significant improvement in walking performance (mean¡SD difference in time: 117¡20 s; difference in distance: 160¡277 m). At isotime (the latest exercise time that was reached on both ESWT), a significant reduction in dyspnoea was observed after bronchodilation.Bronchodilation with salmeterol reduced dyspnoea during walking and improved walking capacity in patients with chronic obstructive pulmonary disease. These findings provide further support for the use of the endurance shuttle walking test as an evaluative tool in chronic obstructive pulmonary disease.

Use of exercise testing in the evaluation of interventional efficacy: an official ERS statement

“…Significant changes are seen with short-and long-acting anticholinergics or salmeterol in COPD patients, with improvements between 70 s and 164 s [174,[195][196][197][198]. In contrast, the MCID for ESWT was not reached with ipratropium in one study of patients with mild COPD [205] and in the post hoc integrated data analysis of two studies with the fixed combination umeclidinium/vilanterol (55/22 μg) [198].…”

“…Thus, coefficient of variations have been reported to range between 60% and 120% of the corresponding means [174,[194][195][196][197][198]. While no recommendation on how to adjust test duration has yet been proposed, it is reasonable to assume that the range of baseline test durations used for the CWRET is desirable (i.e.…”

Prospective validation of the endurance shuttle walking test in the context of bronchodilation in COPD

“…The use of the ESWT for the evaluation of patients with COPD has become increasingly popular in research and clinical fields [8,9,13]. However, the methodological validation of the ESWT is limited.…”

“…As such, measuring the endurance to constant load exercise has been an important objective of several clinical trials evaluating the impact of pharmacological or rehabilitative interventions in COPD [3][4][5]. In this context, the endurance shuttle walking test (ESWT) is gaining acceptance due to its minimal requirement for equipment, low cost and ease of administration [6], and to its responsiveness and sensitivity to interventions, at least in single centre studies [7][8][9][10][11][12]. With the advancement of portable cardiopulmonary monitoring, it is also possible to obtain a thorough physiological assessment during the ESWT.…”

Impact of Bronchodilator Responsiveness on Quality of Life and Exercise Capacity in Patients With COPD

“…14,32 On the other hand, in some COPD patients it is possible to increase exercise capacity with bronchodilator. 33 The shuttle walk test seems to be more sensitive to changes in postbronchodilator exercise tolerance than is cycling performance 34 or the 6-min walk test. 35 Our COPD subjects with positive reversibility had lower exercise capacity than the negative reversibility subjects, and this was manifested in both time to exhaustion and shuttle-walk distance, above all among those in moderate to severe stages of the disease.…”