Correlates of variability in endurance shuttle walk test time in patients with chronic obstructive pulmonary disease

A.A.F. Stoffels*, B. van den Borst, J.B. Peters, M.P.M. Klaassen, H.A.C. van Helvoort, R. Meys, P. Klijn, C. Burtin, F.M.E. Franssen, A.J. van't Hul, M.A. Spruit, H.W.H. van Hees, BASES Consortium

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

1 Citation (Web of Science)

Abstract

Background

The endurance shuttle walk test (ESWT) is used to evaluate exercise tolerance in patients with chronic obstructive pulmonary disease (COPD). The recommended pre-intervention tolerated duration (Tlim) is between 3-8 minutes for optimal interpretation of treatment effects. However, this window may be exceeded and factors determining ESWT Tlim are not completely understood. Therefore, we aimed to determine whether pulmonary function, physical and incremental shuttle walk test (ISWT) performance measures are associated with ESWT Tlim in COPD patients.

Methods

Assessment data from patients eligible for pulmonary rehabilitation was retrospectively analyzed. Inclusion criteria were: diagnosis of COPD and complete data availability regarding ESWT and ISWT. Patients performed an ESWT at 85% of ISWT speed and were divided into three groups (ESWT Tlim: 8 minutes). Subject characteristics, severity of complaints, pulmonary function, physical capacity and activity, exercise tolerance and quadriceps muscle strength were evaluated.

Results

245 COPD patients (FEV1 38 (29-52)% predicted) were included. Median ESWT Tlim was 6.0 (3.7-10.3) minutes, 41 (17%) patients walked 8 minutes. Body mass index, maximal oxygen consumption, Tlim on constant work rate cycle test, physical activity level, maximal ISWT speed, dyspnoea Borg score at rest and increase of leg fatigue Borg score during ISWT independently predicted Tlim in multivariate regression analysis (R-2 = 0.297, p

Conclusion

This study reported a large variability in ESWT Tlim in COPD patients. Secondly, these results demonstrated that next to maximal ISWT speed, other ISWT performance measures as well as clinical measures of pulmonary function, physical capacity and physical activity were independent determinants of ESWT Tlim. Nevertheless, as these determinants only explained similar to 30% of the variability, future studies are needed to establish whether additional factors can be used to better adjust individual ESWT pace in order to reduce ESWT Tlim variability.

Original languageEnglish
Article numbere0249786
Number of pages14
JournalPLOS ONE
Volume16
Issue number4
DOIs
Publication statusPublished - 21 Apr 2021

Keywords

  • EXERCISE INTOLERANCE
  • MUSCLE ENDURANCE
  • REFERENCE VALUES
  • COPD
  • CAPACITY
  • DETERMINANTS
  • RELIABILITY
  • VALIDATION
  • DISABILITY
  • PEOPLE

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