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

doi:10.1371/journal.pone.0249786

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 journal › Article › Academic › peer-review

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 language	English
Article number	e0249786
Number of pages	14
Journal	PLOS ONE
Volume	16
Issue number	4
DOIs	https://doi.org/10.1371/journal.pone.0249786
Publication status	Published - 21 Apr 2021

Keywords

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

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Cite this

Stoffels, A. A. F., van den Borst, B., Peters, J. B., Klaassen, M. P. M., van Helvoort, H. A. C., Meys, R., Klijn, P., Burtin, C., Franssen, F. M. E., van't Hul, A. J., Spruit, M. A., van Hees, H. W. H., & BASES Consortium (2021). Correlates of variability in endurance shuttle walk test time in patients with chronic obstructive pulmonary disease. PLOS ONE, 16(4), Article e0249786. https://doi.org/10.1371/journal.pone.0249786

@article{471719b8de22445cb05dda6712d54452,

title = "Correlates of variability in endurance shuttle walk test time in patients with chronic obstructive pulmonary disease",

abstract = "BackgroundThe 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.MethodsAssessment 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.Results245 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, pConclusionThis 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.",

keywords = "EXERCISE INTOLERANCE, MUSCLE ENDURANCE, REFERENCE VALUES, COPD, CAPACITY, DETERMINANTS, RELIABILITY, VALIDATION, DISABILITY, PEOPLE",

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

year = "2021",

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day = "21",

doi = "10.1371/journal.pone.0249786",

language = "English",

volume = "16",

journal = "PLOS ONE",

issn = "1932-6203",

publisher = "Public Library of Science",

number = "4",

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Stoffels, AAF, van den Borst, B, Peters, JB, Klaassen, MPM, van Helvoort, HAC, Meys, R, Klijn, P, Burtin, C, Franssen, FME, van't Hul, AJ, Spruit, MA, van Hees, HWH & BASES Consortium 2021, 'Correlates of variability in endurance shuttle walk test time in patients with chronic obstructive pulmonary disease', PLOS ONE, vol. 16, no. 4, e0249786. https://doi.org/10.1371/journal.pone.0249786

TY - JOUR

T1 - Correlates of variability in endurance shuttle walk test time in patients with chronic obstructive pulmonary disease

AU - Stoffels, A.A.F.

AU - van den Borst, B.

AU - Peters, J.B.

AU - Klaassen, M.P.M.

AU - van Helvoort, H.A.C.

AU - Meys, R.

AU - Klijn, P.

AU - Burtin, C.

AU - Franssen, F.M.E.

AU - van't Hul, A.J.

AU - Spruit, M.A.

AU - van Hees, H.W.H.

AU - BASES Consortium

PY - 2021/4/21

Y1 - 2021/4/21

N2 - BackgroundThe 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.MethodsAssessment 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.Results245 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, pConclusionThis 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.

AB - BackgroundThe 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.MethodsAssessment 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.Results245 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, pConclusionThis 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.

KW - EXERCISE INTOLERANCE

KW - MUSCLE ENDURANCE

KW - REFERENCE VALUES

KW - COPD

KW - CAPACITY

KW - DETERMINANTS

KW - RELIABILITY

KW - VALIDATION

KW - DISABILITY

KW - PEOPLE

U2 - 10.1371/journal.pone.0249786

DO - 10.1371/journal.pone.0249786

M3 - Article

C2 - 33882094

SN - 1932-6203

VL - 16

JO - PLOS ONE

JF - PLOS ONE

IS - 4

M1 - e0249786

ER -