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Abstract

Purpose: The aim of this study was to evaluate a new field test, the six-minute stepper test (6-MST), by studying its reproducibility, sensitivity and validity.

Methods: After a familiarization test, 16 patients with chronic obstructive pulmonary disease (COPD) and 15 healthy subjects performed two six-minute stepper tests per day over three evaluation days. Ten of the 16 patients with COPD also performed a six-minute walking test (6-MWT) with an analysis of gas exchange to compare the metabolic requirements of the two tests. Dyspnoea Borg values were evaluated with Borg’s CR-10 scale.

Results: The mean (SD) scores for the COPD group for the first and second six-minute stepper tests were 382.49 (106.01) and 412.45 (118.39) strokes/6 minutes, respectively. Crossed comparison between the first or the second six-minute stepper tests of each evaluation day revealed no significant difference, indicating the reproducibility of the test. The sensitivity was demonstrated by a significantly higher performance in the healthy group (P<0.001), demonstrating the ability of the test to detect two groups with different fitness levels. Finally, mean dyspnoea Borg values (SD) were significantly lower (P<0.05) during the six-minute stepper test than during 6-MWT (2.5 (1.5) versus 3.1 (1.2)).

Conclusions: This study demonstrated that the six-minute stepper test is a reproducible, sensitive, secure, well-tolerated and feasible test for patients with COPD. The reproducibility and sensitivity of the six-minute stepper test suggests that this test could be used in the evaluation of exercise tolerance in patients with COPD.

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References

Butland RJ , Pang J. , Gross ER , Woodcock AA , Geddes DM Two-, six-, and 12-minute walking tests in respiratory disease. Br Med J (Clin Res Ed) 1982; 284: 1607 608.

McGavin CR , Gupta SP , McHardy GJR Twelve-minute walking test for assessing disability in chronic bronchitis . BMJ 1976; 1: 822 23.

Behnke M. , Wewel AR , Kirsten D. , Jorres RA , Magnussen H. Exercise training raises daily activity stronger than predicted from exercise capacity in patients with COPD. Respir Med 2005; 99: 711 17.

Weiner P. , Magadle R. , Beckerman M. , Weiner M. , Berar-Yanay N. Maintenance of inspiratory muscle training in COPD patients: one year follow-up . Eur Respir J 2004; 23: 61 65.

Troosters T. , Vilaro J. , Rabinovich R. et al. Physiological responses to the 6-min walk test in patients with chronic obstructive pulmonary disease. Eur Respir J 2002; 20: 564 69.

Norweg AM , Whiteson J. , Malgady R. , Mola A. , Rey M. The effectiveness of different combinations of pulmonary rehabilitation program components: a randomized controlled trial. Chest 2005; 128: 663 72.

Lipkin DP , Scriven AJ , Crake T. , Poole-Wilson PA Six minute walking test for assessing exercise capacity in chronic heart failure . Br Med J (Clin Res Ed) 1986; 292: 653 55.

Kervio G. , Carre F. , Ville NS Reliability and intensity of the six-minute walk test in healthy elderly subjects . Med Sci Sports Exerc 2003; 35: 169 74.

Troosters T. , Gosselink R. , Decramer M. Six minute walking distance in healthy elderly subjects. Eur Respir J. 1999; 14: 270 74.

10.

Camarri B. , Eastwood PR , Cecins NM , Thompson PJ , Jenkins S. Six minute walk distance in healthy subjects aged 55 75 years. Respir Med 2006; 100: 658 65.

11.

Zugck C. , Kruger C. , Durr S. et al. Is the 6-minute walk test a reliable substitute for peak oxygen uptake in patients with dilated cardiomyopathy? Eur Heart J 2000; 21: 540 49.

12.

Rostagno C. , Galanti G. , Comeglio M. , Boddi V. , Olivo G. , Gastone Neri Serneri G. Comparison of different methods of functional evaluation in patients with chronic heart failure. Eur J Heart Fail 2000; 2: 273 80.

13.

Gayda M. , Temfemo A. , Choquet D. , Ahmaidi S. Cardiorespiratory requirements and reproducibility of the six-minute walk test in elderly patients with coronary artery disease. Arch Phys Med Rehabil 2004; 85: 1538 43.

14.

Ozdirenc M. , Biberoglu S. , Ozcan A. Evaluation of physical fitness in patients with Type 2 diabetes mellitus. Diabetes Res Clin Pract 2003; 60: 171 76.

15.

Rabinovich RA , Vilaro J. , Roca J. [Evaluation exercise tolerance in COPD patients: the 6-minute walking test]. Arch Bronconeumol 2004; 40: 80 85.

16.

American Thoracic Society. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med 2002; 166: 111 17.

17.

Singh SJ , Morgan MD , Scott S. , Walters D. , Hardman AE Development of a shuttle walking test of disability in patients with chronic airways obstruction. Thorax 1992; 47: 1019 24.

18.

Revill SM , Morgan MD , Singh SJ , Williams J. , Hardman AE The endurance shuttle walk: a new field test for the assessment of endurance capacity in chronic obstructive pulmonary disease. Thorax 1999; 54: 213 22.

19.

Dal Corso S. , Duarte SR , Neder JA et al. A step test to assess exercise-related oxygen desaturation in interstitial lung disease . Eur Respir J 2007; 29: 330 36.

20.

Rammaert B. , Leroy S. , Cavestri B. , Wallaert B. , Grosbois JM [Home-based pulmonary rehabilitation in idiopathic pulmonary fibrosis]. Rev Mal Respir 2009; 26: 275 82.

21.

Borg GA Psychophysical bases of perceived exertion. Med Sci Sports Exerc 1982; 14: 37781. 22 McLaughlin JE , King GA , Howley ET , Bassett Jr DR , Ainsworth BE Validation of the COSMED K4 b2 portable metabolic system. Int J Sports Med 2001; 22: 280 84.

22.

Bland JM , Altman DG Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986; 1: 307 10.

23.

Knox AJ , Morrison JF , Muers MF Reproducibility of walking test results in chronic obstructive airways disease . Thorax 1988; 43: 388 92.

24.

Mungall IP , Hainsworth R. Assessment of respiratory function in patients with chronic obstructive airways disease. Thorax 1979; 34: 254 58.

25.

Guyatt GH , Pugsley SO , Sullivan MJ et al. Effect of encouragement on walking test performance. Thorax 1984; 39: 818 22.

26.

Leung AS , Chan KK , Sykes K. , Chan KS Reliability, validity, and responsiveness of a 2-min walk test to assess exercise capacity of COPD patients. Chest 2006; 130: 119 25.

27.

Balfour-Lynn IM , Prasad SA , Laverty A. , Whitehead BF , Dinwiddie R. A step in the right direction: assessing exercise tolerance in cystic fibrosis. Pediatr Pulmonol 1998; 25: 278 84.

28.

Ong KC , Chong WF , Soh C. , Earnest A. Comparison of different exercise tests in assessing outcomes of pulmonary rehabilitation. Respir Care 2004; 49: 1498 503.

29.

Rosa FW , Camelier A. , Mayer A. , Jardim JR Evaluating physical capacity in patients with chronic obstructive pulmonary disease: comparing the shuttle walk test with the encouraged 6-minute walk test. J Bras Pneumol 2006; 32: 106 13.

30.

Nici L. , Donner C. , Wouters E. et al. American Thoracic Society/European Respiratory Society statement on pulmonary rehabilitation. Am J Respir Crit Care Med 2006; 173: 1390 413.

31.

Palange P. , Forte S. , Onorati P. , Manfredi F. , Serra P. , Carlone S. Ventilatory and metabolic adaptations to walking and cycling in patients with COPD. J Appl Physiol 2000; 88: 1715 20.

32.

Man WD , Soliman MG , Gearing J. et al. Symptoms and quadriceps fatigability after walking and cycling in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2003; 168: 562 67.

33.

Celli BR , Rassulo J. , Make BJ Dyssynchronous breathing during arm but not leg exercise in patients with chronic airflow obstruction. N Engl J Med 1986; 314: 1485 90.

An original field evaluation test for chronic obstructive pulmonary disease population: the six-minute stepper test

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