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Validation of shuttle tests in children with cystic fibrosis
Hiran C Selvadurai1, Peter J Cooper, Nicholas Meyers
1Children's Chest Research Centre and Department of Respiratory Medicine, Children's Hospital at Westmead (Royal Alexandra Hospital for Children), Sydney, Australia. hiran.selvaldurai@sickkids.ca
Insights
Shuttle tests are reproducible and valid for assessing cardiorespiratory fitness in children with cystic fibrosis (CF). These simple field tests offer a reliable alternative when formal exercise testing is not feasible.
Area of Science:
- Pediatric Pulmonology
- Exercise Physiology
- Cardiorespiratory Fitness Assessment
Background:
- Shuttle tests are established field methods for estimating cardiorespiratory status in healthy children.
- Validation of shuttle tests in pediatric populations with cystic fibrosis (CF) was previously lacking.
- CF impacts cardiorespiratory health, necessitating reliable assessment tools.
Purpose of the Study:
- To evaluate the reproducibility and criterion validity of 10-m and 20-m shuttle tests in children with CF.
- To determine if shuttle tests can serve as a viable alternative to traditional exercise testing in this population.
Main Methods:
- Ninety-three children with CF (ages 6-16) with varying disease severity participated.
- Participants performed either the 10-m or 20-m shuttle test twice over two weeks.
- Gas analysis via a polargraphic analyzer was used during testing; results compared to treadmill testing.
Main Results:
- Both 10-m and 20-m shuttle tests demonstrated good reproducibility in CF patients.
- Differences between shuttle test results and treadmill testing were not statistically significant for either test.
- Mean differences in VO(2) for reproducibility were 2.41 mL/kg/min (10-m) and 2.07 mL/kg/min (20-m).
Conclusions:
- Shuttle tests are reproducible and valid for assessing cardiorespiratory fitness in children with cystic fibrosis.
- These tests provide a practical and accessible alternative when formal exercise testing is not feasible.
- Findings support the use of shuttle tests in routine clinical assessment of CF pediatric patients.
Abstract:
Shuttle tests are simple, inexpensive field tests that have been used to estimate the cardiorespiratory status of children. It has yet to be validated in children with CF. The aim of this study was to assess the reproducibility and criterion validity of shuttle tests in children with cystic fibrosis (CF). Ninety-three CF patients aged 6 to 16 years of age with a wide range of disease severity performed the study. The 10-m shuttle test was used for children 7 years of age and younger and those deemed too chronically ill by their physicians to perform the longer test (n = 35.) All other children performed the 20-m shuttle test (n = 58). Reproducibility and criterion validity were assessed for each child over a two week period. Gas analysis was performed throughout testing using a polargraphic gas analyzer. The 10-m shuttle tests were reproducible (mean difference between tests VO(2) 2.41 mL/kg/min, CI 3.46,-0.18) and the difference from treadmill testing was not statistically significant (mean difference VO(2) 5.30 mL/kg/min, CI-7.46, 1.18). The 20-m shuttle tests were reproducible (mean difference between tests VO(2) 2.07 mL/kg/min, CI-3.90,0.60) and the difference from treadmill testing was not statistically significant (mean difference VO(2) 3.50 mL/kg/min, CI-4.90, 1.60). We conclude that when formal exercise testing with treadmill or cycle ergometer cannot be performed, the shuttle tests provide a reproducible and valid alternative.