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Modified shuttle test performance in hospitalized children and adolescents with cystic fibrosis
Narelle S Cox1, Jennifer Follett, Karen O McKay
1Department of Physiotherapy, The Children's Hospital at Westmead, Westmead NSW, Australia.
Insights
The Modified Shuttle Test (MST) effectively measures exercise capacity changes in pediatric cystic fibrosis (CF) patients during hospitalization for antibiotic treatment. The MST showed responsiveness similar to lung function tests, highlighting its utility in this population.
Area of Science:
- Pediatric Pulmonology
- Exercise Physiology
- Clinical Trials
Background:
- The Modified Shuttle Test (MST) is validated for assessing exercise capacity in adult cystic fibrosis (CF) patients.
- Recent studies confirm MST validity in pediatric populations.
- Assessing treatment responsiveness in pediatric CF is crucial.
Purpose of the Study:
- To demonstrate the utility of the MST in measuring responsiveness to hospitalization for intravenous antibiotic and supportive therapy in pediatric and adolescent CF patients.
- To evaluate the MST as a sensitive indicator of clinical improvement following inpatient CF treatment.
Main Methods:
- 28 children and adolescents with CF underwent MST and lung function tests (FEV1, FVC, FEF25-75) within 48 hours of hospital admission and discharge.
- Participants received intravenous antibiotics and supportive care during their 14.7-day average hospital stay.
- Mean age of participants was 12.7 years.
Main Results:
- Significant improvements were observed in FEV1 (15%), FVC (13%), FEF25-75 (39%), and MST distance (102 m) post-treatment (all p<0.001).
- The percentage improvement in MST distance (18%) was comparable to FEV1 improvement.
- MST improvement could not be predicted by changes in FEV1 alone.
Conclusions:
- The Modified Shuttle Test is a useful tool for assessing the impact of hospitalization and i.v. antibiotic therapy on exercise capacity in pediatric and adolescent CF patients.
- MST responsiveness parallels improvements in lung function, offering a complementary measure of treatment efficacy.
- The MST provides valuable insights into functional recovery during CF exacerbation management.
Background:
The Modified Shuttle Test (MST) is a valid and sensitive measure of exercise capacity in adult CF patients. Recently, its validity in children has been demonstrated. The aim of this study was to demonstrate the utility of the MST as a measure of responsiveness to hospitalisation for i.v. antibiotic and supportive therapy in children and adolescents with CF.
Methods:
28 children and adolescents (40 admissions) performed a MST and lung function within 48 h of admission and discharge to hospital for administration of intravenous antibiotics. Mean age was 12.7 years and antibiotic therapy length was 14.7 days.
Results:
Upon admission, the mean (S.D.) FEV(1) was 63 (19)% predicted, FVC was 80 (18)% predicted, FEF(25-75) 43 (29)% predicted and MST distance 718 (232) m. FEV(1) increased by 15% (p
Conclusion:
This study demonstrated the utility of the MST to assess the effect of hospitalisation for i.v. antibiotic and supportive therapy in children and adolescents with CF.
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