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Related Experiment Videos

Minimum clinically important improvement for the incremental shuttle walking test.

S J Singh1, P W Jones, R Evans

  • 1Pulmonary Rehabilitation Research Group, Department of Respiratory Medicine and Thoracic Surgery, Glenfield Hospital, University Hospitals of Leicester NHS Trust, Groby Road, Leicester LE3 9QP, UK. sally.singh@uhl-tr.nhs.uk

Thorax
|April 9, 2008
PubMed
Summary
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The minimum clinically important difference for the Incremental Shuttle Walking Test (ISWT) in COPD patients is 47.5 meters. This finding helps quantify meaningful improvements in exercise capacity after pulmonary rehabilitation.

Area of Science:

  • Pulmonary Medicine
  • Rehabilitation Science
  • Clinical Exercise Physiology

Background:

  • The Incremental Shuttle Walking Test (ISWT) is a key measure of exercise capacity in Chronic Obstructive Pulmonary Disease (COPD) patients.
  • It is frequently used as an outcome in pulmonary rehabilitation programs.

Purpose of the Study:

  • To establish the minimum clinically important difference (MCID) for the ISWT.
  • To determine a threshold for meaningful improvement in exercise capacity for COPD patients undergoing rehabilitation.

Main Methods:

  • 372 COPD patients completed an ISWT pre- and post- a 7-week outpatient pulmonary rehabilitation program.
  • Patient-reported perceived change in exercise performance was assessed using a 5-point Likert scale immediately after the ISWT.

Related Experiment Videos

Main Results:

  • The mean ISWT distance improved from 168.5 m to 234.7 m post-rehabilitation (65.9 m difference).
  • Patients reporting 'slightly better' exercise tolerance improved by 47.5 m.
  • Patients reporting 'better' exercise tolerance improved by 78.7 m.

Conclusions:

  • Two distinct levels of meaningful improvement were identified for the ISWT.
  • The MCID for the ISWT was established at 47.5 meters.
  • An additional benefit was discernible at a 78.7-meter improvement.