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Is a practice incremental shuttle walk test really necessary?

Fran Dyer1, Pamela Marriner, Katherine Cheema

  • 1The Respiratory Care Team, Surrey Community Health North West Locality, Chertsey, UK. fran.dyer@nhs.net

Chronic Respiratory Disease
|July 30, 2011
PubMed
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Omitting a practice incremental shuttle walking test (ISWT) in pulmonary rehabilitation may lead to clinical misjudgements. Patients perform significantly better on the actual ISWT than a practice ISWT, impacting exercise tolerance assessments.

Area of Science:

  • Pulmonary Rehabilitation
  • Exercise Physiology
  • Clinical Assessment

Background:

  • Incremental and endurance shuttle walking tests (ISWT and ESWT) are key measures of exercise tolerance in pulmonary rehabilitation (PR).
  • A practice ISWT is recommended but frequently omitted in PR settings.
  • The clinical impact of omitting a practice ISWT requires investigation.

Purpose of the Study:

  • To evaluate the effect of omitting a practice ISWT on patient outcomes within a clinical PR service.
  • To determine if a practice ISWT influences the assessment of exercise tolerance.

Main Methods:

  • A cohort of 392 patients attending PR between October 2002 and October 2008 were studied.
  • All patients completed both a practice ISWT and a formal ISWT.

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  • Endurance shuttle walking test (ESWT) levels were compared based on calculations from practice ISWT versus formal ISWT.

    • Main Results:

    • Patients demonstrated significantly greater walking distances on the ISWT compared to the practice ISWT (p ≤ 0.001).
    • A significant difference in ESWT levels was observed between those calculated from the practice ISWT and those from the formal ISWT (p ≤ 0.001).
    • No statistically significant relationship was found between baseline walking distance and the magnitude of difference between the two walks (p = 0.409).

    Conclusions:

    • The absence of a practice ISWT in clinical pulmonary rehabilitation may result in inaccurate clinical assessments.
    • Practice ISWTs are crucial for reliable evaluation of exercise tolerance and guiding PR interventions.
    • Omission of practice ISWTs could lead to misjudgements in patient management and program design.