Fixed-altitude stair-climbing test replacing the conventional symptom-limited test. A pilot study

Area of Science:

• Pulmonary function testing
• Cardiopulmonary exercise assessment
• Clinical exercise physiology

Background:

• Assessing maximum patient capacity is crucial for clinical decisions.
• Stair-climbing tests are used to evaluate exercise tolerance.
• A simpler, reliable test is needed for routine clinical practice.

Purpose of the Study:

• To compare patient maximal capacity between a standard 27m stair-climbing test and a 12m fixed-altitude test.
• To determine if the simpler fixed-altitude test can substitute the standard test.
• To validate the use of a simplified stair-climbing protocol in clinical settings.

Main Methods:

• A prospective, observational study involving 33 patients undergoing lung resection.
• Comparison of two stair-climbing tests: standard (27m) and fixed-altitude (12m).
• Measurement of heart rate, oxygen saturation, and calculation of power output (Watt) for both tests, analyzed using regression and Bland-Altman plots.

Main Results:

• All 33 patients completed the 12m fixed-altitude test, compared to only 12 for the 27m standard test.
• Mean power outputs were 184.1±65W (standard) and 214.5±75.1W (fixed-altitude).
• Regression analysis (R²=0.67) and Bland-Altman plots indicated reasonable concordance and no fixed bias between the tests.

Conclusions:

• The 12m fixed-altitude stair-climbing test demonstrates reasonable concordance with the standard 27m test.
• The fixed-altitude test is a viable and simpler alternative for assessing patient capacity.
• This simplified test can be recommended for clinical practice, improving patient adherence and feasibility.