Exercise testing for children with cystic fibrosis: A systematic review
Ray Lei Lang1, Kellie Stockton2, Christine Wilson2
1School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia.
Insights
This review assesses exercise tests for children with cystic fibrosis (CF), finding the cardiopulmonary exercise test (CPET), 6-minute walk test (6MWT), and modified shuttle test (MST) offer fair to good psychometric properties.
Area of Science:
- Pediatric Pulmonology
- Exercise Physiology
- Rehabilitation Science
Background:
- Exercise testing is crucial for assessing exercise capacity in pediatric cystic fibrosis (CF) patients.
- A systematic review of psychometric properties of available exercise tests for this population was lacking.
Purpose of the Study:
- To systematically review the psychometric properties of exercise tests used in children aged 8-18 with CF.
- To provide guidance for selecting appropriate exercise tests for this population.
Main Methods:
- A systematic literature search was conducted across multiple databases (PubMed, Web of Science, etc.) for studies published after 1950.
- Included studies reported original psychometric data for exercise capacity measures in children with CF (ages 8-18).
- The COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist was used to evaluate psychometric evidence.
Main Results:
- 1025 papers were identified, with 46 included, covering 15 different exercise tests.
- Tests included incremental cardiopulmonary exercise test (CPET) via cycle or treadmill, 6-minute walk test (6MWT), modified shuttle test (MST), and others.
- The CPET, 6MWT, and MST demonstrated fair to good psychometric properties, though each has unique clinical benefits and drawbacks.
Conclusions:
- A wide range of exercise tests exist for pediatric CF patients, with variable psychometric quality.
- The CPET, 6MWT, and MST are recommended due to their relatively robust psychometric evidence.
- A Selection Guide was developed to aid clinicians and researchers in choosing the most suitable exercise test based on specific needs.
Background:
Exercise testing is routinely used to measure exercise capacity in children with cystic fibrosis (CF). Various tests are available, however the psychometric properties of these measures have not been systematically reviewed for this population.
Method:
A systematic search of electronic databases (PubMed, Web of Science, Medline, CINHAL, Cochrane, and PEDro) was performed to identify papers that: (a) reported original psychometric data, (b) examined a measure of exercise capacity, (c) examined children with CF aged eight to 18 years; and (d) were published in English after 1950. The level of psychometric evidence was evaluated using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist.
Results:
Searches identified 1025 papers. Forty-six papers were included, covering 15 tests: incremental cardiopulmonary exercise test using a cycle ergometer (CPET(cycle)) or treadmill (CPET(treadmill)), 6 minute walk test (6MWT), modified shuttle test (MST), 3-minute step test (3MST), 2 minute walk test (2MWT), Bratteby walk test, intermittent sprint test, speed ramp test, incremental step test, forward-backwards jump test (FBJT), astride jump test (AJT), motor quotient test, Munich fitness test, and Glittre ADL test.
Conclusion:
There is a plethora of exercise tests available with varying psychometric robustness. The CPET, 6MWT, and MST have fair to good psychometric properties, but each with their clinical advantages and limitations. Thus, a Selection Guide was developed to assist clinicians and researchers in selecting the most appropriate exercise test for various situations.
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