Assessment of Exercise Capacity in Home Healthcare: Differences in Three Self-Paced Tests

Area of Science:

• Gerontology
• Exercise Physiology
• Clinical Assessment

Background:

• Submaximal functional endurance tests are common in clinical settings for assessing older adults.
• Understanding the physiological and perceptual responses to different functional tests is crucial for effective clinical application.
• Self-paced tests allow for individualized intensity, but direct comparisons of their impact are needed.

Purpose of the Study:

• To compare cardiovascular responses (heart rate, blood pressure), perceived exertion, and performance measures across three 2-minute functional endurance tests.
• To evaluate the differences between stepping in standing, seated stepping, and a 2-minute walk test in community-dwelling older adults.

Main Methods:

• Pilot study with a prospective, observational, cross-sectional design involving 16 community-dwelling older adults.
• Participants completed three randomly allocated, 2-minute, self-paced tests: stepping in standing (2MSTD), seated stepping (2MSIT), and a 2-minute walk test (2MWT).
• Cardiovascular measures (HR, SBP, DBP) and rating of perceived exertion (RPE) changes were analyzed using within-subjects repeated measures ANOVA; performance correlations were assessed using Pearson's correlations.

Main Results:

• Stepping in standing (2MSTD) resulted in significantly higher changes in heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and rating of perceived exertion (RPE) compared to seated stepping (2MSIT).
• 2MSTD also showed significantly higher SBP and RPE changes compared to the 2-minute walk test (2MWT).
• Strong correlations were found between steps completed in sitting and standing (r = 0.83) and moderate correlations between standing steps and walking distance (r = 0.56).

Conclusions:

• Two minutes of self-paced stepping in standing appears to be a more demanding functional endurance test for older adults, eliciting greater cardiovascular and perceptual responses.
• Seated stepping (2MSIT) may serve as a suitable alternative for individuals unable to perform standing or walking tests.
• The findings provide valuable insights for home care physical therapists in selecting appropriate functional endurance assessments.