Related Experiment Video
Updated: May 15, 2025

Home-Based Prescribed Pulmonary Exercise in Patients with Stable Chronic Obstructive Pulmonary Disease
Published on: August 24, 2019
Estimating endurance training intensity prescription from the 6-minute stepper test in people with chronic
Tristan Bonnevie1,2, Augustin Clet1,2, Marc Beaumont3,4
1Association ADIR, Aide à domicile aux Insuffisants Respiratoires, Rouen, France.
Background:
Home-based pulmonary rehabilitation (PR) can enhance accessibility to PR, but no at-home field exercise test has been validated for individualized endurance training prescriptions.
Research Question:
What is the accuracy of the six-minute stepper test (6MST) in estimating endurance training intensity as determined during cardiopulmonary exercise testing (CPET)?
Study Design And Method:
This multicenter (N = 3) cross-sectional study included individuals with COPD. Participants performed CPET and two 6MSTs to evaluate the 6MST's ability to estimate endurance training intensity based on CPET-derived heart rate at the first ventilatory threshold (HRvt1), the corresponding power output (Pvt1), and peak power output (Ppeak). Predictive equations were tested for external validity using data from two prior studies.
Results:
105 patients were included (mean age 61 (SD 9) years; mean FEV1 61 (SD 21) %). Predictive equations moderately predicted HRvt1 (r² = 0.38), strongly predicted Pvt1 (r² = 0.63) and very strongly predicted Ppeak (r² = 0.75). External validity was small to moderate for HRvt1 and Pvt1 but was strong for 60% of Ppeak (mean absolute difference: 10W, 95% CI 5 to 10). Passing and Bablok regression confirmed interchangeability for Pvt1 and 60% of Ppeak.
Interpretation:
The 6MST offers a reliable method to set initial training intensity when CPET is unavailable.
Clinical Trial Registration:
NCT02842463.
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