The incremental shuttle walk test was initially developed to be carried out in a hallway (ISWT-H) but has been modified to be performed on a treadmill (ISWT-T). However, it is still unknown whether performance on ISWT-H and ISWT-T are similar in patients with bronchiectasis. In this study, we compared the performance, physiological responses, and perception of effort between the ISWT-T with a handrail and ISWT-H for subjects with bronchiectasis. We also sought to estimate and compare the prescription for training intensity with both tests.
METHODS:
This was a cross-sectional study in which 24 subjects with bronchiectasis were evaluated on 2 different days (24 h apart). Distance walked (m) was compared between the ISWT-H and ISWT-T. A training session was held on a treadmill at 75% of the speed obtained from both tests. The walking distance, oxygen uptake (V̇O2), carbon dioxide production (V̇CO2), heart rate, and ventilation (V̇E) were measured.
RESULTS:
There was a difference in the walking distance between the ISWT-T and ISWT-H, but physiological responses for V̇O2, V̇CO2, heart rate, and V̇E were similar. However, the speed estimated for training was different, as were the V̇O2, V̇CO2, and heart rate.
CONCLUSIONS:
The ISWT-T with handrail and the ISWT-H are not interchangeable in subjects with bronchiectasis. A slower speed of training intensity may occur when the test is performed in a hallway, as originally described, and this may underestimate responses to aerobic training
SinghSJ, MorganMD, ScottS, WaltersD, HardmanAE. Development of a shuttle walking test of disability in patients with chronic airways obstruction. Thorax, 1992; 47(12):1019–1024.
2.
LeeAL, HillCJ, CecinsN, JenkinsS, McDonaldCF, BurgeAT, et al. The short and long term effects of exercise training in non-cystic fibrosis bronchiectasis: a randomised controlled trial. Respir Res, 2014; 15(1):44.
3.
HollandAE, SpruitMA, SinghSJ. How to carry out a field walking test in chronic respiratory disease. Breathe (Sheff), 2015; 11(2):128–139.
4.
StevensD, ElpernE, SharmaK, SzidonP, AnkinM, KestenS. Comparison of hallway and treadmill six-minute walk tests. Am J Respir Crit Care Med, 1999; 160(5 Pt 1):1540–1543.
5.
De AlmeidaFG, VictorEG, RizzoJA. Hallway versus treadmill 6-minute-walk tests in patients with chronic obstructive pulmonary disease. Respir Care, 2009; 54(12):1712–1716.
6.
SwertsPM, MostertR, WoutersEF. Comparison of corridor and treadmill walking in patients with severe chronic obstructive pulmonary disease. Phys Ther, 1990; 70(7):439–442.
7.
BeaumontA, CockcroftA, GuzA. A self paced treadmill walking test for breathless patients. Thorax, 1985; 40(6):459–464.
8.
MoloneyED, ClaytonN, MukherjeeDK, GallagherCG, EganJJ. The shuttle walk exercise test in idiopathic pulmonary fibrosis. Resp Med, 2003; 97(6):682–687.
9.
AlmodhyM, BenekeR, CardosoF, TaylorMJ, SandercockGR. Pilot investigation of the oxygen demands and metabolic cost of incremental shuttle walking and treadmill walking in patients with cardiovascular disease. BMJ, 2014; 4(9):e005216.
10.
LeeSJ, HidlerJ. Biomechanics of overground vs. treadmill walking in healthy individuals. J Appl Physiol, 2008; 104(3):747–755.
11.
ChangMD, ShaikhS, ChauT. Effect of treadmill walking on the stride interval dynamics of human gait. Gait Posture, 2009; 30(4):431–435.
12.
OrtegaJD, FehlmanLA, FarleyCT. Effects of aging and arm swing on the metabolic cost of stability in human walking. J Biomech, 2008; 41(16):3303–3308.
13.
UmbergerBR. Effects of suppressing arm swing on kinematics, kinetics, and energetics of human walking. J Biomech, 2008; 41(11):2575–2580.
14.
HollandAE, SpruitMA, TroostersT, PuhanMA, PepinV, SaeyD, et al. An official European Respiratory Society/American Thoracic Society technical standard: field walking tests in chronic respiratory disease. Eur Respir J, 2014; 44(6):1428–1446.
15.
FosterC, CroweAJ, DainesE, DumitM, GreenMA, LettauS, et al. Predicting functional capacity during treadmill testing independent of exercise protocol. Med Sci Sports Exerc, 1996; 28(6):752–756.
16.
HoffmannCL, DoughertyC, AbkarianHK, FoxM, JurisPM. The reduction of metabolic cost while using handrail support during inclined treadmill walking is dependent on the handrail use instruction. Int J Exercise Science, 2014; 7(4):339–345.
17.
BerlingJ, FosterC, GibsonM, DobersteinS, PorcariJ. The effect of handrail support on oxygen uptake during steady state treadmill exercise. J Cardiopulm Rehabil, 2006; 26(6):391–394.
18.
ArellanoCJ, KramR. The energetic cost of maintaining lateral balance during human running. J Appl Physiol, 2012; 112(3):427–434.
19.
McConnellT, FosterC, ConlinN, ThompsonN. Prediction of functional capacity during treadmill testing: effect of handrail support. J Cardiopulm Rehabil, 1991; 11(4):255–260.
20.
SpruitMA, SinghSJ, GarveyC, ZuWallackR, NiciL, RochesterC, et al. An official American Thoracic Society/European Respiratory Society statement: key concepts and advances in pulmonary rehabilitation. Am J Respir Crit Care Med, 2013; 188(8):e13–e64.
21.
PasteurM, BiltonD, HillA, StockleyRA, WilsonR, PasteurMC, et al. British Thoracic Society guidelines for non-CF bronchiectasis. Thorax, 2010; 65(Suppl 1):i1–i58.
22.
WHO Expert Committee. Physical status: the use and interpretation of anthropometry. World Health Organ Tech Rep Ser, 1995; 854:1–452.
23.
Sociedade Brasileira de Pneumologia. Diretrizes para testes da função pulmonar. J Pneumol, 2002; 28(Suppl 3):S44–S58.
24.
PereiraCAC, SatoT, RodriguesSC. New reference values for forced spirometry in white adults in Brazil. J Bras Pneumol, 2007; 33(4):397–406.
25.
KovelisD, SegrettiNO, ProbstVS, LareauSC, BrunettoAF, PittaF. Validação do Modified Pulmonary Functional Status and Dyspnea Questionnaire e da escala do Medical Research Council para o uso em pacientes com doença pulmonar obstrutiva crônica no Brasil. J Bras Pneumol, 2008; 34(12):1008–1018.
26.
BorgGA. Psychophysical bases of perceived exertion. Med Sci Sports Exerc, 1982; 14(5):377–381.
27.
ProbstVS, HernandesNA, TeixeiraDC, FelcarJM, MesquitaRB, GonçalvesCG, et al. Reference values for the incremental shuttle walking test. Respir Med, 2012; 106(2):243–248.
28.
GarberCE, BlissmerB, DeschenesMR, FranklinBA, LamonteMJ, LeeIM, et al. American College of Sports Medicine position stand. Quantity and quality of exercise for developing and maintaining cardiorespiratory, musculoskeletal, and neuromotor fitness in apparently healthy adults: guidance for prescribing exercise. Med Sci Sports Exerc, 2011; 43(7):1334–1359.
29.
CasaburiR, PatessioA, IoliF, ZanaboniS, DonnerCF, WassermanK. Reductions in exercise lactic acidosis and ventilation as a result of exercise training in patients with obstructive lung disease. Am Rev Respir Dis, 1991; 143(1):9–18.
30.
ChristmanSK, FishAF, BernhardL, FridDJ, SmithBA, MitchellL. Continuous handrail support, oxygen uptake, and heart rate in women during submaximal step treadmill exercise. Res Nurs Health, 2000; 23(1):35–42.
31.
ParreiraVF, Janaudis-FerreiraT, EvansRA, MathurS, GoldsteinRS, BrooksD. Measurement properties of the incremental shuttle walk test: a systematic review. Chest, 2014; 145(6):1357–1369.
32.
RevillSM, MorganMD, SinghSJ, WilliamsJ, HardmanAE. The endurance shuttle walk: a new field test for the assessment of endurance capacity in chronic obstructive pulmonary disease. Thorax, 1999; 54(3):213–222.
33.
HillK, DolmageTE, WoonL, CouttsD, GoldsteinR, BrooksD. A simple method to derive speed for the endurance shuttle walk test. Respir Med, 2012; 106(12):1665–1670.
