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Which field walking test should be used to assess functional exercise capacity in lung cancer? An observational study.

BMC pulmonary medicine
January 1, 1970
Catherine L Granger et al. (7 authors)
Journal ArticleObservational StudyResearch Support, Non-U.S. Gov'tHuman StudyClinical
Study Details

Study Goal

The researchers aimed to determine the criterion and construct validity of three walking tests (6MWT, ISWT, ESWT) compared to CPET, as well as their clinical applicability in individuals with NSCLC.

Results Summary

The ISWT showed moderate criterion validity with CPET peak oxygen consumption, while the 6MWT and ESWT had poor relationships. The 6MWT demonstrated moderate construct validity with respiratory function, but no walking tests correlated with function, strength, or HRQoL. The ESWT had a ceiling effect, and all walking tests were safe and required minimal time and personnel.

Population

Individuals with stage I-IIIb NSCLC (n=20, 40% male, mean age 66.1 ± 6.5 years).

Effective Dosage

Not Assessed

Duration

Not Assessed

Interactions

None mentioned

Extracted Claims (8)
InterventionDirectionEndpointPopulationDosageImpactClaim #
ISWT
increase
CPET peak oxygen consumption
participants with stage I-IIIb NSCLC
r = 0.61
demonstrated criterion validity with a moderate relationship
#1
6MWD
no change
CPET
participants with stage I-IIIb NSCLC
r = 0.24
poor relationship
#2
ESWT
no change
CPET
participants with stage I-IIIb NSCLC
r = 0.02
poor relationship
#3
6MWD
increase
forced vital capacity % predicted
participants with stage I-IIIb NSCLC
r = 0.53
moderate construct validity existed
#4
6MWD
increase
forced expiratory volume in the first second % predicted
participants with stage I-IIIb NSCLC
r = 0.55
moderate construct validity existed
#5
walking tests
no change
measures of function, strength or HRQoL
participants with stage I-IIIb NSCLC
-
no relationships
#6
ESWT
increase
maximum time
participants with stage I-IIIb NSCLC
18 %
had a ceiling effect
#7
tests
no change
floor effects
participants with stage I-IIIb NSCLC
-
No floor effects were seen
#8
Abstract

BACKGROUND: There is emerging evidence regarding the efficacy of exercise training to improve exercise capacity for individuals with non-small cell lung cancer (NSCLC). Cardiopulmonary exercise testing (CPET) is the gold standard measure of exercise capacity; however this laboratory test has limitations for use in research and clinical practice. Alternative field walking tests are the six-minute walk test (6MWT), incremental-shuttle walk test (ISWT) and endurance-shuttle walk test (ESWT); however there is limited information about their clinimetric properties in NSCLC. AIMS: In NSCLC to determine the 1) criterion validity of the 6MWT, ISWT and ESWT against CPET; 2) construct validity of the 6MWT, ISWT and ESWT against measures of function, strength, respiratory function and health-related quality of life (HRQoL); and 3) clinical applicability of the tests. METHODS: Twenty participants (40 % male, mean ± SD age 66.1 ± 6.5 years) with stage I-IIIb NSCLC completed the 6MWT, ISWT, ESWT and CPET within six months of treatment. Testing order was randomised. Additional measures included Eastern Cooperative Oncology Group Performance-Status (ECOG-PS, function), respiratory function, hand-grip dynamometry and HRQoL. Correlations and regression analyses were used to assess relationships. RESULTS: The ISWT demonstrated criterion validity with a moderate relationship between ISWT distance and CPET peak oxygen consumption (r = 0.61, p = 0.007). Relationships between CPET and six minute walk distance (6MWD) (r = 0.24, p = 0.329) or ESWT time (r = 0.02, p = 0.942) were poor. Moderate construct validity existed for the 6MWD and respiratory function (forced vital capacity % predicted r = 0.53, p = 0.019; forced expiratory volume in the first second % predicted r = 0.55, p = 0.015). There were no relationships between the walking tests and measures of function, strength or HRQoL. The ESWT had a ceiling effect with 18 % reaching maximum time. No floor effects were seen in the tests. The mean ± SD time required to perform the individual 6MWT, ISWT and ESWT was 12.8 ± 2.5, 14.7 ± 3.7 and 16.3 ± 5.0 min respectively; in comparison to CPET which was 51.2 ± 12.7 min. Only one assessor was required to perform all field walking tests and no adverse events occurred. CONCLUSIONS: The ISWT is a promising measure of functional exercise capacity in lung cancer. Findings need to be confirmed in a larger sample prior to translation into practice.

Medical Subject Headings (MeSH)
AgedCarcinoma, Non-Small-Cell LungExercise TestExercise ToleranceFemaleFollow-Up StudiesForced Expiratory VolumeHumansLung NeoplasmsMaleOxygen ConsumptionProspective StudiesReproducibility of ResultsWalking
Study Links
Quality Scores
Safety100
Efficacy70/10
Quality75/10
Citation Metrics
Total Citations28
Citations/Year2.8
Relative Citation Ratio1.16
NIH Percentile55.7%
Research Impact Scores
APT Score0.75
Weight Score1.72
Normalized Score0.83
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