AACVPR News & Views - April/May 2015 - (Page Cover3)

Why is this important in pulmonary rehabilitation? The six minute walk is the most commonly used test to evaluate program impact and outcome in PR. The incremental and endurance shuttle walk tests (ISWT and ESWT) are growing in use as they provide a valid approach to measure functional capacity in limited space. These articles provide the highest level of evidence (meta-analysis of randomized controlled trials) as well as the recommended "how-to" to perform these field tests that are central to PR impact measurement. Pulmonary Point of View Continued from page 13 * * been reported with similar observations for the ISWT. All were found to be sensitive to change, particularly after a course of PR. Testing procedures that are consistent across the 6MWT, ISWT and ESWT include test location and staffing, patient assessment and preparation, use of oxygen and medications, indications for test cessation, and quality assurance. Difference across tests: * The 6MWT performance can be influenced by course layout and track length. These variations have not been reported for ISWT or ESWT. * The 6MWD is very sensitive to variations in methodology, including use of encouragement, provision of supplemental oxygen, changes in track layout 18 News&Views APRIL/MAY 2015 * * * and length, and use of wheeled walkers. These factors should be held constant on repeat testing. Continuous pulse oximetry is recommended during the 6MWT, to ensure that the lowest SpO2 is recorded. The primary outcome for the 6MWT and the ISWT is distance in meters while the outcome for ESWT is usually reported as time walked. Walking aids improving walk distance has been reported only in the 6MWT. Minimally clinically important differences: * 6MWT: between 25 and 33 meters. * ISWT: A change of 47.5 meters (approximately 5 shuttles). * ESWT: 65 seconds or 85 meters after bronchodilation; after rehabilitation is yet to be determined. Available in PDF format at the American Thoracic Society Documents: Pulmonary Function Testing webpage.  References Singh SJ, Puhan MA, Andrianopoulos V, Hernandes NA, Mitchell KE, Hill CJ, Lee AL, Camillo CO, Troosters T, Spruit MA, Carlin BW, Wanger J, Pepin V, Saey D, Pitta F, Kaminsky DA, McCormack MC, MacIntyre N, Culver BH, Sciurba FC, Revill SM, Delafosse V, & Holland AE. (2014). An official systematic review of the European Respiratory Society/ American Thoracic Society: measurement properties of field walking tests in chronic respiratory disease. European Respiratory Journal 44: 1447-1478 | DOI: 10.1183/09031936.00150414 Holland AE, Spruit MA, Troosters T, Puhan MA, Pepin V, Saey D, McCormack MC, Carlin BW, Sciurba FC, Pitta F, Wanger J, MacIntyre N, Kaminsky DA, Culver BH, Revill SM, Hernandes NA, Andrianopoulos V, Camillo CO, Mitchell KE, Lee AL, Hill CJ, & Singh SJ. (2014). An official European Respiratory Society/American Thoracic Society technical standard: field walking tests in chronic respiratory disease. European Respiratory Journal 44: 1428-1446 | DOI: 10.1183/09031936.00150314 http://www.thoracic.org/patients/patient-resources/resources/pulmonary-function-tests.pdf http://www.thoracic.org/patients/patient-resources/resources/pulmonary-function-tests.pdf http://www.thoracic.org/patients/patient-resources/resources/pulmonary-function-tests.pdf

AACVPR News & Views - April/May 2015

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