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Sally Singh - One of the best experts on this subject based on the ideXlab platform.

  • minimum important difference of the incremental Shuttle Walk Test distance in patients with copd
    Thorax, 2019
    Co-Authors: Rachael A Evans, Sally Singh
    Abstract:

    We aimed to describe the minimum important difference (MID) of the incremental Shuttle Walk Test (ISWT) in patients with COPD using both distribution and anchor-based methods. Two cohorts were used (n=613) with eligibility criteria of a clinical diagnosis of COPD, an FEV1/FVC

  • the minimal important difference for the endurance Shuttle Walk Test in individuals with chronic obstructive pulmonary disease following a course of pulmonary rehabilitation
    Chronic Respiratory Disease, 2019
    Co-Authors: Jakub Zatloukal, Sally Singh, Linzy Houchenwolloff, Sarah Ward, Theresa Harveydunstan
    Abstract:

    The endurance Shuttle Walk Test (ESWT) is frequently used as an outcome measure for pulmonary rehabilitation (PR). The minimal important difference (MID) for the ESWT after a course of rehabilitati...

  • the validity and reliability of the incremental Shuttle Walk Test and six minute Walk Test compared to an incremental cycle Test for people who have had a mild to moderate stroke
    Physiotherapy, 2019
    Co-Authors: Nicola Claguebaker, Thompson G Robinson, Annegret Hagenberg, Sophie Drewry, Clare L Gillies, Sally Singh
    Abstract:

    Abstract Objective To determine the construct validity and Test re-Test reliability of the Six-minute Walk Test (6MWT) and Incremental Shuttle Walk Test (ISWT) in the sub-acute recovery phase following mild-to-moderate severity stroke. Participants 40 stroke patients (mean age: 68.27 years, SD: 13.48) of median National Institutes of Health Stroke Scale (NIHSS) score 1.2 (range: 0 to 8) within six months of stroke. Method Each participant completed one Incremental Cycle Test (ICT) followed by two ISWT and two 6MWT in a randomised order. Pearson’s Correlation Coefficients were used to determine the validity and Bland Altman plots were used to determine the Test re-Test reliability. Results The Incremental Cycle Test (ICT) was positively correlated with the ISWT (r = 0.59, 95% confidence intervals 0.35 to 0.76, P = 0.001) and the 6MWT (0.55, 0.35 to 0.71, P  Conclusion The ISWT and 6MWT have a significant, modest correlation with the ICT for stroke patients in the sub-acute recovery phase. The ISWT and 6MWT are not strongly correlated with ICT (VO2 peak) in a stroke population that is disabled. The Test–reTest reliability of the ISWT and 6MWT indicated that two Tests may be needed to accurately assess an individual’s capabilities.

  • understanding the measurement properties of the incremental Shuttle Walk Test in patients with severe asthma
    Respirology, 2019
    Co-Authors: Sally Majd, Sally Singh, Stacey Hewitt, Lindsay Apps, Anna Murphy, Peter Bradding, Ruth H Green
    Abstract:

    BACKGROUND AND OBJECTIVE We investigated the repeatability and validity of the incremental Shuttle Walk Test (ISWT) distance compared to peak oxygen uptake (VO2pk ) during maximal incremental cycle ergometer (ICE) and treadmill (ITM) Tests in adults with severe asthma. METHODS Adults with severe asthma, Medical Research Council (MRC) dyspnoea ≥2, were recruited from specialists caring for patients with severe asthma. All participants performed three ISWT (familiarization and two subsequent Tests on the same day), an ICE and an ITM in a randomized order, on separate days, to intolerance with expiratory gas analysis. RESULTS A total of 50 patients (32 females, mean (SD), age: 54 (13) years, forced expiratory volume in 1 s (FEV1 ): 1.9 (0.8) L and body mass index (BMI): 32 (6) kg/m2 ) completed all five Tests. The mean (SD) ISWT distance for each Test was 400 (156), 418 (142) and 438 (157) m (P = 0.001), respectively. There was a strong correlation between the ISWT distance with VO2pk derived from ITM (r = 0.74, P < 0.001) and ICE (r = 0.75, P < 0.001). CONCLUSION There was a small increase in the mean ISWT distance on sequential Testing. In clinical practice, the coefficient of repeatability and heteroscedasticity need to be considered when assessing whether a true change has occurred within an individual patient. The ISWT has validity compared to VO2pk on both ICE and ITM, but they are not interchangeable.

  • the influence of south asian ethnicity on the incremental Shuttle Walk Test in uk adults
    Chronic Respiratory Disease, 2018
    Co-Authors: Mark Orme, Sally Singh, M D L Morgan, Michael C Steiner, Lauren B Sherar, Dale W Esliger, Andrew P Kingsnorth
    Abstract:

    The objective of this study was to compare incremental Shuttle Walking Test (ISWT) performance between South Asian and Caucasian British adults, identify predictors of ISWT distance and produce ethnicity-specific reference equations. Data from a mixed gender sample aged 40-75 years from Leicestershire, United Kingdom, were selected for analyses. Analysis of covariance determined differences in ISWT performance between South Asian and Caucasian British ethnic groups. Linear regressions identified predictors of ISWT distance, which determined the reference equations. In total, 144 participants took part in the study (79 South Asian (54 ± 8 years, 71% female) and 65 Caucasian British (58 ± 9 years, 74% female)). Distance Walked for the ISWT was shorter for South Asian individuals compared with Caucasian British (451 ± 143 vs. 575 ± 180 m, p < 0.001). The ethnicity-specific reference equations for ISWT distance explained 33-50% of the variance (standard error of the estimate (SEE): 107-119 m) for South Asians and explained 14-58% of the variance (SEE: 121-169 m) for Caucasian British. Ethnicity univariately explained 12.9% of the variance in ISWT distance and was significantly associated with ISWT distance after controlling for age, gender, height, weight, dyspnoea and lung function ( B = -70.37; 1 = Caucasian British, 2 = South Asian), uniquely explaining 3.7% of the variance. Predicted values for ISWT performance were lower in South Asian people than in Caucasian British. Ethnicity-specific reference equations should account for this.

Dina Brooks - One of the best experts on this subject based on the ideXlab platform.

  • measurement properties of the incremental Shuttle Walk Test a systematic review
    Chest, 2014
    Co-Authors: Veronica Franco Parreira, Roger S Goldstein, Dina Brooks, Tania Janaudisferreira, Rachel Evans, Sunita Mathur
    Abstract:

    Background: The incremental Shuttle Walk Test (ISWT) was developed > 20 years ago and has been used to assess peak exercise capacity in a variety of chronic diseases. The aim of this systematic review is to describe the measurement properties of the ISWT in a clinical population.Methods: Of 800 articles identified by electronic and hand searches, 35 were included. Twenty-one articles included data on the validity of the ISWT, 18 on the reliability, four on the responsiveness,and four on the interpretability.Results: Most of the studies were conducted in patients with COPD (n = 13) or cardiac disease(n = 8). For criterion validity, comparisons between distance covered during the ISWT and peak oxygen consumption reported correlations ranging from 0.67 to 0.95 ( P <.01). Intraclass correlation coefficients for Test-reTest reliability ranged from 0.76 to 0.99. The ISWT was shown to be responsive to pulmonary rehabilitation and bronchodilator administration. The minimal clinically important difference (MCID) in patients with COPD was 48 m. Predictive equations for the distance in the ISWT are available for healthy individuals.Conclusions: The ISWT can be considered a valid and reliable Test to assess maximal exercise capacity in individuals with chronic respiratory diseases. The ISWT has been shown to be responsive to pulmonary rehabilitation and bronchodilator use in individuals with COPD, cystic fibrosis,and asthma. Further studies examining responsiveness and the MCID of the ISWT in patients with conditions other than lung diseases are required for the interpretation of interventions in other populations.

  • a simple method to derive speed for the endurance Shuttle Walk Test
    Respiratory Medicine, 2012
    Co-Authors: Kylie Hill, Thomas E Dolmage, Lynda Woon, Debbie Coutts, Roger S Goldstein, Dina Brooks
    Abstract:

    Summary Background The original method for determining endurance Shuttle Walk Test (ESWT) speed involves components that are time consuming for clinicians. We sought to determine: (i) whether components described in the original method for determining ESWT speed held true and; (ii) the agreement between speeds derived using the original method and that equivalent to 85% of the peak speed achieved during the incremental Shuttle Walk Test (ISWT). Methods Patients with chronic obstructive pulmonary disease (COPD) performed two ISWTs and one ESWT on separate days, wearing a calibrated portable gas analysis unit. A retrospective analysis of these data allowed us to determine whether: (i) the peak rate of oxygen uptake ( V ˙ O 2 peak ) can be accurately estimated from the incremental Shuttle Walk distance (ISWD) and; (ii) ESWTs performed at a speed derived using the original method elicited 85% of V ˙ O 2 peak . Agreement between Walks speeds was determined using Bland–Altman analysis. Results Twenty-two participants (FEV 1 48 ± 13% predicted, age 66 ± 8 yr) completed the study. The V ˙ O 2 peak estimated from the ISWD was less than that measured during the ISWT (mean difference −4.4; 95% confidence interval (CI), −6.0 to −2.9 ml· kg −1 ·min −1 ). The ESWT and ISWT elicited similar V ˙ O 2 peak (mean difference −0.2; 95% CI, −1.5 to 1.2 ml·kg −1 ·min −1 ). The mean difference (±limits of agreement) between ESWT speeds was 0.15 (±0.34) km·h −1 . Conclusions Components of the original method for determining the ESWT speed did not hold true in our sample. ESWT speed can be derived by calculating 85% of the peak speed achieved during the ISWT.

  • comparing peak and submaximal cardiorespiratory responses during field Walking Tests with incremental cycle ergometry in copd
    Respirology, 2012
    Co-Authors: Kylie Hill, Thomas E Dolmage, Lynda Woon, Debbie Coutts, Roger S Goldstein, Dina Brooks
    Abstract:

    Background and objective:  Field and laboratory-based Tests are used to measure exercise capacity in people with COPD. A comparison of the cardiorespiratory responses to field Tests, referenced to a laboratory Test, is needed to appreciate the relative physiological demands. We sought to compare peak and submaximal cardiorespiratory responses to the 6-min Walk Test, incremental Shuttle Walk Test and endurance Shuttle Walk Test with a ramp cycle ergometer Test (CET) in patients with COPD. Methods:  Twenty-four participants (FEV1 50 ± 14%; 66.5 ± 7.7 years; 15 men) completed four sessions, separated by ≥24 h. During an individual session, participants completed either two 6-min Walk Tests, incremental Shuttle Walk Tests, endurance Shuttle Walk Tests using standardized protocols, or a single CET, wearing a portable gas analysis unit (Cosmed K4b2) which included measures of heart rate and arterial oxygen saturation (SpO2). Results:  Between Tests, no difference was observed in the peak rate of oxygen uptake (F3,69 = 1.2; P = 0.31), end-Test heart rate (F2,50 = 0.6; P = 0.58) or tidal volume (F3,69 = 1.5; P = 0.21). Compared with all Walking Tests, the CET elicited a higher peak rate of carbon dioxide output (1173 ± 350 mL/min; F3,62 = 4.8; P = 0.006), minute ventilation (48 ± 17 L/min; F3,69 = 10.2; P < 0.001) and a higher end-Test SpO2 (95 ± 4%; F3,63 = 24.9; P < 0.001). Conclusions:  In patients with moderate COPD, field Walking Tests elicited a similar peak rate of oxygen uptake and heart rate as a CET, demonstrating that both self- and externally paced Walking Tests progress to high intensities.

Jennifer A Alison - One of the best experts on this subject based on the ideXlab platform.

  • repeatability of the endurance Shuttle Walk Test in people with chronic obstructive pulmonary disease
    Clinical Respiratory Journal, 2017
    Co-Authors: Shirley P C Ngai, Lissa Spencer, Alice Y M Jones, Jennifer A Alison
    Abstract:

    Introduction: Walking Tests, including the endurance Shuttle Walk Test (ESWT), have been used to assess functional capacity in people with chronic obstructive pulmonary disease (COPD). Learning effects through repeated practice have been reported for some field Walking Tests. However, the repeatability of ESWT at various time points, i.e. within the same day, within the week and one week apart, has not been examined. Objectives: This study aimed to evaluate the repeatability of ESWT overtime to determine whether or not a learning effect existed. Methods: Twenty-two participants diagnosed with COPD [age 71 ± 6 years; FEV% predicted 54 ± 24%] were recruited. Participants performed two incremental Shuttle Walk Tests to determine the Walking speed for the ESWT and a practice ESWT (E) to determine whether the ESWT level was appropriate. ESWT 1(E) and ESWT 2(E) were performed on the same day, 30 min apart; ESWT 3(E) was performed within a week from E; ESWT 4(E) was performed one week after E. Duration Walked in each ESWT was recorded. The repeatability of the four ESWTs was analyzed using repeated measures analysis of variance. Results: The mean durations of E to E were 368 ± 203 s, 371 ± 182 s, 386 ± 213 s and 367 ± 223 s, respectively, with no time effect (F=0.18, P=0.79). Conclusion: There was no evidence of learning effect when ESWT was repeated within one day, within one week and one week apart, once the appropriate baseline level was established, showing that ESWT is repeatable in people with moderate COPD.

  • estimating endurance Shuttle Walk Test speed using the six minute Walk Test in people with chronic obstructive pulmonary disease
    Chronic Respiratory Disease, 2014
    Co-Authors: Sally L Wootton, Jennifer A Alison, Kylie Hill, Zoe J Mckeough, Sue Jenkins
    Abstract:

    The objective of this study was to derive and validate an equation to estimate the speed for the endurance Shuttle Walk Test (ESWT) using results from the six-minute Walk Test (6MWT) in patients with chronic obstructive pulmonary disease (COPD). Participants with diagnosed COPD (n = 84) performed two incremental Shuttle Walk Tests (ISWTs) and two 6MWTs. ESWT speed was calculated from the ISWT results using the original published method. An equation was derived, which directly related six-minute Walk distance (6MWD) to ESWT speed. The derived equation was validated in a different group of people with COPD (n = 52). There was a strong correlation between average 6MWD and the calculated ESWT speed (r = 0.88, p < 0.001). The ESWT speed (kilometre per hour) was estimated using the following equation: 0.4889 + (0.0083 × 6MWD). The mean difference (±limits of agreement) between ESWT speeds was calculated using the original published method and found to be 0.03 (±0.77) km/hour. When the ISWT is not the Test of choice for clinicians, the 6MWT can be used to accurately estimate the speed for the ESWT.

  • repeatability of the endurance Shuttle Walk Test in copd
    European Respiratory Journal, 2012
    Co-Authors: Shirley P C Ngai, Jennifer A Alison, Lissa Spencer, Alice Y M Jones
    Abstract:

    The aim was to evaluate the repeatability of the endurance Shuttle Walk Test (ESWT) measured within the same day, within the same week and a week apart. Methods: Individuals diagnosed with COPD were recruited. Participants were asked to perform two incremental Shuttle Walk Tests (ISWT) for predicting the Walking intensity for the ESWT. ESWT 1 (E1) and ESWT 2 (E2) were performed on the same day, 30 minutes apart. ESWT 3 (E3) was performed within a week from E2 and ESWT 4 (E4) was performed one week after E3. Heart rate (HR) (Polar RS800CX, Polar, Finland) and dyspnoea (Borg scale 0-10) were measured before and after each ESWT. Duration Walked in each ESWT was measured and the corresponding Walking distance was calculated. The repeatability of the four ESWTs was analyzed using repeated measures ANOVA. Results: Twenty-two participants (mean ± SD age 71±6 years; FEV1% predicted 54 ±24%; TLC 122±21%) completed the study. The mean durations of E1 to E4 were 368±203s, 371±182s, 386±213s and 367±223s respectively, with no time effect (F= 0.18, p=0.79). The corresponding distances Walked in E1 to E4 were 474±300m, 478±267m, 511±349m, 487±358m respectively, with no time effect (F=0.36, p=0.65). The percentage predicted HRmax at the end of E1 to E4 were 79±9 %, 80±11%, 82±9%, 80±9% respectively, with no significant time effect (F=1.94, p=0.13). Conclusion: There was no evidence of a learning effect when an ESWT was repeated within one day, within one week or a week apart, showing that the ESWT is repeatable in people with moderate COPD.

  • prescription of Walking exercise intensity from the incremental Shuttle Walk Test in people with chronic obstructive pulmonary disease
    American Journal of Physical Medicine & Rehabilitation, 2012
    Co-Authors: Rahizan Zainuldin, Martin Mackey, Jennifer A Alison
    Abstract:

    ABSTRACTObjectiveThis study determined the intensity of Walking exercise prescribed from 70% of peak speed achieved during the incremental Shuttle Walk Test (ISWT) in people with chronic obstructive pulmonary disease and whether a steady-state response was achieved when exercising at this intensity.

  • predicting peak cycle work rate from the incremental Shuttle Walk Test in copd
    European Respiratory Journal, 2011
    Co-Authors: Rahizan Zainuldin, Martin Mackey, Nia Luxton, Jennifer A Alison
    Abstract:

    Equations predicting peak work rate (Wpeak) on an incremental cycle Test (ICT) from an incremental Shuttle Walk Test (ISWT) have been developed but often overestimate Wpeak. Since peak oxygen consumption (VO2) from the ISWT and ICT have been shown to be equivalent in moderate to severe COPD, it may be possible to use VO2 as the common measure between ISWT and ICT to improve the accuracy of the predictive equations. The study aimed to develop equations to estimate the Wpeak of an ICT from an ISWT using VO2 as the common link. In a prospective study 45 participants with COPD (mean [SD] FEV1 = 57 [18]%predicted) performed an ICT and two ISWTs. Data from the better ISWT were used for analysis. Gas exchange during exercise Tests was measured by a portable gas analyser. The analyses performed were: 1) Stepwise multiple regression analysis with independent variables of gender, age, height, FEV1 and ISWwork (product of ISWdistance and weight) used to develop an equation predicting peak VO2 (VO2peak(ICT)); 2) The slopes and intercepts of the relationship between VO2(ICT) and work rate for each participant were averaged to create an equation relating VO2(ICT) and work rate. The mean peak VO2 measured in the ISWT and ICT were not significantly different. From the stepwise analysis, the regression equation was VO2peak(ICT) = 0.016$*$ISWwork + 9.28$*$Ht – 831.6 (r=0.79). A linear relationship between VO2(ICT) and work rate was found, thus an equation to predict peak work rate was developed as: Wpeak = (VO2peak(ICT) – 425)/10.3. The calculation of a Wpeak(ICT) from a clinically available ISWT via these equations may aid prescription of cycle training intensity when an ICT is unavailable.

Catherine Billings - One of the best experts on this subject based on the ideXlab platform.

  • incremental Shuttle Walk Test predicts survival in non group 1 pulmonary hypertension without a ceiling effect
    European Respiratory Journal, 2018
    Co-Authors: Catherine Billings, Judith Hurdman, Matthew Austin, Iain Armstrong, Charlie Elliot, I Smith, Athanasios Charalampopoulos, Ian Sabroe, Robert Lewis, Allan Lawrie
    Abstract:

    Background: We have recently demonstrated in Group 1 pulmonary hypertension (PH) that distance Walked during the incremental Shuttle Walking Test (ISWT) correlates with pulmonary haemodynamics and predicts survival without a ceiling effect (1). This study assesses the utility of the ISWT in patients with non-group 1 PH. Methods: Data were retrieved from the ASPIRE registry (Assessing the Spectrum of Pulmonary hypertension Identified at a REferral centre) for consecutive patients diagnosed with pulmonary hypertension between 2001-10 (2). For inclusion patients were required to have been systematically assessed as Group 2-5 PH and to have a baseline ISWT within 3 months of cardiac catheterization. Patients were stratified according to ISWT distance (ISWD) and ISWD%pred. Results: 479 patients with non-group 1 PH were identified. ISWD and ISWD%pred correlated significantly both with the severity of symptoms and with haemodynamic parameters. Kaplan-Meier analysis demonstrated that both ISWD and ISWD%pred predicted survival with no ceiling-effect (p Conclusion: This study shows that the ISWT distance predicts survival in patients with Group 2-5 PH without a ceiling effect. References: 1) Billings et al. J Heart Lung Transplant 2017;36:871-879. 2) Hurdman et al. Eur Respir J 2012;39:945-55.

  • incremental Shuttle Walk Test distance and autonomic dysfunction predict survival in pulmonary arterial hypertension
    Journal of Heart and Lung Transplantation, 2017
    Co-Authors: Catherine Billings, Judith Hurdman, Matthew Austin, Iain Armstrong, Charlie Elliot, Robin Condliffe, I Smith, Neil Hamilton, Athanasios Charalampopoulos, Ian Sabroe
    Abstract:

    Background To ensure effective monitoring of pulmonary arterial hypertension (PAH), a simple, reliable assessment of exercise capacity, applicable over a range of disease severity is needed. The study aim was to assess the ability of the incremental Shuttle Walking Test (ISWT) to correlate with disease severity, measure sensitivity to change and predict survival in PAH. Methods 418 treatment-naive patients with PAH, with baseline ISWT within 3 months of cardiac catheterization, were enrolled. The clinical validity and prognostic value of the ISWT distance was assessed at baseline and 1 year. Results ISWT distance was found to correlate at baseline with World Health Organisation functional class, Borg score and haemodynamics without a ceiling-effect (all p 18, highest SBP, ΔSBP and 3minute SBP ratio) were significant predictors of survival (all p Conclusions In patients with PAH the ISWT is simple to perform, allows assessment of maximal exercise capacity, is sensitive to treatment effect, predicts outcome and has no ceiling-effect. In addition, we have also shown that measures of autonomic function made post-exercise predict survival in PAH.

  • p170 heart rate recovery at one minute following incremental Shuttle Walk Test predicts outcome in pulmonary hypertension
    Thorax, 2014
    Co-Authors: Catherine Billings, Judith Hurdman, Matthew Austin, Iain Armstrong, Charlie Elliot, Robin Condliffe, David G Kiely
    Abstract:

    Background Heart-rate recovery during the first minute of rest (HRR1) after a six minute Walk Test (6MWT) has been shown to be a strong predictor of clinical worsening in patients with pulmonary arterial hypertension.1 No data as yet has been published regarding the utility of HRR1 as a predictor of mortality. Aim To assess the prognostic value of HRR1 after an Incremental Shuttle Walk Test (ISWT) in patients with pulmonary hypertension (PH). Methods Data was retrieved for consecutive cases of PH diagnosed in our unit from 2001–2010. ISWT was performed routinely as part of baseline assessment according to a modified protocol of Singh et al .2 Only treatment-naive patients with ISWT and HRR data from -90 to +30 days from date of diagnosis were included. HRR1 was defined as the difference between maximum heart rate during the ISWT and heart rate after 1 min of rest following the termination of ISWT. Results Data was available for 491 patients (including patients from each of the 5 main PH diagnostic groups). HRR1 correlated significantly with ISWT distance, highest heart-rate, maximal change in heart-rate,% predicted carbon monoxide diffusion (DLco%pred), pulmonary vascular resistance, cardiac output and mixed venous oxygen saturation (p all ≤0.01). Using a cut-off point of 18bpm the Kaplan Meier graph for survival for patients with HRR1 >18 bpm (n = 179) was significantly better than HRR1 ≤18 bpm (n = 312), p = 0.007 ([Figure 1][1]) for all patients and for diagnostic Groups 1 and 2 separately (p = 0.045, p = 0.006). Using univariate Cox proportional hazard analysis for all patients HRR1 (continuous data) had a Hazard Ratio for mortality (HR) of 0.990 with a confidence interval (CI) of 0.962–0.997, p = 0.008. Compared to patients with HRR1 >18, those with HRR1≤18 had a HR of 1.559 (CI 1.127–2.156) p = 0.007. Grouping patients by median distance Walked and HRR1–18 demonstrated that the HRR1 proved a useful predictor only in patients who Walked less than 180 m. Conclusion HRR1 following ISWT predicts outcome in patients with pulmonary hypertension with more severe disease. References 1. 1Minai OA et al . Am J Respir Crit Care Med . 2012;185:400-408 2. Singh et al . Thorax 1992;47:1019–1024 ![Abstract P170 Figure 1][2] Abstract P170 Figure 1 [1]: #F1 [2]: pending:yes

  • incremental Shuttle Walk Test in the assessment of patients with obstructive sleep apnea hypopnea syndrome
    Journal of Sleep Research, 2013
    Co-Authors: Catherine Billings, Thida Aung, Stephen A Renshaw, Stephen Bianchi
    Abstract:

    Summary Obstructive sleep apnea–hypopnea syndrome is associated independently with an increase in cardiovascular risk factors and is associated with self-reported lack of exercise. We aimed to investigate the utility of the incremental Shuttle Walk Test in routine clinical practice to monitor physical capacity of patients with obstructive sleep apnea–hypopnea syndrome and explore whether continuous positive airway pressure therapy alters exercise capacity. Participants with symptomatic moderate/severe obstructive sleep apnea–hypopnea syndrome attending for a trial of continuous positive airway pressure therapy completed questionnaires assessing sleepiness and physical activity and underwent an incremental Shuttle Walk Test. Subjects compliant or partially compliant with continuous positive airway pressure therapy underwent reassessment at 2 weeks, 3 months and 6 months post-initiation of therapy. Participants unable to tolerate continuous positive airway pressure therapy completed a single reassessment 6 months after their initial visit. Continuous positive airway pressure therapy resulted in an increased distance Walked during the incremental Shuttle Walk Test. Improvements in cardiovascular responses to exercise were identified. Compliant patients reported increased daily activity. The incremental Shuttle Walk Test is a simple, reproducible and safe Test that is responsive to continuous positive airway pressure treatment. Our findings support the use of the incremental Shuttle Walk Test for monitoring the effects of continuous positive airway pressure treatment and may suggest its use in rehabilitation programmes designed to reduce obesity and cardiovascular risk factors in patients with obstructive sleep apnea–hypopnea syndrome.

Victor Zuniga Dourado - One of the best experts on this subject based on the ideXlab platform.

  • dynamic physiological responses to the incremental Shuttle Walk Test in adults
    Fisioterapia em Movimento, 2017
    Co-Authors: Evandro Fornias Sperandio, Ricardo Luis Fernandes Guerra, Victor Zuniga Dourado
    Abstract:

    Introduction: Understanding the normal dynamic physiological responses to the incremental Shuttle Walk Test might enhance the interpretation of Walking performance in clinical settings. Objective: To assess dynamic physiological responses to the incremental Shuttle Walk Test and its predictors in healthy adults. Methods: We assessed the simultaneous rates of changes of Δoxygen uptake/ΔWalking velocity (ΔVO2/ΔWV), Δheart rate/Δoxygen uptake (ΔHR/ΔVO2), Δventilation/Δcarbon dioxide production (ΔVE/ΔVCO2), and Δtidal volume/Δlinearized ventilation (ΔVT/ΔlnVE) during the incremental Shuttle Walk Test in 100 men and women older than 40 years. Fat and lean body masses (bioimpedance) were also evaluated. Results: We found that the dynamic relationships were not sex-dependent. Participants aged ≥ 70 presented declines in ΔVO2/ΔWV slope compared to those aged 40-49 (215 ± 69 vs. 288 ± 84 mL.min-1.km.h-1). Obese participants presented shallower slopes for ΔVO2/ΔWV (2.94 ± 0.90 vs. 3.84 ± 1.21 mL.min-1.kg-1.km.h-1) and ΔVT/ΔlnVE (0.57 ± 0.20 vs. 0.67 ± 0.26). We found negative influence of fat body mass on ΔVT/ΔlnVE (R2 = 0.20) and positive influence of lean body mass on ΔVO2/ΔWV (R2 = 0.31), ΔHR/ΔVO2 (R2 = 0.25), and ΔVT/ΔlnVE (R2 = 0.44). Conclusion: Dynamic relationships during Walking were slightly influenced by age, but not sex-dependent. Body composition played an important role in these indices. Our results may provide better interpretation of Walking performance in patients with chronic diseases.

  • does the incremental Shuttle Walk Test require maximal effort in young obese women
    Brazilian Journal of Medical and Biological Research, 2016
    Co-Authors: Soraia Pilon Jurgensen, Victor Zuniga Dourado, Ross Arena, Renata Trimer, L Di Thommazoluporini, Jose Carlos Bonjornojunior, Claudio Ricardo De Oliveira, Audrey Borghisilva
    Abstract:

    Obesity is a chronic disease with a multifaceted treatment approach that includes nutritional counseling, structured exercise training, and increased daily physical activity. Increased body mass elicits higher cardiovascular, ventilatory and metabolic demands to varying degrees during exercise. With functional capacity assessment, this variability can be evaluated so individualized guidance for exercise training and daily physical activity can be provided. The aim of the present study was to compare cardiovascular, ventilatory and metabolic responses obtained during a symptom-limited cardiopulmonary exercise Test (CPX) on a treadmill to responses obtained by the incremental Shuttle Walk Test (ISWT) in obese women and to propose a peak oxygen consumption (VO2) prediction equation through variables obtained during the ISWT. Forty obese women (BMI ≥30 kg/m2) performed one treadmill CPX and two ISWTs. Heart rate (HR), arterial blood pressure (ABP) and perceived exertion by the Borg scale were measured at rest, during each stage of the exercise protocol, and throughout the recovery period. The predicted maximal heart rate (HRmax) was calculated (210 – age in years) (16) and compared to the HR response during the CPX. Peak VO2 obtained during CPX correlated significantly (P<0.05) with ISWT peak VO2 (r=0.79) as well as ISWT distance (r=0.65). The predictive model for CPX peak VO2, using age and ISWT distance explained 67% of the variability. The current study indicates the ISWT may be used to predict aerobic capacity in obese women when CPX is not a viable option.

  • physiologic responses to the incremental Shuttle Walk Test in adolescents with idiopathic scoliosis
    European Respiratory Journal, 2013
    Co-Authors: Evandro Fornias Sperandio, Anderson Sales Alexandre, Fabiola Pereira Reboucas, Patricia Rios Poletto, Alberto Ofenhejm Gotfryd, Milena Carlos Vidotto, Victor Zuniga Dourado
    Abstract:

    Exercise limitation has been described in patients with adolescent idiopathic scoliosis (AIS). However, whether the Walking performance is impaired in these patients should be elucidated. We aimed to evaluate physiologic responses to the incremental Shuttle-Walk Test (ISWT) in patients with AIS. Twenty-nine patients with AIS and 20 healthy adolescents aged 10-18 years performed two ISWT. During the second Test, oxygen uptake (VO 2 ), CO 2 production (VCO 2 ), ventilation (VE) and heart rate (HR) were continuously monitored. We assessed the following rates of changes during the ISWT: ΔVO 2 /ΔWalking-velocity, ΔHR/ΔVO 2 , ΔVE/ΔVCO 2 , and linearized Δtidal-volume (VT)/ΔlnVE. Forced expiratory volume in 1s (FEV 1 ) and forced vital capacity (FVC) were also assessed. Patients with AIS showed significant lower values of incremental Shuttle-Walk distance (ISWD: 498 ± 144 vs. 604 ± 85 m), peak VO 2 [median (interquartile range), 25 (21-27) vs. 28 (24-33) mL/min/kg], peak VE (43 ± 16 vs. 52 ± 14 L/min) as well as lower FEV 1 [2.77 (2.48 to 3.17) vs. 3.33 (3.16 to 3.81) L] and FVC (2.51 ± 0.68 vs. 2.94 ± 0.66 L). Patients also presented significant shalower slope of ΔVT/ΔlnVE (0.32 ± 12 vs. 0.45 ± 16), i.e., worse breathing pattern during exercise. In patients, peak VO 2 correlated significantly with ISWD (r = 0.80), FVC (r = 0.78), FEV 1 (r = 0.73) and ΔVT/ΔlnVE (r = 0.58). We conclude that patients with AIS present significant Walking limitation due to impaired pulmonary function and breathing pattern during exercise. This impairment may partialy explain the reluctance of patients with AIS to perform exercises. Thus, Walking-based aerobic exercises should be encouraged in these patients.

  • reliability and validity of heart rate variability threshold assessment during an incremental Shuttle Walk Test in middle aged and older adults
    Brazilian Journal of Medical and Biological Research, 2013
    Co-Authors: Victor Zuniga Dourado, R L F Guerra
    Abstract:

    Studies on the assessment of heart rate variability threshold (HRVT) during Walking are scarce. We determined the reliability and validity of HRVT assessment during the incremental Shuttle Walk Test (ISWT) in healthy subjects. Thirty-one participants aged 57 ± 9 years (17 females) performed 3 ISWTs. During the 1st and 2nd ISWTs, instantaneous heart rate variability was calculated every 30 s and HRVT was measured. Walking velocity at HRVT in these Tests (WV-HRVT1 and WV-HRVT2) was registered. During the 3rd ISWT, physiological responses were assessed. The ventilatory equivalents were used to determine ventilatory threshold (VT) and the WV at VT (WV-VT) was recorded. The difference between WV-HRVT1 and WV-HRVT2 was not statistically significant (median and interquartile range = 4.8; 4.8 to 5.4 vs 4.8; 4.2 to 5.4 km/h); the correlation between WV-HRVT1 and WV-HRVT2 was significant (r = 0.84); the intraclass correlation coefficient was high (0.92; 0.82 to 0.96), and the agreement was acceptable (-0.08 km/h; -0.92 to 0.87). The difference between WV-VT and WV-HRVT2 was not statistically significant (4.8; 4.8 to 5.4 vs 4.8; 4.2 to 5.4 km/h) and the agreement was acceptable (0.04 km/h; -1.28 to 1.36). HRVT assessment during Walking is a reliable measure and permits the estimation of VT in adults. We suggest the use of the ISWT for the assessment of exercise capacity in middle-aged and older adults.

  • association between the occurrence of falls and the performance on the incremental Shuttle Walk Test in elderly women
    Revista Brasileira De Fisioterapia, 2012
    Co-Authors: Marcela Grigol Bardin, Victor Zuniga Dourado
    Abstract:

    BACKGROUND: Because the incremental Shuttle Walk Test (ISWT) requires agility in its performance, we hypothesized that the Test may be associated with balance and risk of falls in the elderly. Objective: To evaluate and compare the association between the performance on the ISWT, the timed up and go (TUG) and the occurrence of falls in the elderly. METHOD: Thirty-three elderly individuals (68±7 years) performed the TUG and the ISWT. Balance was assessed using the Berg Scale (BBS). Participants who fell at least twice in the last 12 months were placed in the "falls" group (FG) and all other participants comprised the control group (CG). RESULTS: There were seventeen elderly women in the FG and 16 in the CG. Participants from the FG had a significant worse performance (p<0.05) on the TUG (8.01±0.22 vs. 6.22±0.21 s), BBS (51±3 vs. 55±1 points) and ISWT [313±79 (92±15%pred.) vs. 395±75 m (113±19%pred.)] than participants from the CG. The ISWT significantly correlated with the TUG (r=-0.75, p<0.001), BBS (r=0.50, p=0.002) and number of falls (r=0.36, p=0.031). After logistic regression, the TUG was determinant (p=0.03) and the ISWT showed a tendency to determine the occurrence of falls (p=0.05). CONCLUSION: The ISWT was a valid measure to assess the risk of falls and balance and therefore, may be useful for the simultaneous assessment of cardiorespiratory fitness and balance in older women.