How should functional exercise capacity be measured in colorectal cancer? A pilot validation study

Kuan-Yin Lin, Linda Denehy, Helena Catherine Frawley, Tim Dimitriadis, Joel Martin , Selina M. Parry, Louis B Irving, Catherine L. Granger

Research output: Contribution to journalArticleResearch


Background: Cardiopulmonary exercise testing (CPET) is the gold standard measure of functional exercise capacity. Field walking tests including the six-minute walk test (6MWT), incremental-shuttle walk test (ISWT) and endurance-shuttle walk test (ESWT) are potential alternative tests for use in clinical practice (quick and simple). However, the validity of these tests compared to CPET as the gold standard in patients who have undergone treatment for colorectal cancer is unknown. Objective: To explore the criterion validity of three walking tests (6MWT, ISWT and ESWT) against the gold standard test (laboratory CPET)to measure exercise capacity in colorectal cancer. Methods: Ten participants with stage I-III colorectal cancer were evaluated within six months following treatment (surgery, chemotherapy,radiotherapy or targeted treatment). Exercise capacity was assessed by the 6MWT, ISWT, ESWT, and CPET. Additional measures included hand-grip strength, patient-reported physical function, respiratory function and health-related quality of life. Results: Distance walked in the 6MWT (r = 0.82, p = 0.003) and ISWT (r = 0.81, p = 0.005) were significantly related to measures of peak oxygen consumption obtained by CPET. The 6MWT distance and ISWT distance also correlated highly with physical function (r =0.90, p < 0.01 and r=0.84, p = 0.01, respectively). There was no significant association between ESWT time and peak oxygen consumption obtained by CPET (r = 0.60, p = 0.07). All walking tests were safe (no adverse events) and feasible (less than 15minutes to complete each) and required only one assessor. Conclusion: The 6MWT and ISWT are valid measures of functional exercise capacity in patients with colorectal cancer and are a good choice of non-laboratory tests for physiotherapists to use in research and clinical practice. Findings need to be confirmed in a larger study.
Original languageEnglish
Article number017
Number of pages13
JournalJacobs Journal of Physiotherapy and Exercise
Issue number2
Publication statusPublished - 23 Dec 2016
Externally publishedYes

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