Shuttle walk tests in people with COPD who demonstrate exercise-induced oxygen desaturation: An analysis of test repeatability and cardiorespiratory responses

Zoe McKeough, Regina Leung, Ji Hui Neo, Sue Jenkins, Anne Holland, Kylie Hill, Norman Morris, Lissa Spencer, Catherine Hill, Annemarie Lee, Helen Seale, Nola Cecins, Christine McDonald, Jennifer Alison

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Abstract

Exercise-induced oxygen desaturation (EID) is prevalent in people with chronic obstructive pulmonary disease (COPD). This article reports a sub-analysis from a randomized controlled trial (RCT) in people with COPD and EID (COPD/EID). The primary aim, in people with COPD/ EID, was to determine the repeatability of the distance and time walked in the incremental shuttle walk test (ISWT) and endurance shuttle walk test (ESWT), respectively. A secondary aim was to determine whether any participant characteristics predicted those who did not demonstrate improvements on a repeat ISWT or ESWT. Participants with nadir oxygen saturation (SpO2) < 90% on the 6-minute walk test were recruited to the RCT. Two ISWTs and two ESWTs were then performed as part of the baseline assessments, and participants were included in this sub-analysis if their nadir SpO2 was <90% during the better of two ISWTs. Repeatability of the tests was analysed using Bland–Altman plots and paired t-tests. Participant characteristics of age, lung function, level of nadir SpO2 and end-test dyspnoea were used to predict those who were not likely to demonstrate improvements on a repeat test using receiver operating curves. Eighty-seven participants (mean age (standard deviation, SD) 70 (7) years; forced expiratory volume in one second (FEV1) 47 (17)% predicted) were included. The mean differences (coefficient of repeatability) for the ISWTs and ESWTs were 9 m (55 m) and 19 seconds (142 seconds) respectively (p < 0.05). No participant characteristic predicted the absence of improvement on the second ISWT (area under the curve (AUC) ranged from 0.49 to 0.58, all p > 0.2) or the second ESWT (AUC ranged from 0.43 to 0.52, all p > 0.3). Although repeating the tests showed only small improvements in distance (ISWT) and time (ESWT) walked in people with COPD/EID, the variability was large making definite conclusions about test repeatability in these individuals difficult.

Original languageEnglish
Pages (from-to)131-137
Number of pages7
JournalChronic Respiratory Disease
Volume15
Issue number2
DOIs
Publication statusPublished - 1 May 2018
Externally publishedYes

Keywords

  • Chronic obstructive pulmonary disease
  • exercise induced
  • exercise test
  • oxygen desaturation
  • repeatability

Cite this

McKeough, Z., Leung, R., Neo, J. H., Jenkins, S., Holland, A., Hill, K., Morris, N., Spencer, L., Hill, C., Lee, A., Seale, H., Cecins, N., McDonald, C., & Alison, J. (2018). Shuttle walk tests in people with COPD who demonstrate exercise-induced oxygen desaturation: An analysis of test repeatability and cardiorespiratory responses. Chronic Respiratory Disease, 15(2), 131-137. https://doi.org/10.1177/1479972317729051