The PAY test: a new approach for assessing functional performance in children and adolescents with asthma

Objective: To develop, validate, and test the reproducibility of a new test capable of assessing functional performance in children and adolescents (PAY test: Performance Activity in Youth). Methods: participants without and with asthma were included in the development and validation phases, respectively. The PAY test includes five activities: transition from sitting to standing, walking 10 m, step climbing, shoulder extension and flexion, and star jumps. Participants underwent the Pediatric Glittre test (TGlittre-P test time), modified shuttle test (MST), and cardiopulmonary exercise test (CPET). Outcomes: PAY test and TGlittre-P test times, oxygen uptake (VO_2peak), and distance walked in the MST. Results: 8 healthy volunteers, aged 12 (7 - 15) years old were included in the development phase and 34 participants with asthma, aged 11 (7 -14) years old, in the validation phase. The PAY test elicited greater physiological responses (VO_2peak 33.5 ± 6.9 mL/kg) than the TGlittre-P (VO_2peak: 27.4 ± 9.0 mL/kg), but lower than the MST (VO_2peak: 48.9 ± 14.2 mL/kg) and CPET (VO_2peak: 42.0 ± 8.8 mL/kg), p <.05. Moderate correlation between the PAY test time and the TGlittre-P time (r = 0.70, p <.001) and distance walked in the MST (r = -0.72, p <.001). The PAY test time was longer in participants with asthma than in healthy participants (3.1 [3.0 - 3.3] min vs. 2.3 [2.1 – 2.4 min]), p <.001.; and the test was reproducible (ICC 0.78, CI 95% 0.55–0.90, p <.001). Conclusions: The PAY test is a valid and reproducible tool for assessing functional performance in children and adolescents with asthma.