scholarly journals An official systematic review of the European Respiratory Society/American Thoracic Society: measurement properties of field walking tests in chronic respiratory disease

2014 ◽  
Vol 44 (6) ◽  
pp. 1447-1478 ◽  
Author(s):  
Sally J. Singh ◽  
Milo A. Puhan ◽  
Vasileios Andrianopoulos ◽  
Nidia A. Hernandes ◽  
Katy E. Mitchell ◽  
...  
Keyword(s):  
Systematic Review ◽  
Respiratory Disease ◽  
Learning Effect ◽  
Supplemental Oxygen ◽  
Chronic Respiratory Disease ◽  
Track Length ◽  
Measurement Properties ◽  
Walking Distance ◽  
Walk Test ◽  
European Respiratory Society

This systematic review examined the measurement properties of the 6-min walk test (6MWT), incremental shuttle walk test (ISWT) and endurance shuttle walk test (ESWT) in adults with chronic respiratory disease.Studies that report the evaluation or use of the 6MWT, ISWT or ESWT were included. We searched electronic databases for studies published between January 2000 and September 2013.The 6-min walking distance (6MWD) is a reliable measure (intra-class correlation coefficients ranged from 0.82 to 0.99 in seven studies). There is a learning effect, with greater distance walked on the second test (pooled mean improvement of 26 m in 13 studies). Reliability was similar for ISWT and ESWT, with a learning effect also evident for ISWT (pooled mean improvement of 20 m in six studies). The 6MWD correlates more strongly with peak work capacity (r=0.59–0.93) and physical activity (r=0.40–0.85) than with respiratory function (r=0.10–0.59). Methodological factors affecting 6MWD include track length, encouragement, supplemental oxygen and walking aids. Supplemental oxygen also affects ISWT and ESWT performance. Responsiveness was moderate to high for all tests, with greater responsiveness to interventions that included exercise training.The findings of this review demonstrate that the 6MWT, ISWT and ESWT are robust tests of functional exercise capacity in adults with chronic respiratory disease.

scholarly journals An official European Respiratory Society/American Thoracic Society technical standard: field walking tests in chronic respiratory disease

2014 ◽  
Vol 44 (6) ◽  
pp. 1428-1446 ◽  
Author(s):  
Anne E. Holland ◽  
Martijn A. Spruit ◽  
Thierry Troosters ◽  
Milo A. Puhan ◽  
Véronique Pepin ◽  
...  
Keyword(s):  
Respiratory Disease ◽  
Evidence Base ◽  
Chronic Respiratory Disease ◽  
Current Data ◽  
Measurement Properties ◽  
Current Evidence ◽  
Technical Standard ◽  
European Respiratory Society ◽  
Chronic Respiratory Diseases ◽  
Walking Tests

Field walking tests are commonly employed to evaluate exercise capacity, assess prognosis and evaluate treatment response in chronic respiratory diseases. In recent years, there has been a wealth of new literature pertinent to the conduct of the 6-min walk test (6MWT), and a growing evidence base describing the incremental and endurance shuttle walk tests (ISWT and ESWT, respectively). The aim of this document is to describe the standard operating procedures for the 6MWT, ISWT and ESWT, which can be consistently employed by clinicians and researchers.The Technical Standard was developed by a multidisciplinary and international group of clinicians and researchers with expertise in the application of field walking tests. The procedures are underpinned by a concurrent systematic review of literature relevant to measurement properties and test conduct in adults with chronic respiratory disease.Current data confirm that the 6MWT, ISWT and ESWT are valid, reliable and responsive to change with some interventions. However, results are sensitive to small changes in methodology. It is important that two tests are conducted for the 6MWT and ISWT.This Technical Standard for field walking tests reflects current evidence regarding procedures that should be used to achieve robust results.

scholarly journals How to carry out a field walking test in chronic respiratory disease

Breathe ◽  
2015 ◽  
Vol 11 (2) ◽  
pp. 128-139 ◽  
Author(s):  
Anne E. Holland ◽  
Martijn A. Spruit ◽  
Sally J. Singh
Keyword(s):  
Respiratory Disease ◽  
Exercise Test ◽  
Chronic Respiratory Disease ◽  
Incremental Exercise ◽  
List Type ◽  
Walk Test ◽  
Technical Standard ◽  
European Respiratory Society ◽  
Incremental Exercise Test ◽  
Walking Tests

Educational AimsTo provide recommendations for conducting field walking tests in people with chronic respiratory disease, from the new European Respiratory Society/American Thoracic Society Technical StandardTo provide information to assist in selecting a field walking test in people with chronic respiratory disease.Key pointsThe 6MWT, ISWT and ESWT are valid and reliable tests of functional exercise capacity in people with COPD. The 6MWT is also widely used in other chronic respiratory disorders.There is a learning effect for the 6MWT and ISWT, so two tests must be performed if the tests are being used to measure change over time, with the best distance recorded.The 6MWT is very sensitive to changes in the way it is conducted, including use of encouragement, provision of supplemental oxygen, changes in track layout and length, and use of wheeled walkers. These factors should be held constant when the test is repeated.The 6MWT, ISWT and ESWT are strenuous tests, with cardiorespiratory responses that are similar to those during a maximal incremental exercise test. As a result, the contraindications and precautions for these field walking tests should be the same as for a laboratory-based incremental exercise test.SummaryThe European Respiratory Society (ERS) and American Thoracic Society (ATS) have recently published a Technical Standard which documents the standard operating procedures for the 6-min walk test (6MWT), incremental shuttle walk test (ISWT) and endurance shuttle walk test (ESWT). The Technical Standard shows that all three tests are valid and reliable measures of functional exercise capacity in people with chronic respiratory disease and makes recommendations for standardising their performance. Key findings and recommendations of the Technical Standard include:The 6MWT, ISWT and ESWT are strenuous tests which elicit cardiorespiratory responses that are similar to those observed during a maximal incremental exercise test. As a result, the contraindications and precautions for field walking tests should be consistent with those used for a laboratory-based incremental exercise test.There is strong evidence of a learning effect for the 6MWT and ISWT. Two tests should be performed when the 6MWT or ISWT are used to measure change over time.The 6MWT, ISWT and ESWT are responsive to treatment effects in people with chronic respiratory disease, particularly for rehabilitation.The 6MWT is very sensitive to variations in methodology, including use of encouragement, provision of supplemental oxygen, changes in track layout and length, and use of wheeled walkers. These factors should be documented and held constant on repeat testing.The lowestSpO2recorded during a 6MWT is an important marker of disease severity and prognosis. Continuous pulse oximetry is recommended during the 6MWT, to ensure that the lowestSpO2is recorded.In adults with chronic respiratory disease, a change in 6-min walk distance of 30 m or more indicates a clinically significant change has occurred.

scholarly journals The effectiveness of supplemental oxygen during exercise training in patients with chronic obstructive pulmonary disease who show severe exercise-induced desaturation: a protocol for a meta-regression analysis and systematic review

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Shohei Kawachi ◽  
Shuhei Yamamoto ◽  
Kenichi Nishie ◽  
Takayoshi Yamaga ◽  
Manaka Shibuya ◽  
...  
Keyword(s):  
Systematic Review ◽  
Exercise Training ◽  
Exercise Tolerance ◽  
Supplemental Oxygen ◽  
Walking Distance ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Severe Exercise ◽  
Meta Regression ◽  
Exercise Induced

Abstract Background Supplemental oxygen during exercise training is used to increase the training effect of an exercise program in patients with chronic obstructive pulmonary disease (COPD) who show exercise-induced desaturation. Exercise-induced desaturation is not clearly defined in the guidelines; however, it is generally defined in clinical studies as a decrease in SpO2 of more than 4% from rest or a decrease to less than 88% during exercise. Although some meta-analyses examined the effectiveness of supplemental oxygen during exercise training, these studies concluded that it does not further improve exercise tolerance compared to exercise training alone. However, supplemental oxygen during exercise training may be effective in improving exercise tolerance in COPD patients with severe exercise-induced desaturation. Therefore, this study will be performed to elucidate the effectiveness of supplemental oxygen during exercise training and the relationship between its effectiveness and severity of exercise-induced desaturation at baseline. Methods We will first assess the effectiveness of supplemental oxygen during exercise training in COPD. The main outcome is the change in exercise tolerance before and after the intervention, indicated by the 6-min walking distance, the walking distance, or the walking time in incremental shuttle walking test, and analyzed as the standardized mean difference (SMD). The quality and risk of bias in individual studies will be assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system and risk-of-bias tool (RoB ver.2). If statistical heterogeneity in terms of the effectiveness of exercise tolerance is shown, we will conduct meta-regression analyses to examine the association between the effectiveness of exercise training with supplemental oxygen and severity of exercise-induced desaturation at baseline. Discussion One strength of this study is that it is a systematic review with meta-regression analysis to elucidate the effectiveness of supplemental oxygen during exercise training in patients with COPD who show severe exercise-induced desaturation. Furthermore, we will assess the severity of exercise-induced desaturation for which exercise training with supplemental oxygen is effective, the influence of acute effects at baseline, and the effect of supplemental oxygen on adverse events. Systematic review registration Registration number, UMIN000039960.

scholarly journals Effects of exercise training on physical and psychosocial health in children with chronic respiratory disease: a systematic review and meta-analysis

2018 ◽  
Vol 4 (1) ◽  
pp. e000409 ◽  
Author(s):  
Barbara Joschtel ◽  
Sjaan R Gomersall ◽  
Sean Tweedy ◽  
Helen Petsky ◽  
Anne B Chang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Lung Function ◽  
Exercise Training ◽  
Respiratory Disease ◽  
Effect Size ◽  
Meta Analysis ◽  
Chronic Respiratory Disease ◽  
Cardiovascular Fitness ◽  
Standard Mean Difference ◽  
Children With Asthma

IntroductionChronic disease in children is increasing, including the prevalence of chronic respiratory diseases such as asthma, cystic fibrosis (CF), bronchiectasis and bronchopulmonary dysplasia (BPD). The aim of this systematic review and meta-analysis was to evaluate the effects of exercise training on health outcomes in children with chronic respiratory disease.MethodFive databases were searched for randomised controlled trials investigating the effects of exercise training on children with chronic respiratory disease. Following the PRISMA guidelines, eligible studies were identified and data were extracted. A meta-analysis was conducted for the outcomes cardiovascular fitness, lung function and quality of life (QoL).ResultsThe initial search returned 3688 papers. Twenty-seven (17 in children with asthma, 10 in children with CF) were included in the systematic review and 24 of these were included in the meta-analysis. No studies were identified in children with bronchiectasis or BPD. Included papers had a total of 1009 participants aged 8–20 years. In addition to cardiovascular fitness, lung function and QoL, studies also assessed pulmonary function, respiratory muscle strength, muscular strength and inflammation. Meta-analysis showed a large significant effect size in favour of exercise for cardiovascular fitness (peak VO2) (standard mean difference (SMD)=1.16, 95%  CI 0.61 to 1.70) and QoL (SMD=1.27, 95% CI 0.72 to 1.82) as well as a small, non-significant effect size for lung function (FEV1) (SMD=0.02, 95% CI -0.38 to 0.42).ConclusionExercise training significantly improves cardiovascular fitness and QoL in children with asthma and CF. Further research is needed, particularly in children with bronchiectasis and BPD.

scholarly journals The Six-Minute Walk Test in Chronic Pediatric Conditions: A Systematic Review of Measurement Properties

2013 ◽  
Vol 93 (4) ◽  
pp. 529-541 ◽  
Author(s):  
Bart Bartels ◽  
Janke F. de Groot ◽  
Caroline B. Terwee
Keyword(s):  
Systematic Review ◽  
Strong Evidence ◽  
Methodological Quality ◽  
Measurement Properties ◽  
Walk Test ◽  
Test Procedures ◽  
Six Minute Walk Test ◽  
Patient Groups ◽  
Minute Walk

Background The Six-Minute Walk Test (6MWT) is increasingly being used as a functional outcome measure for chronic pediatric conditions. Knowledge about its measurement properties is needed to determine whether it is an appropriate test to use. Purpose The purpose of this study was to systematically review all published clinimetric studies on the 6MWT in chronic pediatric conditions. Data Sources The databases MEDLINE, EMBASE, CINAHL, PEDro, and SPORTDiscus were searched up to February 2012. Study Selection Studies designed to evaluate measurement properties of the 6MWT in a chronic pediatric condition were included in the systematic review. Data Extraction The methodological quality of the included studies and the measurement properties of the 6MWT were examined. Data Synthesis A best evidence synthesis was performed on 15 studies, including 9 different chronic pediatric conditions. Limited evidence to strong evidence was found for reliability in various chronic conditions. Strong evidence was found for positive criterion validity of the 6MWT with peak oxygen uptake in some populations, but negative criterion validity was found in other populations. Construct validity remained unclear in most patient groups because of methodological flaws. Little evidence was available for responsiveness and measurement error. Studies showed large variability in test procedures despite existing guidelines for the performance of the 6MWT. Limitations Unavailability of a specific checklist to evaluate the methodological quality of clinimetric studies on performance measures was a limitation of the study. Conclusions Evidence for measurement properties of the 6MWT varies largely among chronic pediatric conditions. Further research is needed in all patient groups to explore the ability of the 6MWT to measure significant and clinically important changes. Until then, changes measured with the 6MWT should be interpreted with caution. Future studies or consensus regarding modified test procedures in the pediatric population is recommended.

scholarly journals Non-communicable respiratory disease in Malawi: a systematic review and meta-analysis

2020 ◽  
Vol 32 (2) ◽  
pp. 64-73
Author(s):  
Rebecca Nightingale
Keyword(s):  
Systematic Review ◽  
Respiratory Disease ◽  
Meta Analysis ◽  
Airflow Obstruction ◽  
Secondary Data ◽  
Chronic Respiratory Disease ◽  
African Countries ◽  
History Of ◽  
Sub Saharan ◽  
The Life Course

BackgroundNon-communicable respiratory diseases are important contributors to morbidity and mortality in sub-Saharan African countries such as Malawi. AimTo conduct a systematic review of the available literature relating to chronic respiratory disease in Malawi. MethodsWe conducted a systematic protocol-driven literature search of key scientific databases including Scopus and Medline. Papers were independently assessed for eligibility by two authors and included if they reported objective measures (including self-reported standard symptoms) of chronic respiratory disease and were conducted in Malawi. A meta-analysis of available estimates was then conducted. We re-analysed data from three of these studies in a secondary data analysis to allow for between-study comparisons. ResultsOur search identified 393 papers of which 17 (5 involving children and 12 involving adults) met the inclusion criteria. Wheeze was the symptom most frequently reported in children in the community (12.1%), hospital (11.2%) and HIV clinic (8.1%) settings. Cough was the symptom most frequently reported by adults in the community (3–18%). Spirometric abnormalities varied substantially between studies. For example, in adults, airflow obstruction varied between 2.3% and 20% and low forced vital capacity (FVC) varied between 2.7% and 52.8%. ConclusionWe identified a high burden of chronic respiratory symptoms and abnormal spirometry (particularly low FVC) within paediatric and adult populations in Malawi. The estimates for country-wide burden related to this disease were limited by the heterogeneity of the methods used to assess symptoms and spirometry. There is an urgent need to develop a better understanding of the determinants and natural history of non-communicable respiratory disease across the life-course in Malawi.

scholarly journals Characteristics and Role of Neutrophil Extracellular Traps in Asthma

Inflammation ◽  
2021 ◽  
Author(s):  
Fei Chen ◽  
Min Yu ◽  
Yonghong Zhong ◽  
Lina Wang ◽  
Huaqiong Huang
Keyword(s):  
Systematic Review ◽  
Protective Effect ◽  
Allergic Asthma ◽  
Respiratory Disease ◽  
Bronchial Asthma ◽  
Inflammatory Cells ◽  
Neutrophil Extracellular Traps ◽  
Chronic Respiratory Disease ◽  
Extracellular Traps

Abstract Asthma is a common chronic respiratory disease that affects millions of people worldwide. The incidence of asthma has continued to increase every year. Bronchial asthma involves a variety of cells, including airway inflammatory cells, structural cells, and neutrophils, which have gained more attention because they secrete substances that play an important role in the occurrence and development of asthma. Neutrophil extracellular traps (NETs) are mesh-like structures composed of DNA, histones, and non-histone molecules that can be secreted from neutrophils. NETs can enrich anti-bacterial substances and limit pathogen migration, thus having a protective effect in case of inflammation. However, despite of their anti-inflammatory properties, NETs have been shown to trigger allergic asthma and worsen asthma progression. Here, we provide a systematic review of the roles of NETs in asthma.

scholarly journals Tuberculosis and chronic respiratory disease: a systematic review

2015 ◽  
Vol 32 ◽  
pp. 138-146 ◽  
Author(s):  
Anthony L. Byrne ◽  
Ben J. Marais ◽  
Carole D. Mitnick ◽  
Leonid Lecca ◽  
Guy B. Marks
Keyword(s):  
Systematic Review ◽  
Respiratory Disease ◽  
Chronic Respiratory Disease
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