Validity and Reliability of Incremental Shuttle Walking Test in Assessing the Exercise Capacity of Patients with Chronic Obstructive Pulmonary Disease = Validity and Reliability of Incremental Shuttle Walking Test in Assessing the Exercise Capacity of Patients with Chronic Obstructive Pulmonary Disease

다국어 초록 (Multilingual Abstract)

Background/aims
Assessment of exercise capacity in patients with chronic obstructive pulmonary disease (COPD) is important. Although the incremental shuttle walking test (ISWT) has many strengths, it has not yet been widely introduced in clinical settings. The aim of our study was to investigate the validity and reliability of ISWT, analyzing the correlation between the distance of 6-minute walking test (6MWT) and the peak oxygen consumption (VO2) of cardiopulmonary exercise test (CPET) in patients with COPD.
Methods
This was a prospective observational correlation study. Patients with COPD were recruited between May 2020 and December 2020 from two hospitals. Three assessments (ISWT, 6MWT, and CPET) were performed with 2-day intervals for all patients. Pearson’s correlation was used for all correlation analyses. The ISWT and 6MWT were repeated twice in Hospital 1 (UUH) to evaluate reliability using intraclass correlation coefficients (ICCs).
Results
A total of 15 patients were enrolled from Hospital 1 (UUH), and 14 patients were enrolled from Hospital 2 (AMC). Both the distances of the ISWT and 6MWT were significantly correlated with the peak VO2 with Pearson’s r of 0.782 (p<0.001) and 0.512 (p=0.005), respectively. The ICC of both ISWT and 6MWT was high: ISWT with 0.988 (95% CI: 0.965-0.996, p<0.001) and 6MWT with 0.959 (95% CI: 0.871-0.987, p<0.001), respectively.
Conclusion
The ISWT showed a higher correlation with the peak VO2 than the 6MWT and had excellent test-retest reliability in COPD patients. The ISWT can be considered a useful alternative to the CPET to evaluate the exercise capacity.