The minimal detectable difference for endurance shuttle walk test performance in people with COPD on completion of a program of high-intensity ground-based walking - 21/01/19

Doi : 10.1016/j.rmed.2018.11.013

Kylie Hill ^a,^b,^⁎ , Cindy Ng ^a,^c, Sally L. Wootton ^d,^e, Zoe J. McKeough ^d, Peter R. Eastwood ^a,^f,^g, David R. Hillman ^f,^g, Christine Jenkins ^h, Lissa Spencer ⁱ, Sue C. Jenkins ^a,^b,^j, Nola M. Cecins ^b,^j, Jennifer A. Alison ^d,ⁱ
^a School of Physiotherapy and Exercise Science, Faculty of Health Sciences, Curtin University, Western Australia, Australia
^b Institute for Respiratory Health, Sir Charles Gairdner Hospital, Western Australia, Australia
^c Physiotherapy Department, Singapore General Hospital, Singapore
^d Discipline of Physiotherapy, Faculty of Health Sciences, The University of Sydney, New South Wales, Australia
^e Chronic Disease Community Rehabilitation Service, Northern Sydney Local Health District, New South Wales, Australia
^f Department of Pulmonary Physiology & Sleep Medicine, Sir Charles Gairdner Hospital, Western Australia, Australia
^g Centre for Sleep Science, School of Anatomy, Physiology & Human Biology, University of Western Australia, Western Australia, Australia
^h Department of Thoracic Medicine, Concord Hospital, New South Wales, Australia
ⁱ Sydney Local Health District, New South Wales, Australia
^j Physiotherapy Department, Sir Charles Gairdner Hospital, Western Australia, Australia

^∗Corresponding author. School of Physiotherapy and Exercise Science, Curtin University, GPO Box U1987, Perth, Western Australia, 6845, Australia.School of Physiotherapy and Exercise ScienceCurtin UniversityGPO Box U1987PerthWestern Australia6845Australia

Abstract

Background

In people with moderate-to-severe chronic obstructive pulmonary disease (COPD), the minimal detectable difference (MDD) in endurance shuttle walk test (ESWT) performance following exercise training is unclear. We sought to determine the MDD for ESWT performance following supervised ground-based walking training using anchor- and distribution-based approaches and report whether these values exceeded random variation in test performance.

Methods

Participants with COPD trained for 30–45 min, 2–3 times weekly for 8–10 weeks. The ESWT was performed before and after the training period. Immediately after training, participants rated their change in walking ability using a Global Rating of Change scale. Receiver Operating Characteristic curves were used to derive the value that best separated those who perceived their improvement in walking ability to be at least ‘a little’ better from ‘almost the same, hardly any change’. These values were compared with those calculated using a distribution-based method. Random variation in test performance was defined as the minimal detectable change (MDC), calculated using the standard error of measurement.

Results

78 participants (aged 70 ± 8 yr and FEV₁ 43 ± 15% predicted) completed the ESWT before and after training. The value that best separated those who perceived their walking ability as ‘a little’ better was 70 s. The 95% confidence intervals around this estimate traversed zero. The distribution-based estimate was 156 s. The MDC was 227 s.

Conclusions

The MDD established using the anchor- and distribution-based approaches differed considerably. Large variation in test performance cautions against using the MDD to interpret changes in an individual.

Clinical trials registration

Australian New Zealand Clinical Trials Registry (ACTRN12609000472279).

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Keywords : Endurance shuttle walk test, Minimal detectable difference, Exercise training, Chronic obstructive pulmonary disease

Plan

Introduction

Materials and methods

Participants and protocol

Endurance shuttle walk test

Global rating of change scale

Data management and statistical analyses

Conflicts of interest

Funding

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Vol 146

P. 18-22 - janvier 2019 Retour au numéro

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The minimal detectable difference for endurance shuttle walk test performance in people with COPD on completion of a program of high-intensity ground-based walking - 21/01/19

Abstract

Background

Methods

Results

Conclusions

Clinical trials registration

Plan

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