Is the modified shuttle test a maximal effort test in children and adolescents with asthma?

Author(s)

Reimberg, Mariana M. ^[1] ; Ritti-Dias, Raphael ^[1] ; Selman, Jessyca P. ^[1] ; Scalco, Rebeca S. ^[1] ; Wandalsen, Gustavo F. ^[2] ; Sole, Dirceu ^[2] ; Hulzebos, Erik J. ^[3] ; Takken, Tim ^[3] ; Dal Corso, Simone ^[1] ; Lanza, Fernanda C. ^{[1, 4]}

Affiliation

^[1] Univ Nove de Julho, Postgrad Program Rehabil Sci, Sao Paulo, SP - Brazil

^[2] Fed Univ Sao Paulo UNIFESP, Pediat Dept, Sao Paulo, SP - Brazil

^[3] Univ Med Ctr Utrecht, Wilhelmina Childrens Hosp, Child Dev & Exercise Ctr, Utrecht - Netherlands

^[4] Univ Fed Minhas Gerais UFMG, Dept Phys Therapy, Grad Program Rehabil Sci, Belo Horizonte, MG - Brazil

• Document type: Journal article
• Source: PEDIATRIC PULMONOLOGY; v. 57, n. 1 OCT 2021.
• Web of Science Citations: 0

Abstract

Purpose Whether the modified shuttle test (MST) achieves maximal effort in children and adolescents with asthma is unclear. The aim was to compare the physiological responses of MST to the cardiopulmonary exercise test (CPET) in pediatric patients with asthma, to observe its convergent validity. Patients and Methods A cross-sectional study with volunteers with asthma (6-17 years of age) under regular treatment. The MST is an external-paced test, and the participants were allowed to walk/run. CPET was performed on a cycle ergometer to compare with MST. Gas exchange (VO2, VCO2, and VE) and heart rate (HR) were the outcomes and were continuously assessed in both tests. Results Forty-seven volunteers were included, normal lung function expiratory forced volume at 1st second/forced vital capacity (FEV1/FVC) 88.6 (7.7). VO2peak was higher at MST (2.0 +/- 0.6 L/min) compared to CPET (1.6 +/- 0.5 L/min), p < 0.001. Similar results was observed to VE at MST (50 +/- 16 L/min) versus VE at CPET (40 +/- 13 L/min), and to VCO2 at MST (2.1 +/- 0.8 L/min) versus VCO2 at CPET (1.7 +/- 0.6 L/min), p < 0.001. HR was also higher at MST (94 +/- 6%pred) versus CPET (87 +/- 8%pred), p = 0.002. VO2peak in MST correlated to the CPET (r = 0.78, p < 0.001). The ICC of VO2peak between tests was 0.73 (0.06-0.89), p < 0.001, and VO2peak Bland-Altman analysis showed a bias of 0.46 L/min. Conclusion The MST showed a maximal physiologic response in children and adolescents with asthma. It is a valid test and can be used as an alternative to evaluating exercise capacity. (AU)

• FAPESP's process: 16/17553-0 - Relationship between lung function, functional capacity and daily physical activity in asthmatic children and adolescents
• Grantee: Rebeca Souza Scalco
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• FAPESP's process: 17/11729-2 - ERS International Congress 2017
• Grantee: Fernanda de Cordoba Lanza
• Support Opportunities: Research Grants - Meeting - Abroad