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(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

A symptom-limited incremental step test determines maximum physiological responses in patients with chronic obstructive pulmonary disease

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Author(s):
Dal Corso, Simone [1] ; de Camargo, Anderson Alves [1] ; Izbicki, Meyer [2] ; Malaguti, Carla [2, 3] ; Nery, Luiz Eduardo [2]
Total Authors: 5
Affiliation:
[1] Univ Nove Julho UNINOVE, Postgrad Program Rehabil Sci, BR-01504001 Sao Paulo - Brazil
[2] Fed Univ Sao Paulo UNIFESP, Dept Med, Div Resp Dis, Sao Paulo - Brazil
[3] Univ Fed Juiz de Fora, Human Physiol Dept, Juiz De Fora, MG - Brazil
Total Affiliations: 3
Document type: Journal article
Source: RESPIRATORY MEDICINE; v. 107, n. 12, p. 1993-1999, DEC 2013.
Web of Science Citations: 16
Abstract

Background: Step tests have been used to evaluate exercise tolerance and effort-related hypoxemia in different diseases. A symptom-limited incremental step test (IST) has never been tested in COPD patients. Aim: To compare maximal physiological responses between an IST and cardiopulmonary exercise testing (CPET), to test the reproducibility of the IST on different days, and to provide a predict equation to estimate VO2 from the IST in patients with COPD. Material and methods: At the same day, thirty-four patients (VEF1 46 +/- 14% of pred) underwent a CPET on cycle ergometer and the first 151 (IST-1) (1 h apart). After 2-5 days, patients repeated the IST (IST-2). Pulmonary gas exchange was measured during all tests. Results: Peak VO2 was significantly higher in IST-1 and IST-2 than in CEPT (Mean +/- SD: 1.19 +/- 0.39 L, 1.20 +/- 0.40 L, 1.07 +/- 0.35 L) with no difference for ventilation (VE), heart rate (HR), and perception of effort. ISTs were highly reproducible, with significant intraclass correlation coefficient (CCI {[}95% confidence interval]) for number of steps (0.98{[}0.95-0.99]), VO2 (0.99 {[}0.98-0.99]), VE (0.97{[}0.93-0.99]), HR (0.92{[}0.81-0.97]), and SpO(2) (0.96{[}0.90-0.98]). Desaturation was significantly higher for IST-1 and IST-2 compared with cycling (Mean +/- SD: -6 +/- 5%, -6 +/- 4%, - 3 +/- 3%). Number of steps and patient weight explained 81% of the variance in peak VO2 (p < 0.001). Conclusion: A symptom-limited incremental step test, externally paced, elicits maximal cardiopulmonary and metabolic responses, and is well tolerated and reproducible in patients with COPD. (C) 2013 Elsevier Ltd. All rights reserved. (AU)

FAPESP's process: 10/09732-6 - Validity and reproducibility of an incremental step test in patients with chronic obstructive pulmonary disease
Grantee:Simone Dal Corso
Support Opportunities: Regular Research Grants