Good repeatability ( for the 6MWT and ESWT ) and reproducibility ( for the 6MWT , 12-minute walk test , ISWT , ESWT , and incremental cycle ergometer test ) were reported by most studies assessing these tests , providing patients were familiarized with them beforeh and .
The 6MWT , ISWT , and particularly the ESWT were reported to be sensitive to therapeutic intervention .
Exercise tests are often used to evaluate the functional status of patients with COPD .
However , to the best of our knowledge , a comprehensive systematic comparison of these tests has not been performed .
We systematic ally review ed studies reporting the repeatability and /or reproducibility of these tests , and studies comparing their sensitivity to therapeutic intervention .
Optimal protocol selection for cardiopulmonary exercise testing in severe COPD.
BACKGROUND The current recommendations of 8 to 12 min for the optimal targeted duration of symptom-limited maximal cardiopulmonary exercise testing ( CPET ) to attain maximal oxygen consumption are based on results from healthy individuals and may not be applicable to patients with severe COPD . We aim ed to determine the optimal duration for a CPET to attain the peak oxygen consumption ( VO2peak ) in a group of patients with severe COPD using different carefully conducted workload protocol s. METHODS We studied 11 subjects with severe COPD ( mean FEV1 , 32 % predicted ; 95 % confidence interval [ CI ] , 27 to 38 % predicted ) . They completed four incremental , symptom-limited exercise tests on a cycle ergometer using four protocol s ( 4 , 8 , and 16 W/min continuous ramp protocol s , and 8 W/min step protocol ) using a r and omized double-blind design . RESULTS The mean duration of these 44 tests was 6.3 min ( 95 % CI , 5.0 to 9.0 min ) . The duration of the exercise tests differed significantly for the protocol s used , as follows : 16-W ramp protocol , 4.0 min ( 95 % CI , 3.0 to 5.1 min ) ; 8-W ramp protocol , 6.6 min ( 95 % CI , 5.0 to 9.0 min ) ; 8-W step protocol , 6.0 min ( 95 % CI , 4.0 to 8.0 min ) ; and 4-W ramp protocol , 8.7 min ( 95 % CI , 4.4 to 13.0 min ; p<0.001 ) . The maximal workload significantly increased as the ramp slope increased from 4 to 8 to 16 W/min ( maximal workload , 35.6 vs 50.7 vs 64.3 W , respectively ; p<0.001 ) . Maximal minute ventilation , heart rate , Borg ratings , and VO2 peak , were not different among the four protocol s. No differences were found between the ramp and step protocol s. CONCLUSIONS In patients with severe COPD ( Global Initiative for Chronic Obstructive Lung Disease stages III-IV ) , a targeted duration of 5 to 9 min for a CPET appears to be more appropriate than the 8 to 12 min proposed in the current guidelines . Maximal workload , in contrast to VO2peak , is highly dependent on the ramp incrementation rate
Good repeatability ( for the 6MWT and ESWT ) and reproducibility ( for the 6MWT , 12-minute walk test , ISWT , ESWT , and incremental cycle ergometer test ) were reported by most studies assessing these tests , providing patients were familiarized with them beforeh and .
The 6MWT , ISWT , and particularly the ESWT were reported to be sensitive to therapeutic intervention .
Exercise tests are often used to evaluate the functional status of patients with COPD .
However , to the best of our knowledge , a comprehensive systematic comparison of these tests has not been performed .
We systematic ally review ed studies reporting the repeatability and /or reproducibility of these tests , and studies comparing their sensitivity to therapeutic intervention .