Minimum clinically important improvement for the incremental shuttle walking test
TL;DR: The minimum clinically important improvement for the ISWT is 47.5 m and patients were able to distinguish an additional benefit at 78.7 m.
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Abstract: Background: The incremental shuttle walking test (ISWT) is used to assess exercise capacity in patients with chronic obstructive pulmonary disease (COPD) and is employed as an outcome measure for pulmonary rehabilitation. This study was designed to establish the minimum clinically important difference for the ISWT. Methods: 372 patients (205 men) performed an ISWT before and after a 7-week outpatient pulmonary rehabilitation programme. After completing the course, subjects were asked to identify, from a 5-point Likert scale, the perceived change in their exercise performance immediately upon completion of the ISWT. The scale ranged from “better” to “worse”. Results: The mean (SD) age was 69.4 (8.4) years, forced expiratory volume in 1 s (FEV 1 ) 1.06 (0.53) l and FEV 1 /forced vital capacity (FVC) ratio 50.8 (18.1)%. The baseline shuttle walking test distance was 168.5 (114.6) m which increased to 234.7 (125.3) m after rehabilitation (mean difference 65.9 m (95% CI 58.9 to72.9)). In subjects who felt their exercise tolerance was “slightly better” the mean improvement was 47.5 m (95% CI 38.6 to 56.5) compared with 78.7 m (95% CI 70.5 to 86.9) in those who reported that their exercise tolerance was “better” and 18.0 m (95% CI 4.5 to 31.5) in those who felt their exercise tolerance was “about the same”. Conclusion: Two levels of improvement were identified. The minimum clinically important improvement for the ISWT is 47.5 m. In addition, patients were able to distinguish an additional benefit at 78.7 m.
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An official American thoracic society/European respiratory society statement: Key concepts and advances in pulmonary rehabilitation
Martijn A. Spruit,Sally J Singh,Chris Garvey,Richard ZuWallack,Linda Nici,Anne E Holland,Suzanne C. Lareau,Fabio Pitta,Louise Sewell,Jo Raskin,Jean Bourbeau,Rebecca Crouch,Frits M.E. Franssen,Richard Casaburi,Jan H. Vercoulen,Ioannis Vogiatzis,Rik Gosselink,Enrico Clini,Tanja Effing,Job van der Palen,Thierry Troosters,Daisy J.A. Janssen,Eileen G. Collins,Judith Garcia-Aymerich,Dina Brooks,Bonnie Fahy,Milo A. Puhan,Martine Hoogendoorn,Rachel Garrod,Annemie M. W. J. Schols,Brian W. Carlin,Roberto P. Benzo,Mike Morgan,Andrew L. Ries,Roger S. Goldstein,Claire A. Dowson,Jan Brozek,Claudio F. Donner,Emiel F.M. Wouters +38 more
TL;DR: The considerable growth in the science and application of pulmonary rehabilitation since 2006 adds further support for its efficacy in a wide range of individuals with chronic respiratory disease.
Pulmonary rehabilitation for chronic obstructive pulmonary disease
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An official European Respiratory Society/American Thoracic Society Technical Standard: field walking tests in chronic respiratory disease
Anne E Holland,Martijn A. Spruit,Thierry Troosters,Milo A. Puhan,Véronique Pepin,Didier Saey,Meredith C. McCormack,Brian W. Carlin,Frank C. Sciurba,Fabio Pitta,J. Wanger,Neil R. MacIntyre,David A. Kaminsky,Bruce H. Culver,S M Revill,Nidia A. Hernandes,Vasileios Andrianopoulos,Carlos Augusto Camillo,Katy E. Mitchell,Annemarie L. Lee,Catherine J. Hill,Sally J Singh +21 more
TL;DR: The aim of this document is to describe the standard operating procedures for the 6MWT, ISWT and ESWT, which can be consistently employed by clinicians and researchers, and reflect current evidence regarding procedures that should be used to achieve robust results.
An official systematic review of the European Respiratory Society/American Thoracic Society: measurement properties of field walking tests in chronic respiratory disease
Sally J Singh,Milo A. Puhan,Vasileios Andrianopoulos,Nidia A. Hernandes,Katy E. Mitchell,Catherine J. Hill,Annemarie L. Lee,Carlos Augusto Camillo,Thierry Troosters,Martijn A. Spruit,Brian W. Carlin,J. Wanger,Véronique Pepin,Didier Saey,Fabio Pitta,David A. Kaminsky,Meredith C. McCormack,Neil R. MacIntyre,Bruce H. Culver,Frank C. Sciurba,S M Revill,Veronica Delafosse,Anne E Holland +22 more
TL;DR: It is demonstrated that the 6MWT, ISWT and ESWT are robust tests of functional exercise capacity in adults with chronic respiratory disease and responsive to interventions that included exercise training.
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British Thoracic Society guideline on pulmonary rehabilitation in adults.
Charlotte E. Bolton,Elaine Bevan-Smith,John D. Blakey,Patrick Crowe,Sarah L. Elkin,Rachel Garrod,Neil J. Greening,Karen Heslop,James H. Hull,William D.-C. Man,Mike Morgan,David Proud,C Michael Roberts,Louise Sewell,Sally J Singh,Paul Walker,Sandy Walmsley +16 more
TL;DR: The role of pulmonary rehabilitation in patients for pulmonary rehabilitation and specific situations at assessment are described.
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