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

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dc.contributor.authorDal Corso, Simone [UNIFESP]
dc.contributor.authorCamargo, Anderson Alves de
dc.contributor.authorIzbicki, Meyer [UNIFESP]
dc.contributor.authorMalaguti, Carla [UNIFESP]
dc.contributor.authorNery, Luiz Eduardo [UNIFESP]
dc.contributor.institutionUniv Nove Julho UNINOVE
dc.contributor.institutionUniversidade Federal de São Paulo (UNIFESP)
dc.contributor.institutionUniv Fed Juiz de Fora
dc.date.accessioned2016-01-24T14:34:44Z
dc.date.available2016-01-24T14:34:44Z
dc.date.issued2013-12-01
dc.description.abstractBackground: 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 B.V. All rights reserved.en
dc.description.affiliationUniv Nove Julho UNINOVE, Postgrad Program Rehabil Sci, BR-01504001 São Paulo, Brazil
dc.description.affiliationFed Univ São Paulo UNIFESP, Dept Med, Div Resp Dis, São Paulo, Brazil
dc.description.affiliationUniv Fed Juiz de Fora, Human Physiol Dept, Juiz de Fora, MG, Brazil
dc.description.affiliationUnifespFed Univ São Paulo UNIFESP, Dept Med, Div Resp Dis, São Paulo, Brazil
dc.description.sourceWeb of Science
dc.description.sponsorshipFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
dc.description.sponsorshipCoordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)
dc.description.sponsorshipIDFAPESP: 2010/09732-6
dc.format.extent1993-1999
dc.identifierhttp://dx.doi.org/10.1016/j.rmed.2013.06.013
dc.identifier.citationRespiratory Medicine. London: W B Saunders Co Ltd, v. 107, n. 12, p. 1993-1999, 2013.
dc.identifier.doi10.1016/j.rmed.2013.06.013
dc.identifier.fileWOS000329558700023.pdf
dc.identifier.issn0954-6111
dc.identifier.urihttp://repositorio.unifesp.br/handle/11600/37001
dc.identifier.wosWOS:000329558700023
dc.language.isoeng
dc.publisherW B Saunders Co Ltd
dc.relation.ispartofRespiratory Medicine
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectExercise toleranceen
dc.subjectCOPDen
dc.subjectOxygen uptakeen
dc.subjectStep testen
dc.subjectCardiopulmonary exercise testen
dc.subjectField testen
dc.titleA symptom-limited incremental step test determines maximum physiological responses in patients with chronic obstructive pulmonary diseaseen
dc.typeinfo:eu-repo/semantics/article
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