The association between six-minute walk test and one minute sit to stand test in patients with acute exacerbations of COPD

Year 2024, Volume: 14 Issue: 3, 137 - 142, 31.05.2024

Zeynep Pelin Dündar , Nihan Kafa , Neslihan Alkan Durutürk , Hülya Vatansev , Adil Zamani

https://doi.org/10.16899/jcm.1470332

Abstract

ABSTRACT
Aim: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are a major complication of COPD and a leading cause of hospitalization, detrimentally affecting functional exercise capacity. The 6-minute walk test (6MWT) is a reliable measure of exercise capacity in chronic lung diseases. Conversely, the 1-minute sit-to-stand test (1STST) offers a simpler assessment of physical function. The aim was to demonstrate the association of functional exercise capacity assessed by 1STST and 6MWT in COPD patients with acute exacerbation.
Materials and Methods: In this study, 37 hospitalized patients with acute exacerbation COPD (mean age:66 years) underwent assessments including pulmonary function testing, 6MWT, 1STST and modified Medical Research Council (MMRC). Parameters such as heart rate, oxygen saturation, and perceived dyspnea (via the modified Borg scale) were monitored during tests.
Results: The results showed a significant correlation between 6MWT and 1STST performance (r=0.656, p<0.001). Notably, end-tidal oxygen saturation differed between tests, with the 6MWT showing higher end-tidal dyspnea scores. During recovery, 1STST induced increased heart rate and decreased oxygen saturation. Both 6MWT and 1STST were negatively associated with age and MMRC. Positive correlations were observed between 6MWT and FEV1(L) and PEF(L).
Conclusions: Similar to the 6MWT, the 1STS test may be used to evaluate how well patients with AECOPD perform during functional exercise. We propose that the 1STST is a suitable alternative to the 6MWT for the assessment of functional exercise performance during hospitalization in AECOPD patients.

Keywords

Acute exacerbations, chronic obstructive pulmonary disease, six-minute walk test, 1-minute sit to stand test

Akut Alevlenmesi Olan KOAH Hastalarında Altı Dakika Yürüme Testi ile Bir Dakika Otur Kalk Testi Arasındaki İlişki

Abstract

ÖZ
Amaç: Akut alevlenme dönemleri, Kronik obstrüktif akciğer hastaları (KOAH) için önemli bir komplikasyon ve hastaneye yatışın önde gelen nedenlerinden biridir. Bu durum fonksiyonel egzersiz kapasitesini olumsuz yönde etkiler. Altı dakika yürüme testi (6DYT) kronik akciğer hastalıklarında egzersiz kapasitesinin değerlendirilmesinde kullanılan güvenilir bir testtir. Öte yandan, 1 dakika otur-kalk testi fiziksel fonksiyonun daha basit bir değerlendirmesini sunar. Bu çalışmada akut alevlenen KOAH hastalarında, fonksiyonel egzersiz kapasitesinin değerlendirilmesinde kullanılan 6DYT ve 1 dakika otur kalk testinin arasındaki ilişkinin gösterilmesi amaçlanmıştır.
Gereç ve Yöntem: Hastanede yatan 37 akut alevlenen KOAH hastasına (ortalama yaş: 66 yıl) solunum fonksiyon testi, 6DYT, 1 dakika otur kalk testi ve Modifiye Medical Research Council (MMRC) ölçeği ile değerlendirmeler yapıldı. Testler sırasında kalp hızı, oksijen satürasyonu ve algılanan dispne parametreleri (modifiye Borg ölçeği) izlendi.
Bulgular: 6DYT ile 1 dakika otur kalk testinin performansı arasında anlamlı bir korelasyon bulunmuştur (r=0.656, p<0.001). Özellikle, test sonu oksijen satürasyonu testler arasında farklılık göstermiştir ve test sonu bulgularında 6DYT daha yüksek dispne algısına sebep olmuştur. Toparlanma sırasında, 1 dakika otur kalk testinin vital bulgularında kalp hızında daha fazla artış ve oksijen satürasyonunda daha fazla düşüş görülmüştür. Hem 6DYT hem de 1 dakika otur kalk testi yaş ve MMRC parametreleri ile negatif ilişkiliydi. 6DYT ile FEV1(L) ve PEF(L) arasında pozitif korelasyon gözlenmiştir.
Sonuç: Altı-DYT gibi, 1 dakika otur kalk testi de akut alevlenen KOAH hastalarının fonksiyonel egzersizin değerlendirilmesi sırasında kullanılabilir. Akut alevlenen KOAH hastalarında hastanede yatış sırasında fonksiyonel egzersiz performansının değerlendirilmesi için 1 dakika otur kalk testini 6DYT'nin yerine uygun bir alternatif olarak öneriyoruz.

Keywords

Akut alevlenme, Kronik obstrüktif akciğer hastalığı, 6-dakika yürüme testi, 1 dakika otur kalk testi

References

• 1. Troosters T, Janssens W, Demeyer H, Rabinovich RA. Pulmonary rehabilitation and physical interventions. Eur Respir Rev 2023;32-168.
• 2. Lu HY, Chen CF, Lee DL, Tsai YJ, Lin PC. Effects of Early Pulmonary Rehabilitation on Hospitalized Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis. Int J Chron Obstruct Pulmon Dis 2023;18:881-93.
• 3. Machado A, Barusso M, De Brandt J, Quadflieg K, Haesevoets S, Daenen M, et al. Impact of acute exacerbations of COPD on patients' health status beyond pulmonary function: A scoping review. Pulmonology 2022;29:518-534
• 4. A. T. S. Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med 2002;166(1):111-7.
• 5. Singh SJ, Puhan MA, Andrianopoulos V, Hernandes NA, Mitchell KE, Hill CJ, et al. An official systematic review of the European Respiratory Society/American Thoracic Society: measurement properties of field walking tests in chronic respiratory disease. Eur Respir J 2014;44(6):1447-78.
• 6. Reychler G, Boucard E, Peran L, Pichon R, Le Ber-Moy C, Ouksel H, et al. One minute sit-to-stand test is an alternative to 6MWT to measure functional exercise performance in COPD patients. Clin Respir J 2018;12(3):1247-56.
• 7. McDonald O, Perraton L, Osadnik C. Validity and clinical applicability of the 60-second sit-to-stand test in people with acute exacerbations of COPD. Respir Med 2023;107264.
• 8. Meriem M, Cherif J, Toujani S, Ouahchi Y, Hmida AB, Beji M. Sit-to-stand test and 6-min walking test correlation in patients with chronic obstructive pulmonary disease. Ann Thorac Med. 2015;10(4):269-73.
• 9. Watson K, Winship P, Cavalheri V, Vicary C, Stray S, Bear N, et al. In adults with advanced lung disease, the 1-minute sit-to-stand test underestimates exertional desaturation compared with the 6-minute walk test: an observational study. J Physiother 2023;69(2):108-13.
• 10. Ozalevli S, Ozden A, Itil O, Akkoclu A. Comparison of the Sit-to-Stand Test with 6 min walk test in patients with chronic obstructive pulmonary disease. Respir Med 2007;101(2):286-93.
• 11. Mahler DA, Wells CK. Evaluation of Clinical Methods for Rating Dyspnea. Chest 1988;93(3):580-6.
• 12. Celli BR, Cote CG, Marin JM, Casanova C, Montes de Oca M, Mendez RA, et al. The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med 2004;350(10):1005-12.
• 13. Miller MR, Crapo R, Hankinson J, Brusasco V, Burgos F, Casaburi R, et al. General considerations for lung function testing. Eur Respir J 2005;26(1):153-61.
• 14. Bestall JC, Paul EA, Garrod R, Garnham R, Jones PW, Wedzicha JA. Usefulness of the Medical Research Council (MRC) dyspnoea scale as a measure of disability in patients with chronic obstructive pulmonary disease. Thorax 1999;54(7):581-6.
• 15. Holland AE, Spruit MA, Troosters T, Puhan MA, Pepin V, Saey D, et al. An official European Respiratory Society/American Thoracic Society technical standard: field walking tests in chronic respiratory disease. Eur Respir J 2014;44(6):1428-46.
• 16. Vaidya T, de Bisschop C, Beaumont M, Ouksel H, Jean V, Dessables F, et al. Is the 1-minute sit-to-stand test a good tool for the evaluation of the impact of pulmonary rehabilitation? Determination of the minimal important difference in COPD. Int J Chron Obstruct Pulmon Dis 2016;11:2609-16.
• 17. Crook S, Busching G, Schultz K, Lehbert N, Jelusic D, Keusch S, et al. A multicentre validation of the 1-min sit-to-stand test in patients with COPD. Eur Respir J 2017;49(3).
• 18. Marin JM, Carrizo SJ, Gascon M, Sanchez A, Gallego B, Celli BR. Inspiratory capacity, dynamic hyperinflation, breathlessness, and exercise performance during the 6-minute-walk test in chronic obstructive pulmonary disease. Am J Respir Crit Care Med 2001;163(6):1395-9.
• 19. Nasis I, Kortianou E, Vasilopoulou M, Spetsioti S, Louvaris Z, Kaltsakas G, et al. Hemodynamic effects of high intensity interval training in COPD patients exhibiting exercise-induced dynamic hyperinflation. Respir Physiol Neurobiol 2015;217:8-16.
• 20. Foglio K, Carone M, Pagani M, Bianchi L, Jones PW, Ambrosino N. Physiological and symptom determinants of exercise performance in patients with chronic airway obstruction. Respir Med 2000;94(3):256-63.
• 21. Quadflieg K, Machado A, Haesevoets S, Daenen M, Thomeer M, Ruttens D, et al. Physical Tests Are Poorly Related to Patient-Reported Outcome Measures during Severe Acute Exacerbations of COPD. J Clin Med 2021;11(1).
• 22. Zhang Q, Li YX, Li XL, Yin Y, Li RL, Qiao X, et al. A comparative study of the five-repetition sit-to-stand test and the 30-second sit-to-stand test to assess exercise tolerance in COPD patients. Int J Chron Obstruct Pulmon Dis 2018;13:2833-9.
• 23. Fernandes AL, Neves I, Luis G, Camilo Z, Cabrita B, Dias S, et al. Is the 1-Minute Sit-To-Stand Test a Good Tool to Evaluate Exertional Oxygen Desaturation in Chronic Obstructive Pulmonary Disease? Diagnostics (Basel) 2021;11(2).
• 24. Casanova C, Cote C, Marin JM, Pinto-Plata V, de Torres JP, Aguirre-Jaime A, et al. Distance and oxygen desaturation during the 6-min walk test as predictors of long-term mortality in patients with COPD. Chest 2008;134(4):746-52.