Sit-to-Stand Test: A Practical Tool for Evaluating Exercise Capacity in Children with Chronic Respiratory Disease

Yıl 2025, Cilt: 7 Sayı: 2, 562 - 571, 07.08.2025

Meltem Kaya , Hikmet Uçgun , Ayşenur Temizel Tombul , Erkan Cakir , Hilal Denizoğlu Külli

https://doi.org/10.46413/boneyusbad.1615116

Öz

Aim: Chronic respiratory disease (CRD) is frequently associated with a reduced exercise capacity. Exercise capacity is routinely assessed through six-minute walk test (6MWT), but the sit-to-stand test (STST) is commonly explored as an alternative test method in various conditions. The present study aimed to investigate the correlation between the 6MWT and the 1-minute STST (1min-STST) and 30-second STST (30s-STST) in children with CRD.
Materials and Method: A total of 159 children (mean age: 11.74±3.41 years) with CRD (asthma, primary ciliary dyskinesia, cystic fibrosis, Kartagener's Syndrome, and postinfectious bronchiectasis) were included in the study. All participants performed 1min-STST, 30s-STST, and 6MWT. Test results and cardiorespiratory responses to tests were recorded.
Results: 6MWT was strongly correlated with the 1min-STST and 30s-STST (r=0.769, r=0.758, respectively) (p<0.001). Levels of dyspnea and fatigue after the 1min-STST and 30s-STST were significant but weakly correlated with levels of dyspnea and fatigue after the 6MWT (dyspnea r=0.245, r=0.248, respectively; fatigue r=0.239, r=0.241, respectively) (p<0.05). There were statistically significant differences among the tests regarding cardiorespiratory responses (p<0.05). There were statistically significant differences among the disease groups in terms of 6MWT, 30s-STST, and 1min-STST (p=0.028, p=0.038, and p=0.035, respectively) (p<0.05).
Conclusion: 30s-STST and 1min-STST may serve as practical, efficient, and time-saving alternatives for assessing exercise capacity in children with CRD.

Anahtar Kelimeler

Chronic respiratory disease , Children , exercise capacity , Six-minute walk test , Sit-to-stand test

Etik Beyan

The study was approved by the Istanbul Atlas University Ethics Board (protocol number: 23.12.2024; 10/08)

Otur-Kalk Testi: Kronik Solunum Hastalığı Olan Çocuklarda Egzersiz Kapasitesini Değerlendirmek için Pratik Bir Araç

Öz

Amaç: Kronik solunum hastalığı, azalmış egzersiz kapasitesi ile sıklıkla ilişkilendirilmektedir. Egzersiz kapasitesi genellikle altı dakika yürüme testi (6DYT) ile değerlendirilir, ancak otur-kalk testi (OKT), çeşitli durumlarda alternatif bir test yöntemi olarak araştırılmaktadır. Bu çalışmada, kronik solunum hastalığı olan çocuklarda 6DYT ile 1 dakika OKT (1dk-OKT) ve 30 saniye OKT (30sn-OKT) arasındaki korelasyonunun araştırması amaçlandı.
Gereç ve Yöntem: Çalışmaya kronik solunum hastalığı olan (astım, primer siliyer diskinezi, kistik fibrozis, Kartagener Sendromu ve post-enfeksiyöz bronşektazi) 159 çocuk (ortalama yaş: 11.74±3.41 yıl) dahil edildi. Tüm katılımcılara 1dk-OKT, 30sn-OKT ve 6DYT uygulandı. Test sonuçları ve testlere verilen kardiyorespiratuar yanıtlar kaydedildi.
Bulgular: 6DYT mesafesi ile 1dk-OKT ve 30sn-OKT arasında güçlü bir korelasyon saptandı (sırasıyla r=0.769, r=0.758; p<0.001). 1dk-OKT ve 30sn-OKT sonrası ölçülen dispne ve yorgunluk seviyeleri, istatistiksel olarak anlamlı olmakla birlikte, 6DYT sonrası dispne ve yorgunluk seviyeleri ile zayıf bir korelasyon gösterdi. (dispne r=0.245 ve r=0.248; yorgunluk r=0.239 ve r=0.241; p<0.05). Kardiyorespiratuar yanıtlar açısından testler arasında istatistiksel olarak anlamlı fark tespit edildi (p<0.05). Hastalık grupları arasında 6DYT, 30sn-OKT ve 1dk-OKT sonuçları açısından istatistiksel olarak anlamlı farklılık saptandı (sırasıyla p = 0.028, p = 0.038 ve p = 0.035; p<0.05).
Sonuç: 30sn-OKT ve 1dk-OKT, kronik solunum hastalığı olan çocuklarda egzersiz kapasitesini değerlendirmek için geçerli, etkili ve zaman tasarrufu sağlayan alternatif yöntemlerdir.

Anahtar Kelimeler

Kronik solunum hastalığı , Çocuklar , egzersiz kapasitesi , Altı dakika yürüme testi , Otur-kalk testi

Kaynakça

• Aguilaniu, B., Roth, H., Gonzalez-Bermejo, J., Jondot, M., Maitre, J., Denis, F., & Similowski, T. (2014). A simple semipaced 3-minute chair rise test for routine exercise tolerance testing in COPD. International journal of chronic obstructive pulmonary disease, 1009-1019.
• ATS statement: guidelines for the six-minute walk test. (2002). Am J Respir Crit Care Med, 166(1), 111-117. doi:10.1164/ajrccm.166.1.at1102
• Bar-Yoseph, R., Ilivitzki, A., Cooper, D. M., Gur, M., Mainzer, G., Hakim, F., . . . Zucker-Toledano, M. (2019). Exercise capacity in patients with cystic fibrosis vs. non-cystic fibrosis bronchiectasis. PloS one, 14(6), e0217491.
• Beekman, E., Mesters, I., Hendriks, E. J., Klaassen, M. P., Gosselink, R., van Schayck, O. C., & de Bie, R. A. (2013). Course length of 30 metres versus 10 metres has a significant influence on six-minute walk distance in patients with COPD: an experimental crossover study. J Physiother, 59(3), 169-176. doi:10.1016/s1836-9553(13)70181-4
• Bisca, G. W., Morita, A. A., Hernandes, N. A., Probst, V. S., & Pitta, F. (2015). Simple lower limb functional tests in patients with chronic obstructive pulmonary disease: a systematic review. Archives of physical medicine and rehabilitation, 96(12), 2221-2230.
• Borg, G. A. (1982). Psychophysical bases of perceived exertion. Medicine and science in sports and exercise, 14(5), 377-381.
• Cakmak, A., Inal-Ince, D., Sonbahar-Ulu, H., Bozdemir-Ozel, C., Ozalp, O., Calik-Kutukcu, E., . . . Selcuk, Z. T. (2020). Physical activity of patients with bronchiectasis compared with healthy counterparts: A cross-sectional study. Heart & Lung, 49(1), 99-104.
• Chetta, A., & Olivieri, D. (2009). The Clinical Relevance of Exercise Capacity Assessment in Respiratory Diseases: Introduction. Respiration, 77(1), 2-2. doi:10.1159/000178797
• Cohen, J. (1992). A power primer. Psychol Bull, 112(1), 155-159. doi:10.1037//0033-2909.112.1.155
• Combret, Y., Boujibar, F., Gennari, C., Medrinal, C., Sicinski, S., Bonnevie, T., . . . Le Roux, P. (2021). Measurement properties of the one-minute sit-to-stand test in children and adolescents with cystic fibrosis: a multicenter randomized cross-over trial. PloS one, 16(2), e0246781.
• Crook, S., Büsching, G., Schultz, K., Lehbert, N., Jelusic, D., Keusch, S., . . . Frey, M. (2017). A multicentre validation of the 1-min sit-to-stand test in patients with COPD. European Respiratory Journal, 49(3).
• Csuka, M. (1993). Simple method for measurement of lower extremity muscle strength. Am J Med, 78, 21-27. de Groot, J. F., & Takken, T. (2011). The six-minute walk test in paediatric populations. J Physiother, 57(2), 128. doi:10.1016/s1836-9553(11)70026-1
• Gephine, S., Bergeron, S., PF, T. L., Mucci, P., Saey, D., & Maltais, F. (2020). Cardiorespiratory Response during the 1-min Sit-to-Stand Test in Chronic Obstructive Pulmonary Disease. Medicine and science in sports and exercise, 52(7), 1441-1448.
• Grover, A., & Joshi, A. (2015). An overview of chronic disease models: a systematic literature review. Global journal of health science, 7(2), 210.
• Gruet, M., Peyré-Tartaruga, L. A., Mely, L., & Vallier, J.-M. (2016). The 1-minute sit-to-stand test in adults with cystic fibrosis: correlations with cardiopulmonary exercise test, 6-minute walk test, and quadriceps strength. Respiratory care, 61(12), 1620-1628.
• Gurses, H. N., Zeren, M., Kulli, H. D., & Durgut, E. (2018). The relationship of sit-to-stand tests with 6-minute walk test in healthy young adults. Medicine, 97(1), e9489.
• Kohlbrenner, D., Benden, C., & Radtke, T. (2020). The 1-minute sit-to-stand test in lung transplant candidates: an alternative to the 6-minute walk test. Respiratory care, 65(4), 437-443.
• Li, A. M., Yin, J., Yu, C., Tsang, T., So, H., Wong, E., . . . Sung, R. (2005). The six-minute walk test in healthy children: reliability and validity. European Respiratory Journal, 25(6), 1057-1060.
• Meriem, M., Cherif, J., Toujani, S., Ouahchi, Y., Hmida, A. B., & Beji, M. (2015). Sit-to-stand test and 6-min walking test correlation in patients with chronic obstructive pulmonary disease. Annals of thoracic medicine, 10(4), 269-273.
• Miller, M. R., Hankinson, J., Brusasco, V., Burgos, F., Casaburi, R., Coates, A., . . . Wanger, J. (2005). Standardisation of spirometry. Eur Respir J, 26(2), 319-338. doi:10.1183/09031936.05.00034805
• Milner, S. C., Boruff, J. T., Beaurepaire, C., Ahmed, S., & Janaudis-Ferreira, T. (2018). Rate of, and barriers and enablers to, pulmonary rehabilitation referral in COPD: a systematic scoping review. Respiratory medicine, 137, 103-114.
• Morita, A. A., Bisca, G. W., Machado, F. V., Hernandes, N. A., Pitta, F., & Probst, V. S. (2018). Best protocol for the sit-to-stand test in subjects with COPD. Respiratory care, 63(8), 1040-1049.
• Ng, S. S., Yu, P. C., To, F. P., Chung, J. S., & Cheung, T. H. (2013). Effect of walkway length and turning direction on the distance covered in the 6-minute walk test among adults over 50 years of age: a cross-sectional study. Physiotherapy, 99(1), 63-70. doi:10.1016/j.physio.2011.11.005
• Nunez-Cortes, R., Rivera-Lillo, G., Arias-Campoverde, M., Soto-Garcia, D., Garcia-Palomera, R., & Torres-Castro, R. (2021). Use of sit-to-stand test to assess the physical capacity and exertional desaturation in patients post COVID-19. Chronic respiratory disease, 18, 1479973121999205.
• Ozalevli, S., Ozden, A., Itil, O., & Akkoclu, A. (2007). Comparison of the Sit-to-Stand Test with 6 min walk test in patients with chronic obstructive pulmonary disease. Respiratory medicine, 101(2), 286-293.
• Pasteur, M. C., Bilton, D., & Hill, A. T. (2010). British thoracic Society guideline for non-CFbronchiectasis. Thorax, 65(Suppl 1), i1-i58.
• Radtke, T., Puhan, M. A., Hebestreit, H., & Kriemler, S. (2016). The 1-min sit-to-stand test—A simple functional capacity test in cystic fibrosis? Journal of Cystic Fibrosis, 15(2), 223-226.
• Rasekaba, T., Lee, A. L., Naughton, M. T., Williams, T. J., & Holland, A. E. (2009). The six-minute walk test: a useful metric for the cardiopulmonary patient. Internal Medicine Journal, 39(8), 495-501. doi:https://doi.org/10.1111/j.1445-5994.2008.01880.x
• Reychler, G., Boucard, E., Peran, L., Pichon, R., Le Ber‐Moy, C., Ouksel, H., . . . Beaumont, M. (2018). One minute sit‐to‐stand test is an alternative to 6MWT to measure functional exercise performance in COPD patients. The clinical respiratory journal, 12(3), 1247-1256.
• Singh, S. J., Puhan, M. A., Andrianopoulos, V., Hernandes, N. A., Mitchell, K. E., Hill, C. J., . . . Spruit, M. A. (2014). An official systematic review of the European Respiratory Society/American Thoracic Society: measurement properties of field walking tests in chronic respiratory disease. European Respiratory Journal, 44(6), 1447-1478.
• Soriano, J. B., Kendrick, P. J., Paulson, K. R., Gupta, V., Abrams, E. M., Adedoyin, R. A., . . . Ahmadian, E. (2020). Prevalence and attributable health burden of chronic respiratory diseases, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. The Lancet Respiratory Medicine, 8(6), 585-596.
• Takken, T., Bongers, B. C., Van Brussel, M., Haapala, E. A., & Hulzebos, E. H. (2017). Cardiopulmonary exercise testing in pediatrics. Annals of the American Thoracic Society, 14(Supplement 1), S123-S128.
• Vaes, A. W., Burtin, C., Casaburi, R., Celli, B. R., Evans, R. A., Lareau, S. C., . . . Troosters, T. (2024). Prevalence and prognostic importance of exercise limitation and physical inactivity in COPD. Breathe, 20(2).
• Vaidya, T., Chambellan, A., & De Bisschop, C. (2017). Sit-to-stand tests for COPD: a literature review. Respiratory medicine, 128, 70-77.
• Vogiatzis, I., & Zakynthinos, S. (2012). Factors limiting exercise tolerance in chronic lung diseases. Comprehensive Physiology, 2(3), 1779-1817.
• Zar, H. J., & Ferkol, T. W. (2014). The global burden of respiratory disease—impact on child health. In (Vol. 49, pp. 430-434): Wiley Online Library.
• Zeren, M., Gurses, H. N., Kulli, H. D., Ucgun, H., & Cakir, E. (2020). Sit-to-stand test in children with bronchiectasis: Does it measure functional exercise capacity? Heart & Lung, 49(6), 796-802.
• Zhang, Q., Li, Y.-x., Li, X.-l., Yin, Y., Li, R.-l., Qiao, X., . . . Han, Y.-f. (2018). 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. International journal of chronic obstructive pulmonary disease, 2833-2839.