Incremental shuttle and six-minute walking tests in the assessment of functional capacity in chronic heart failure
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Data
2008-02-01
Autores
Pulz, Cristiane [UNIFESP]
Diniz, Rosiane Viana Zuza [UNIFESP]
Alves, Alexandre N. Ferreira [UNIFESP]
Tebexreni, Antonio Sergio [UNIFESP]
Carvalho, Antonio Carlos [UNIFESP]
De Paola, Angelo Amato Vincenzo [UNIFESP]
Almeida, Dirceu Rodrigues de [UNIFESP]
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BACKGROUND: The incremental shuttle test presents some theoretical advantages over the six-minute walk test in chronic heart failure (CHF), including better standardization and less dependency on collaboration.OBJECTIVES: The present study evaluated test-retest repeatability, test accuracy in predicting a peak oxygen consumption (VO(2)) of 14 mL/kg/min or less, as well as the prognostic value of both walking tests in stable CHF patients.METHODS: Sixty-three patients (44 men; New York Heart Association functional class II to IV) underwent an incremental treadmill exercise test and, on another day, the walk test in duplicate.RESULTS: Patients showed well-preserved functional capacity according to the distance walked in both tests (six-minute walk test 491 +/- 94 in versus incremental shuttle walk test 422 +/- 119 in; P < 0.001). Interestingly, the six-minute and incremental shuttle walk test differences in distance walked were higher in more disabled patients. The mean bias 95% CI of the within,test differences were similar (7 +/- 40 m and 8 +/- 45 in, respectively). Peak VO(2), but not distance walked in either test, was associated with survival (P < 0.05).CONCLUSIONS: The incremental shuttle walk test showed similar repeatability and accuracy in estimating peak VO(2) compared with the six-minute walk test in CHF patients. Direct measurement of peak VO(2), however, remains superior to either walking test in predicting survival - at least in patients with well-preserved functional capacity.
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Canadian Journal Of Cardiology. New York: Elsevier Science Inc, v. 24, n. 2, p. 131-135, 2008.