Please use this identifier to cite or link to this item: http://hdl.handle.net/11054/1779
Title: Application of the modified incremental step test for pulmonary rehabiliation.
Author: Burge, A.
Rodrigues Jr., P.
Abramson, M.
Cox, N.
Bondarenko, J.
Webb, E.
Marceau, T.
Handley, E.
Macdonald, Heather
Askin, Annabel
Calasans, G.
do Amaral, D.
Dreger, J.
Dal Corso, S.
Holland, A.
Issue Date: 2021
Publication Title: Physical Therapy & Rehabilitation Journal
Volume: 101
Issue: 5
Start Page: pzab044
Abstract: Objective: A Modified Incremental Step Test (MIST) performed in the home may facilitate entirely home-based pulmonary rehabilitation programs. The aims of this study were to investigate the reliability and responsiveness, and the utility of the MIST for exercise prescription in people with stable chronic lung disease. Methods: The MIST was undertaken at the center and home in random order, before and after pulmonary rehabilitation, with 2 tests at each time point. Reliability was assessed using intraclass correlation coefficient. Responsiveness was evaluated as effect size. The minimal important difference was appraised using distribution and anchor-based methods. In a substudy, physiological responses to MIST were measured by a portable metabolic system, followed by a constant step rate test at 60% of peak oxygen uptake (VO2peak), to evaluate utility for exercise prescription. Results: Forty-six participants were recruited (29% of eligible candidates). There was excellent reliability for number of steps recorded in home- and center-based settings (intraclass correlation coefficient = 0.954, 95% CI = 0.915-0.976). A small-moderate effect size was demonstrated following pulmonary rehabilitation (0.34), and the minimal detectable change was 7 steps. All participants in the substudy achieved 60% of VO2peak and achieved steady state by the fourth minute, with 60% of VO2peak corresponding to a mean 37% (95% CI = 29-44) of the MIST final level. Conclusions: The MIST is reliable and responsive to pulmonary rehabilitation in people with stable chronic respiratory disease. It provides new opportunities to assess exercise capacity, prescribe exercise training, and reassess exercise program outcomes in environments where established field walking tests are not feasible. Impact: Pulmonary rehabilitation is a highly effective treatment that is underutilized worldwide. Home-based pulmonary rehabilitation may improve access for patients and deliver equivalent clinical outcomes but is limited by the availability of a robust exercise test that can be used at home to assess exercise capacity and prescribe training intensity. This study tested the clinimetric properties of the MIST and demonstrated a new way to assess exercise capacity, prescribe exercise training of an appropriate intensity, and reassess exercise capacity in environments where established field walking tests are not feasible.
URI: http://hdl.handle.net/11054/1779
DOI: https://doi.org/10.1093/ptj/pzab044
Internal ID Number: 01733
Health Subject: BRONCHIECTASIS
CHRONIC OBSTRUCTIVE PULMONARY
DISEASE
EXERCISE TOLERANCE
OUTCOME ASSESSMENT (HEALTH CARE)
PULMONARY REHABILITATION
Type: Journal Article
Article
Appears in Collections:Research Output

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