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Santos-de-Araújo AD, da Luz Goulart C, Marinho RS, Dourado IM, Mendes RG, Roscani MG, Bassi-Dibai D, Phillips SA, Arena R, Borghi-Silva A. The six-minute step test can predict COPD exacerbations: a 36-month follow-up study. Sci Rep 2024; 14:3649. [PMID: 38351306 PMCID: PMC10864352 DOI: 10.1038/s41598-024-54338-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 02/12/2024] [Indexed: 02/16/2024] Open
Abstract
The six-minute step test (6MST) has been shown to be effective in assessing exercise capacity in individuals with COPD regardless of severity and, despite its easy execution, accessibility and validity, information on the prognostic power of this test remains uncertain. The aim of this study is to investigate whether the 6MST can predict the occurrence of exacerbations in patients with COPD. This is a prospective cohort study with a 36-month follow-up in patients with COPD. All patients completed a clinical assessment, followed by pulmonary function testing and a 6MST. The 6MST was performed on a 20 cm high step; heart rate, blood pressure, oxygen saturation, BORG dyspnea and fatigue were collected. Sixty-four patients were included in the study, the majority being elderly men. Performance on the 6MST demonstrated lower performance compared to normative values proposed in the literature, indicating a reduced functional capacity. Kaplan Meier analysis revealed that ≤ 59 steps climbed during the 6MST was a strong predictor of COPD exacerbation over a 36-month follow-up. We have identified a minimal threshold number of steps (≤ 59) obtained through the 6MST may be able predict the risk of exacerbations in patients with COPD.
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Affiliation(s)
| | - Cássia da Luz Goulart
- Cardiopulmonary Physiotherapy Laboratory, Universidade Federal de São Carlos, São Carlos, SP, 13565-905, Brazil
| | - Renan Shida Marinho
- Cardiopulmonary Physiotherapy Laboratory, Universidade Federal de São Carlos, São Carlos, SP, 13565-905, Brazil
| | - Izadora Moraes Dourado
- Cardiopulmonary Physiotherapy Laboratory, Universidade Federal de São Carlos, São Carlos, SP, 13565-905, Brazil
| | - Renata Gonçalves Mendes
- Cardiopulmonary Physiotherapy Laboratory, Universidade Federal de São Carlos, São Carlos, SP, 13565-905, Brazil
| | - Meliza Goi Roscani
- Department of Medicine, Universidade Federal de São Carlos (UFSCar), Sao Carlos, SP, Brazil
| | - Daniela Bassi-Dibai
- Postgraduate Program in Management in Health Programs and Services, Universidade CEUMA, São Luís, MA, Brazil
| | - Shane A Phillips
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois Chicago, Chicago, IL, USA
| | - Ross Arena
- Department of Physical Therapy, College of Applied Health Sciences, University of Illinois Chicago, Chicago, IL, USA
| | - Audrey Borghi-Silva
- Cardiopulmonary Physiotherapy Laboratory, Universidade Federal de São Carlos, São Carlos, SP, 13565-905, Brazil.
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Salles Albuquerque1 V, Dal Corso2 S, Pereira do Amaral2 D, Medina Dutra de Oliveira1 T, Fonseca Souza3 G, Naara Silva de Souza3 R, Karolyn Menezes Nogueira3 A, Dal Lago4 P, Luísa Rocha Dadalt4 M, Faraco Correa4 I, França Bernardelli Cipriano5 G, Maria Ferreira Silva5 F, Rodrigues Britto6 R, José1 A, Malaguti1 C. Normative values and reference equation for the six-minute step test to evaluate functional exercise capacity: a multicenter study. J Bras Pneumol 2022. [PMCID: PMC9496468 DOI: 10.36416/1806-3756/e20210511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective: To establish normative values and a reference equation for the number of steps climbed during the six-minute step test (6MST) in healthy adults, and to assess the reliability of the test and of the equation. Methods: This was a multicenter cross-sectional study involving 468 healthy volunteers (age range: 18-79 years) recruited from the general community in six research laboratories across different regions of Brazil, which is a country with continental dimensions. The 6MST was performed twice (30-min interval), and clinical, demographic, and functional variables were evaluated. An independent sample of 24 volunteers was evaluated to test the reference equation a posteriori. Results: The number of steps had excellent test-retest reliability (intraclass correlation coefficient = 0.96 [95%CI: 0.95-0.97]), and the mean number of steps was 175 ± 45, the number being 14% greater in males than in females. The best performance on the test was correlated with age (r = -0.60), sex (r = 0.28), weight (r = 0.13), height (r = 0.41), BMI (r = -0.22), waist circumference (r = -0.22), thigh circumference (r = 0.15), FVC (r = 0.54), and physical activity level (r = 0.17; p < 0.05 for all). In the regression analysis, age, sex, height, and weight explained 42% of the variability of the 6MST. Normative values were established for the 6MST according to age and sex. There was no difference between the 6MST values from the independent sample and its predicted values (157 ± 29 steps vs. 161 ± 25 steps; p = 0.47; 97% of predicted values). Conclusions: The normative values and the reference equation for the 6MST in this study seem adequate to accurately predict the physical functional performance in adults in Brazil.
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Affiliation(s)
- Vanessa Salles Albuquerque1
- 1. Programa de Pós-Graduação em Ciências de Reabilitação e Desempenho Físico-Funcional, Universidade Federal de Juiz de Fora – UFJF – Juiz de Fora (MG) Brasil
| | | | - Daniel Pereira do Amaral2
- 2. Programa de Pós-Graduação em Ciências de Reabilitação, Universidade Nove de Julho – UNINOVE – São Paulo (SP) Brasil
| | - Túlio Medina Dutra de Oliveira1
- 1. Programa de Pós-Graduação em Ciências de Reabilitação e Desempenho Físico-Funcional, Universidade Federal de Juiz de Fora – UFJF – Juiz de Fora (MG) Brasil
| | - Gerson Fonseca Souza3
- 3. Departamento de Fisioterapia, Universidade Federal do Rio Grande do Norte – UFRN – Natal (RN) Brasil
| | | | | | - Pedro Dal Lago4
- 4. Programa de Pós-Graduação em Ciências de Reabilitação, Universidade Federal de Ciências da Saúde de Porto Alegre – UFCSPA – Porto Alegre (RS) Brasil
| | - Maria Luísa Rocha Dadalt4
- 4. Programa de Pós-Graduação em Ciências de Reabilitação, Universidade Federal de Ciências da Saúde de Porto Alegre – UFCSPA – Porto Alegre (RS) Brasil
| | - Isadora Faraco Correa4
- 4. Programa de Pós-Graduação em Ciências de Reabilitação, Universidade Federal de Ciências da Saúde de Porto Alegre – UFCSPA – Porto Alegre (RS) Brasil
| | | | - Fabíola Maria Ferreira Silva5
- 5. Programa de Pós-Graduação em Ciências e Tecnologias em Saúde. Universidade de Brasília – UnB – Brasília (DF) Brasil
| | - Raquel Rodrigues Britto6
- 6. Programa de Pós-Graduação em Ciências de Reabilitação, Universidade Federal de Minas Gerais –UFMG – Belo Horizonte (MG) Brasil
| | - Anderson José1
- 1. Programa de Pós-Graduação em Ciências de Reabilitação e Desempenho Físico-Funcional, Universidade Federal de Juiz de Fora – UFJF – Juiz de Fora (MG) Brasil
| | - Carla Malaguti1
- 1. Programa de Pós-Graduação em Ciências de Reabilitação e Desempenho Físico-Funcional, Universidade Federal de Juiz de Fora – UFJF – Juiz de Fora (MG) Brasil
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