Is confidence to perform an Incremental Shuttle Walk Test (ISWT), walk at home, and manage breathlessness influenced by performing an ISWT?

Abstract

Introduction: The ISWT is routinely conducted in pulmonary rehabilitation (PR) assessments. However, performing an ISWT could improve confidence and thus impact upon repeat tests and exercise behaviours. We aimed to examine change in confidence using a Visual Analogue Scale (VAS) in 3 areas: confidence in walking at home (Q1), managing breathlessness (Q2), and performing another ISWT (Q3).

Methods: We conducted a prospective observational study. At initial PR assessment, we asked patients pre- and post- practice ISWT to report confidence in 3 areas (walking at home, managing breathlessness, and performing an ISWT) based on a VAS 0-10.

Results: A total of 91 patients with Chronic Respiratory Disease [mean (SD) age 67.5 years (10.3), male 49.5%, MRC 2-5] completed the confidence questions pre- and post- practice ISWT. Confidence in all questions improved after a practice ISWT (p<0.01 Wilcoxon signed rank)(table 1). No clinically significant change in ISWT distance was noted [mean (SD) practice ISWT 211.9m (133.9) to second ISWT 232.9m (143.2)]. No association was found between changes in confidence and changes in ISWT distance (r²=(Q1) -0.04, (Q2)-0.09, (Q3)0.04, p>0.05).

Conclusion: Confidence increased in all areas post- practice ISWT. This may be important for research trials as exercise behaviours (e.g walking at home) may be affected by conducting baseline exercise tests.