The PAY test: a new approach to assessing functional performance in children and adolescents with asthma

Abstract

To develop, validate, and to test reproducibility of new test capable of assessing functional performance in children and adolescents (PAY: Performance Activity in Youth). Method: participants with and without asthma were included in the development and validation phases, respectively. The PAY test includes five activities: transition from sitting to standing, walking 10 meters, step climbing, shoulder extension and flexion, and star jumps. Participants also underwent the Pediatric Glittre test (TGlittre-P), modified shuttle test (MST), and cardiopulmonary exercise test (CPET). Outcomes: PAY test time, oxygen uptake (VO2peak), and distance walked in the MST. Results: 10 healthy volunteers, age 14 (7 -16) years old were included in the development phase and 32 participants with asthma, age 10 (8 -13) years old, in the validation phase. All participants were able to complete the PAY test. The PAY test elicited greater physiological responses (VO2peak 33.5 ± 6.9ml/kg) than TGlittre-P (VO2peak: 27.4 ± 9.0ml/kg), but lower than the MST (VO2peak: 48.9 ± 14.2ml/kg) and CPET (VO2peak: 42.0 ± 8.8ml/kg), p < 0.05. There was moderate correlation between the PAY test time and the TGlittre-P time (r = 0.70, p < 0.001) and distance walked in the MST (r = -0.72, p < 0.001). The PAY test time was longer in participants with asthma than in healthy participants (3.3 1.1 min vs. 2.1 ± 1.0 min, p = 0.01). The PAY test was reproducible (ICC 0.78, CI 95% 0.55–0.90, p < 0.001), with a mean difference of -0.22 (0.90–0.43 min). Conclusions: The PAY test is a valid and reproducible tool for assessing functional performance in children and adolescents with asthma.