Chest
Original ResearchPulmonary RehabilitationProperties of Self-Paced Walking in Chronic Respiratory Disease: A Patient Goal-Oriented Assessment
Section snippets
Study Design
Patients were prospectively recruited to this longitudinal, single-group study at the start of their PR program. During the first week, the following assessments were conducted: two SPWs on separate days; two 6MWTs conducted according to American Thoracic Society guidelines,3 with the second test being used for analysis; functional limitation resulting from dyspnea using the Medical Research Council (MRC) dyspnea scale13, 14; and spirometry (Elite DL; Medical Graphics Corp; St. Paul, Minnesota)
Results
A total of 124 patients were screened for eligibility, and 64 (52%) consented to participate in the study. Their characteristics are summarized in Table 1. Supplemental oxygen was used in 40% of participants and a wheeled walker (rollator) in 50%. The reasons participants were excluded from analysis are provided in Figure 1. Two SPWs were completed before and after the program in 50 and 37 participants, respectively. Compared with those who completed two SPWs, those who did not had a lower 6MWT
Discussion
SPW is used to monitor walking performance in PR programs. To our knowledge, this study is the first to report its construct validity, repeatability and responsiveness as well as the sustainable SPW speed selected by patients with severe chronic respiratory disease. We found that SPW speed demonstrated construct validity and that SPW time was highly responsive to the effects of PR. The repeatability of SPW was unaltered by PR, despite patients walking on a daily basis as part of their program.
Acknowledgments
Author contributions: Dr Goldstein had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Dr Evans: contributed to conducting the study, data analysis and interpretation, and preparation of the manuscript.
Dr Hill: contributed to the design of the study, data interpretation, and preparation of the manuscript.
Mr Dolmage: contributed to the design of the study, data analysis and interpretation, and preparation of
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Cited by (0)
Funding/Support: This study was funded in part by an unrestricted grant from AstraZeneca. Dr Goldstein is funded through the University of Toronto-National Sanitarium Association Chair in Respiratory Rehabilitation Research. Dr Brooks holds a Canada Research Chair.
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