2021, Number 2
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Rev Nefrol Dial Traspl 2021; 41 (2)
Results and short-term reproducibility of the Incremental Shuttle Walking Test in patients with chronic kidney disease on hemodialysis
Mautner C, Schneider N, Contreras R, Báez C, Rodríguez-Núñez I
Language: Spanish
References: 47
Page: 89-99
PDF size: 426.21 Kb.
ABSTRACT
Introduction: The Incremental
Shuttle Walk Test has been used to
determine physical capacity in patients
with chronic kidney disease. However,
its applicability and reproducibility
have seldom been studied in hemodialysis patients.
The objective of this study was to evaluate the
performance and reproducibility of the incremental
shuttle walk test in patients with chronic kidney
disease on hemodialysis.
Methods: Patients with
chronic kidney disease on dialysis and subjects
without chronic kidney disease were included. Each
individual performed two Incremental Shuttle
Walk Test with an interval of 30 minutes. We
recorded the distance traveled, maximum speed,
heart rate and perceived effort. Reproducibility
was analyzed by calculating the intraclass
correlation coefficient and the standard error of
the mean. Using the Bland-Altman analysis, we
calculated the discrepancy of the distance traveled
and the peak heart rate. The minimum detectable
change was also calculated for all parameters of the
incremental shuttle walk test. A value of p=‹0.05
was considered significant.
Results: 68 subjects
entered the study (34 were patients with chronic
kidney disease, and 34 subjects constituted the
control group). Patients with chronic kidney
disease walked a shorter distance than those in
the control group (-40%; p=‹0.0001). In both
groups, excellent test-retest reliability was found in
all outcome measurements (intraclass correlation
coefficient calculation ›0.80). The standard error of
measurement and the minimum detectable change
for the distance traveled were 26.0 m and 72.1 m,
respectively. The Bland-Altman analysis for the
distance traveled showed a mean difference of -0.9
m with limits of agreement between 65.5 and -63.7
m.
Conclusion: Patients with chronic kidney
disease on hemodialysis show lower performance
during the incremental shuttle walk test, compared
to individuals without chronic kidney disease. The
outcome measurements of the Incremental Shuttle
Walk Test show high test-retest reproducibility in
the short run in this group of patients.
REFERENCES
Glassock RJ, Warnock DG, Delanaye P. The globalburden of chronic kidney disease: estimates, variabilityand pitfalls. Nat Rev Nephrol. 2017;13(2):104-14. doi:10.1038/nrneph.2016.163.
Biljak VR, Aakre KM, Yucel D, Bargnoux AS, CristolJP, Piéroni L. A Pathway to National Guidelines forLaboratory Diagnostics of Chronic Kidney Disease -Examples from Diverse European Countries. EJIFCC.2017;28(4):289-301.
Carney EF. The impact of chronic kidney disease onglobal health. Nat Rev Nephrol. 2020;16(5):251. doi:10.1038/s41581-020-0268-7.
Pecoits-Filho R, Sola L, Correa-Rotter R, Claure-Del Granado R, Douthat WG, Bellorin-Font E;International Society of Nephrology RegionalBoard. Kidney disease in Latin America: currentstatus, challenges, and the role of the ISN in thedevelopment of nephrology in the region. Kidney Int.2018;94(6):1069-72. doi: 10.1016/j.kint.2018.07.026.
Schardong J, Marcolino MAZ, Plentz RDM. Muscleatrophy in chronic kidney disease. Adv Exp Med Biol.2018;1088:393-412. doi: 10.1007/978-981-13-1435-3_18.
Pereira RA, Cordeiro AC, Avesani CM, Carrero JJ,Lindholm B, Amparo FC, et al. Sarcopenia in chronickidney disease on conservative therapy: prevalence andassociation with mortality. Nephrol Dial Transplant.2015;30(10):1718-25. doi: 10.1093/ndt/gfv133.
Andrade FP, Rezende PS, Ferreira TS, Borba GC,Müller AM, Rovedder PME. Effects of intradialyticexercise on cardiopulmonary capacity in chronickidney disease: systematic review and meta-analysisof randomized clinical trials. Sci Rep. 2019;9(1):18470.doi: 10.1038/s41598-019-54953-x.
Torino C, Manfredini F, Bolignano D, Aucella F,Baggetta R, Barillà A, et al.; EXCITE WorkingGroup. Physical performance and clinical outcomes indialysis patients: a secondary analysis of the EXCITEtrial. Kidney Blood Press Res. 2014;39(2-3):205-11. doi:10.1159/000355798.
O’Hare AM, Tawney K, Bacchetti P, JohansenKL. Decreased survival among sedentary patientsundergoing dialysis: results from the dialysis morbidityand mortality study wave 2. Am J Kidney Dis.2003;41(2):447-54. doi: 10.1053/ajkd.2003.50055.
Tran D. Cardiopulmonary Exercise Testing. MethodsMol Biol. 2018;1735:285-95. doi: 10.1007/978-1-4939-7614-0_18.
Shi Y, Zheng D, Zhang L, Yu Z, Yan H, Ni Z, et al.Six-minute walk test predicts all-cause mortality andtechnique failure in ambulatory peritoneal dialysispatients. Nephrology (Carlton). 2017;22(2):118-24. doi:10.1111/nep.12726.
Fassbinder TR, Winkelmann ER, Schneider J,Wendland J, Oliveira OB. Functional capacity andquality of life in patients with chronic kidney diseasein pre-dialytic treatment and on hemodialysis: a crosssectional study. J Bras Nefrol. 2015;37(1):47-54. doi:10.5935/0101-2800.20150008.
Kohl L de M, Signori LU, Ribeiro RA, Silva AM,Moreira PR, Dipp T, et al. Prognostic value of thesix-minute walk test in end-stage renal disease lifeexpectancy: a prospective cohort study. Clinics(Sao Paulo). 2012;67(6):581-6. doi: 10.6061/clinics/2012(06)06.
Gollie JM, Harris-Love MO, Patel SS, Argani S.Chronic kidney disease: considerations for monitoringskeletal muscle health and prescribing resistanceexercise. Clin Kidney J. 2018 ;11(6):822-831. doi:10.1093/ckj/sfy054.
Wilkinson TJ, Xenophontos S, Gould DW, VogtBP, Viana JL, Smith AC, et al. Test-retest reliability,validation, and “minimal detectable change” scores forfrequently reported tests of objective physical functionin patients with non-dialysis chronic kidney disease.Physiother Theory Pract. 2019;35(6):565-76. doi:10.1080/09593985.2018.1455249.
Hadjiioannou I, Wong K, Lindup H, Mayes J, CastleE, Greenwood S. Test-retest reliability for physicalfunction measures in patients with chronic kidneydisease. J Ren Care. 2020;46(1):25-34. doi: 10.1111/jorc.12310.
Singh SJ, Morgan MD, Scott S, Walters D, HardmanAE. Development of a shuttle walking test of disabilityin patients with chronic airways obstruction. Thorax.1992;47(12):1019-24. doi: 10.1136/thx.47.12.1019.
Wilund KR, Tomayko EJ, Wu PT, Ryong ChungH, Vallurupalli S, Lakshminarayanan B, Fernhall B.Intradialytic exercise training reduces oxidative stressand epicardial fat: a pilot study. Nephrol Dial Transplant.2010;25(8):2695-701. doi: 10.1093/ndt/gfq106.
Greenwood SA, Lindup H, Taylor K, Koufaki P, RushR, Macdougall IC, et al. Evaluation of a pragmaticexercise rehabilitation programme in chronic kidneydisease. Nephrol Dial Transplant. 2012;27(Suppl.3):iii126-34. doi: 10.1093/ndt/gfs272.
Greenwood SA, Castle E, Lindup H, Mayes J, WaiteI, Grant D, et al. Mortality and morbidity followingexercise-based renal rehabilitation in patients withchronic kidney disease: the effect of programmecompletion and change in exercise capacity. NephrolDial Transplant. 2019;34(4):618-25. doi: 10.1093/ndt/gfy351.
Singh SJ, Morgan MD, Hardman AE, Rowe C,Bardsley PA. Comparison of oxygen uptake during aconventional treadmill test and the shuttle walkingtest in chronic airflow limitation. Eur Respir J.1994;7(11):2016-20.
Parreira VF, Janaudis-Ferreira T, Evans RA, MathurS, Goldstein RS, Brooks D. Measurement propertiesof the incremental shuttle walk test. a systematicreview. Chest. 2014;145(6):1357-69. doi: 10.1378/chest.13-2071.
Xenophontos S, Wilkinson TJ, Gould DW, WatsonEL, Viana JL, Smith AC. Peak aerobic capacityfrom incremental shuttle walk test in chronic kidneydisease. J Ren Care. 2019;45(3):185-92. doi: 10.1111/jorc.12293.
Holland AE, Spruit MA, Troosters T, PuhanMA, Pepin V, Saey D, et al. An official EuropeanRespiratory Society/American Thoracic Societytechnical standard: field walking tests in chronicrespiratory disease. Eur Respir J. 2014;44(6):1428-46.doi: 10.1183/09031936.00150314.
Singh SJ, Puhan MA, Andrianopoulos V, HernandesNA, Mitchell KE, Hill CJ, et al. An official systematicreview of the European Respiratory Society/AmericanThoracic Society: measurement properties of fieldwalking tests in chronic respiratory disease. Eur Respir J.2014;44(6):1447-78. doi: 10.1183/09031936.00150414.
Broers NJH, Martens RJH, Cornelis T, van der SandeFM, Diederen NMP, Hermans MMH, et al. Physicalactivity in end-stage renal disease patients: the effectsof starting dialysis in the first 6 months after thetransition period. Nephron. 2017;137(1):47-56. doi:10.1159/000476072.
Hadjiioannou I, Wong K, Lindup H, Mayes J, CastleE, Greenwood S. Test-Retest Reliability for PhysicalFunction Measures in Patients with Chronic KidneyDisease. J Ren Care. 2020;46(1):25-34. doi: 10.1111/jorc.12310.
Peixoto-Souza FS, Sampaio LM, de Campos EC,Cangussu Barbalho-Moulim M, Nascimento de AraujoP, Laurino Neto RM, et al. Reproducibility of theincremental shuttle walk test for women with morbidobesity. Physiother Theory Pract. 2015;31(6):428-32.doi: 10.3109/09593985.2015.1010242.
Lu MJ, Zhong WH, Liu YX, Miao HZ, Li YC, JiMH. Sample size for assessing agreement between twomethods of measurement by Bland-Altman Method.Int J Biostat. 2016;12(2):/j/ijb.2016.12.issue-2/ijb-2015-0039/ijb-2015-0039.xml. doi: 10.1515/ijb-2015-0039.
Giles D, Draper N, Neil W. Validity of the Polar V800heart rate monitor to measure RR intervals at rest.Eur J Appl Physiol. 2016;116(3):563-71. doi: 10.1007/s00421-015-3303-9.
Borg GA. Psychophysical bases of perceived exertion.Med Sci Sports Exerc. 1982;14(5):377-81.
Neves CD, Lacerda AC, Lage VK, Lima LP, FonsecaSF, de Avelar NC, et al. Cardiorespiratory responsesand prediction of peak oxygen uptake during theshuttle walking test in healthy sedentary adult men.PLoS One. 2015;10(2):e0117563. doi: 10.1371/journal.pone.0117563.
de Camargo AA, Justino T, de Andrade CH, MalagutiC, Dal Corso S. Chester step test in patients withCOPD: reliability and correlation with pulmonaryfunction test results. Respir Care. 2011;56(7):995-1001.doi: 10.4187/respcare.01047.
de Vet HC, Terwee CB, Knol DL, Bouter LM.When to use agreement versus reliability measures. JClin Epidemiol. 2006;59(10):1033-9. doi: 10.1016/j.jclinepi.2005.10.015.
Rogan A, McCarthy K, McGregor G, HamborgT, Evans G, Hewins S, et al. Quality of lifemeasures predict cardiovascular health and physicalperformance in chronic renal failure patients. PLoSOne. 2017;12(9):e0183926. doi: 10.1371/journal.pone.0183926.
Ting SM, Hamborg T, McGregor G, OxboroughD, Lim K, Koganti S, et al. Reduced cardiovascularreserve in chronic kidney failure: a matched cohortstudy. Am J Kidney Dis. 2015;66(2):274-84. doi:10.1053/j.ajkd.2015.02.335.
Faria Rde S, Fernandes N, Lovisi JC, ReboredoMde M, Marta MS, Pinheiro Bdo V, Bastos MG.Pulmonary function and exercise tolerance are relatedto disease severity in pre-dialytic patients with chronickidney disease: a cross-sectional study. BMC Nephrol.2013;14:184. doi: 10.1186/1471-2369-14-184.
Jürgensen SP, Antunes LC, Tanni SE, Banov MC,Lucheta PA, Bucceroni AF, et al. The incrementalshuttle walk test in older Brazilian adults. Respiration.2011;81(3):223-8. doi: 10.1159/000319037.
Chen CN, Chuang LM, Wu YT. Clinical measures ofphysical fitness predict insulin resistance in people atrisk for diabetes. Phys Ther. 2008;88(11):1355-64. doi:10.2522/ptj.20080064.
Ramos RA, Guimarães FS, Dionyssiotis Y, TsekouraD, Papathanasiou J, Ferreira AS. Development of amultivariate model of the six-minute walked distanceto predict functional exercise capacity in hypertension.J Bodyw Mov Ther. 2019;23(1):32-8. doi: 10.1016/j.jbmt.2018.01.010.
Ribeiro LR, Mesquita RB, Vidotto LS, Merli MF,Carvalho DR, de Castro LA, et al. Are 30 minutesof rest between two incremental shuttle walking testsenough for cardiovascular variables and perceivedexertion to return to baseline values? Braz J Phys Ther.2015;19(2):105-13. doi: 10.1590/bjpt-rbf.2014.0078.
Probst VS, Hernandes NA, Teixeira DC, Felcar JM,Mesquita RB, Gonçalves CG, et al. Reference valuesfor the incremental shuttle walking test. Respir Med.2012;106(2):243-8. doi: 10.1016/j.rmed.2011.07.023.
Kurella Tamura M, Covinsky KE, Chertow GM,Yaffe K, Landefeld CS, McCulloch CE. Functionalstatus of elderly adults before and after initiation ofdialysis. N Engl J Med. 2009;361(16):1539-47. doi:10.1056/NEJMoa0904655.
Hung RK, Al-Mallah MH, Whelton SP, MichosED, Blumenthal RS, Ehrman JK, et al. Effect of betablockertherapy, maximal heart rate, and exercisecapacity during stress testing on long-term survival(from The Henry Ford Exercise Testing Project).Am J Cardiol. 2016;118(11):1751-7. doi: 10.1016/j.amjcard.2016.08.060.
Beninato M, Portney LG. Applying concepts ofresponsiveness to patient management in neurologicphysical therapy. J Neurol Phys Ther. 2011;35(2):75-81.doi: 10.1097/NPT.0b013e318219308c.
Singh SJ, Jones PW, Evans R, Morgan MD. Minimumclinically important improvement for the incrementalshuttle walking test. Thorax. 2008;63(9):775-7. doi:10.1136/thx.2007.081208.
Carrero JJ, Johansen KL, Lindholm B, Stenvinkel P,Cuppari L, Avesani CM. Screening for muscle wastingand dysfunction in patients with chronic kidneydisease. Kidney Int. 2016;90(1):53-66. doi: 10.1016/j.kint.2016.02.025.