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Strategies to minimize dynamic hyperinflation (DH) and dyspnea, such as slow chest compression (SCC), are relevant in people with chronic obstructive pulmonary disease (COPD). To analyze the acute effects of SCC after exercise on DH and dyspnea in people with COPD and to identify responders to the technique. This is a cross-over study with 40 patients. Two six-minute step tests (6MSTs) were performed followed by a one-minute application of SCC (6MSTSCC) or rest (6MSTCONTROL), at random. End-expiratory lung volume (EELV) and dyspnea were assessed. A difference ≥76 ml in ΔEELV between SCC and control characterized the responders. The performance in 6MSTSCC and 6MSTCONTROL were similar. There was a greater reduction in EELV after 6MSTSCC compared to 6MSTCONTROL (124 ± 193 ml vs. 174 ± 183 ml; p =.049), while there was no difference in change in dyspnea between the SCC and control groups. Twenty-one participants were SCC responders and had higher functional residual capacity [FRC: 5.36 ± 1.09 vs. 4.58 ± 0.94; p =.02; cutoff point: 4.56; sensitivity = 76%; specificity = 53%; AUC = 0.71 (95%CI: 0.54 to 0.87); p =.02]. SCC applied immediately after exercise reduced DH, but did not reduce dyspnea in people with COPD. The technique is beneficial only for some patients and FRC can help to identify them. [ABSTRACT FROM AUTHOR]

Verify which test, Glitttre-ADL test (TGlittre) or six-minute walk test (6MWT), better predicts balance, fear, and risk of falling in middle-aged and older adults. Twenty-eight individuals (15 women) completed the study protocol, which included: anthropometric assessment, spirometry, Falls Efficacy Scale-International-Brazil (FES-I-Brazil), Activities-specific Balance Confidence Scale (ABC), Timed Up and Go Test (TUG), Berg Balance Scale (BBS), TGlittre, and 6MWT. The Shapiro Wilk test investigated the distribution of the data. To verify if there was a correlation between the performance in TGlittre and 6MWT and the balance, fear, and risk of falling variables, the Pearson or Spearman correlation coefficient were used. Simple linear regression and stepwise multiple linear regression were conducted to identify which functional capacity test better predicts balance, fear, and risk of falling. Both TGlittre and 6MWT correlated (r = 0.44, p =.02 and r = −0.59, p =.003, respectively) and were able to predict the TUG (R2 = 0.17 and R2 = 0.26, p <.005, respectively). However, when analyzed in a multiple regression model, the 6MWT was better predictor of TUG (26%). Only TGlittre correlated (r = 0.39 and r = −0.38, p =.04) and was able to predict the FES-I-Brazil and BBS scores (17%), suggesting that TGlittre better reflects the worry about falls and balance in multiple ADL contexts. The 6MWT and the TGlittre are able to predict balance assessed by the TUG. However, the 6MWT has proved to be more effective in predicting TUG results. [ABSTRACT FROM AUTHOR]

The relationship between lung function and performance in some functional tests, as the six-minute walk test (6MWT) and Glittre-ADL test (TGlittre) are still discrepant in patients with chronic obstructive pulmonary disease (COPD). This study aimed to verify which test better correlates and is better explained by the pulmonary function, and which test better discriminates patients regarding the severity of the disease. Seventy-four patients with moderate to very severe COPD (54 men; 66 ± 9 years; FEV1: 37.2 ± 14.3%pred) were included. Spirometry, 6MWT and TGlittre were performed. The results showed weak to moderate correlation between pulmonary function variables and 6MWT (0.36 ≤ r ≤ 0.45) and TGlittre (−0.44 ≤ r ≤ −0.53). In patients with performance of ≤400 m in the 6MWT, a strong correlation was observed between TGlittre with FEV1 (%pred) (r = −0.82; p <.001). The pulmonary function variable that better predict the functional tests performance was FEV1 (R2 = 0.17). Both functional tests were able to discriminate patients with COPD GOLD 4 from the other classifications. When compared to GOLD 2 patients, GOLD 4 patients presented higher time spent on TGlittre (p <.001). When compared to GOLD 3 patients, GOLD 4 patients had higher TGlittre (p =.001). No statistical differences were found in the 6MWT between GOLD 3 and 4, as well as between GOLD 2 and 3. In conclusion, the pulmonary function presents stronger correlations and better explain the variability of TGlittre than of the 6MWT, especially in patients with greater functional impairment. The TGlittre seems to better discriminate patients with COPD regarding the severity of lung function. [ABSTRACT FROM AUTHOR]

Objective: To compare the performance of the Six-Minute Walk Test on 20-meter (6MWT20) and 30-meter (6MWT30) tracks and to test the validity and reliability of the 6MWT20 in middle-aged and older adults. Method: The subjects underwent lung function assessment and performed the 6MWT30 and 6MWT20. Student´s t-tests or Wilcoxon tests were used to compare the variables. The Pearson or Spearman correlation coefficients were used to evaluate the validity of the 6MWT20 and the reliability of the 6MWT20. The 6MWT30 was tested by the two-way mixed model of the Intraclass Correlation Coefficient (ICC 3,1). Results: Twenty-five subjects (age: 60 ± 10 years) walked, on average, 11.0 ± 21.9 m more in the 6MWT30 than in the 6MWT20 (p <.05). The walking distance, the number of steps, the energy expenditure and the movement intensity between the 6MWT20 and 6MWT30 was correlated (r = 0.95; r = 0.81; r = 0.91; r = 0.67; respectively, p <.001). The walking distances showed high reliability and were similar between test and re-test in the 6MWT30 (544 ± 72.1 vs. 551 ± 70.5; p <.05; ICC = 0.97) and in the 6MWT20 (533 ± 73.1 vs. 532 ± 59.1; p <.05; ICC = 0.87). Conclusion: The 6MWT20 performance is lower than the 6MWT30 However, this difference is not clinically relevant. Additionally, the 6MWT20 is a valid and reproducible test to assess the functional capacity of middle-aged and older adults. [ABSTRACT FROM AUTHOR]

BACKGROUND: Test-retest reproducibility of the 6-min step test (6MST) is controversial in patients with COPD because the decision to perform a second test is influenced by interruptions, physiological overload, and the patient's exercise tolerance. The aim of this study was to analyze the reproducibility of performance on the 6MST (ie, number of steps climbed and interruptions) and physiological variables in subjects with COPD, with and without poor exercise tolerance, and with and without interruptions during the test. METHODS: Subjects performed 2 6MST (6MST1, 6MST2) with a minimum of 30 min rest between tests. Physiological variables were assessed with a gas analyzer. Subjects who performed ≤ 78 steps in the 6MST1 and ≤ 86 steps in the test with the higher number of steps performed (6MSTBEST) were considered to have poor exercise tolerance. Subjects were also stratified according to those who interrupted the 6MSTBEST and those who did not interrupt the 6MSTBEST. RESULTS: 40 subjects (31 men; FEV1 percent of predicted = 50.4 ± 13.5) participated in the study. The number of steps, interruptions, and physiological variables showed moderate to high reliability (intraclass correlation coefficient: 0.70-0.99, P < .001). Thirty-one (77.5%) subjects had a better performance during 6MST2 than 6MST1 (mean difference: 4.65 ± 5.59, P < .001). Although the number of times subjects were interrupted was similar between the 2 tests (P = .66), the duration of these interruptions was shorter during 6MST2 (mean difference: -0.12 ± 0.39 s, P = .040). The difference in the number of steps (6MST2 -- 6MST1) did not differ between subjects who performed ≤78 steps (mean difference: 5.64 ± 5.32 steps; 10.3%; P < 0.001) and ≥ 79 steps (3.00 ± 5.82 steps; 6.13%; P = 0.08) on the 6MST1 (P = 0.15) and between subjects who performed ≤ 86 steps (5.39 ± 5.14 steps; 9.39%; P < 0.001) and ≥ 87 steps (2.92 ± 6.43 steps; 2.74%; P = 0.14) steps on the 6MSTBEST (P = 0.20). CONCLUSIONS: Performance and physiological variables in the 6MST were reproducible, and a second test did not impose greater physiological overload. Two tests were essential for patients with poor exercise tolerance. [ABSTRACT FROM AUTHOR]

The study objective was to determine a cut-off point for the Glittre activities of daily living (ADL)test (TGlittre) to discriminate patients with normal and abnormal functional capacity. Fifty-nine patients with moderate to very severe COPD (45 males; 65 ± 8.84 years; BMI: 26 ± 4.78 kg/m2; FEV1: 35.3 ± 13.4% pred) were evaluated for spirometry, TGlittre, 6-minute walk test (6 MWT), physical ADL, modified Medical Research Council scale (mMRC), BODE index, Saint George's Respiratory Questionnaire (SGRQ), and COPD Assessment Test (CAT). The receiver operating characteristic (ROC) curve was used to determine the cut-off point for TGlittre in order to discriminate patients with 6 MWT < 82% pred. The ROC curve indicated a cut-off point of 3.5 minutes for the TGlittre (sensitivity = 92%, specificity = 83%, and area under the ROC curve = 0.95 [95% CI: 0.89–0.99]). Patients with abnormal functional capacity had higher mMRC (median difference 1 point), CAT (mean difference: 4.5 points), SGRQ (mean difference: 12.1 points), and BODE (1.37 points) scores, longer time of physical activity <1.5 metabolic equivalent of task (mean difference: 47.9 minutes) and in sitting position (mean difference: 59.4 minutes) and smaller number of steps (mean difference: 1,549 minutes);p< 0.05 for all. In conclusion, the cut-off point of 3.5 minutes in the TGlittre is sensitive and specific to distinguish COPD patients with abnormal and normal functional capacity. [ABSTRACT FROM AUTHOR]

Background: Test-retest reproducibility of the 6-min step test (6MST) is controversial in patients with COPD because the decision to perform a second test is influenced by interruptions, physiological overload, and the patient's exercise tolerance. The aim of this study was to analyze the reproducibility of performance on the 6MST (ie, number of steps climbed and interruptions) and physiological variables in subjects with COPD, with and without poor exercise tolerance, and with and without interruptions during the test., Methods: Subjects performed 2 6MST (6MST 1 , 6MST 2 ) with a minimum of 30 min rest between tests. Physiological variables were assessed with a gas analyzer. Subjects who performed ≤ 78 steps in the 6MST 1 and ≤ 86 steps in the test with the higher number of steps performed (6MST BEST ) were considered to have poor exercise tolerance. Subjects were also stratified according to those who interrupted the 6MST BEST and those who did not interrupt the 6MST BEST ., Results: 40 subjects (31 men; FEV 1 percent of predicted = 50.4 ± 13.5) participated in the study. The number of steps, interruptions, and physiological variables showed moderate to high reliability (intraclass correlation coefficient: 0.70-0.99, P < .001). Thirty-one (77.5%) subjects had a better performance during 6MST 2 than 6MST 1 (mean difference: 4.65 ± 5.59, P < .001). Although the number of times subjects were interrupted was similar between the 2 tests ( P = .66), the duration of these interruptions was shorter during 6MST 2 (mean difference: -0.12 ± 0.39 s, P = .040). The difference in the number of steps (6MST 2 - 6MST 1 ) did not differ between subjects who performed ≤78 steps (mean difference: 5.64 ± 5.32 steps; 10.3%; P < 0.001) and ≥ 79 steps (3.00 ± 5.82 steps; 6.13%; P = 0.08) on the 6MST 1 ( P = 0.15) and between subjects who performed ≤ 86 steps (5.39 ± 5.14 steps; 9.39%; P < 0.001) and ≥ 87 steps (2.92 ± 6.43 steps; 2.74%; P = 0.14) steps on the 6MST BEST ( P = 0.20)., Conclusions: Performance and physiological variables in the 6MST were reproducible, and a second test did not impose greater physiological overload. Two tests were essential for patients with poor exercise tolerance., Competing Interests: This study was supported in part by Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - Brasil (Finance Code 001) and Fundação de Amparo à Pesquisa e Inovação do Estado de Santa Catarina (Termo de Outorga 2017TR645). The authors have disclosed no conflicts of interest., (Copyright © 2021 by Daedalus Enterprises.)