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Introduction: Field tests are commonly used as complements of cardiopulmonary exercise test (CPET) to evaluate the functional exercise capacity. The aims of this study were to validate the one-minute sit-to-stand test (STST) in congenital heart disease (CHD) children and to evaluate the possibility of predicting the peakVO 2 using the STST in this paediatric population., Methods: Children (8- to 18-year-old) followed for a CHD and performing CPET were recruited prospectively. Concomitantly, they performed STST. The heart rate (HR), oxygen saturation (SpO 2 ), muscular fatigue and dyspnoea were recorded before (t0), immediately after (t1) and 1min after the end of the STST (t2)., Results: We observed a poor but significant correlation between the STST and the peakVO 2 (r=0.306; p=0.013). A significant difference between girls and boys were observed for peakVO 2 (p<0.001), HR t0 (p=0.030), HR t1 (p=0.002) and HR t2 (p<0.001). The proposed model of prediction, including the number of STST, weight, height and age explains 37% of the predicted peakVO 2 variance., Conclusion: The STST can provide relevant data on physical capacity in children with CHD. When CPET cannot be performed, we therefore propose an alternative equation using the STST as a surrogate of peakVO 2 in CHD children., (Copyright © 2024 SEPAR. Published by Elsevier España, S.L.U. All rights reserved.)

Background: Several studies have evaluated the effect of nasal high-flow (NHF) therapy to enhance exercise performance and tolerance in patients with chronic obstructive pulmonary disease (COPD); however, results are disparate. Objective: The aim of this systematic review and meta-analysis was to assess the effect of NHF therapy as an adjuvant to exercise training on functional exercise capacity in patients with COPD. Data Sources: An electronic search was performed in the following databases: PubMed, the Cochrane Central Register of Controlled Trials, the Physiotherapy Evidence Database, ScienceDirect, the Web of Science, OpenGrey, ClinicalTrials.gov, and European Respiratory Society and American Thoracic Society databases. Data Extraction: Two authors independently selected relevant randomized trials (parallel-group or crossover design), extracted data, assessed the risk of bias, and rated the quality of the evidence. Synthesis: Eleven studies were included, involving 408 participants (eight full papers and three conference abstracts). Most studies had a high risk of bias or other methodological limitations. The use of NHF therapy during a single session increased functional exercise capacity (standardized mean difference, 0.36 [95% confidence interval (CI), 0.03 to 0.69]; P  = 0.03, heterogeneity [ I 2  = 83%]). When conference abstracts were included in the pooled analysis, the estimated effect did not change ( P  = 0.006). The use of NHF therapy throughout a pulmonary rehabilitation program (parallel-group randomized controlled trials) increased functional exercise capacity at 4-12 weeks compared with training without NHF therapy (standardized mean difference, 0.34 [95% CI, 0.00-0.68]; P  = 0.05, heterogeneity [ I 2  = 18%]). Conclusions: There is very-low-quality to low-quality evidence that NHF therapy improves functional exercise capacity. Patient responses to NHF therapy were highly variable and heterogeneous, with benefits ranging from clinically trivial to worthwhile.

Background: Field tests are useful to assess the functional exercise capacity. The 6minute walking test (6MWT) is the most common field test even if alternatives are needed. The main aim of the study was to verify if the 3minute step test (3MST) is a valid tool to measure the functional exercise capacity and can surrogate the 6MWT in healthy children from 6- to 12-years-old., Methods: This randomized cross-over trial recruited 30 healthy children from 6 to 12 years. One 6MWT and two 3MST (3MST 1 and 3MST 2 ) were performed randomly on 3 consecutive days. The variables were the distance (6MWT), the number of steps (3MST) and the cardiorespiratory parameters., Results: The distance walked during 6MWT was very strongly correlated to the number of steps during the 3MST (3MST 1 : rho=0.833; P<0.001 and 3MST 2 : rho=0.868; P<0.001). Heart rate (HR) was lower than the theoretical maximal HR at the end of both tests. The change in HR and perceived fatigue were significantly higher after the 3MST. A learning effect was observed in the 3MST (+8 steps; P<0.001)., Conclusions: The 3MST is validated and can be a surrogate for the 6MWT in healthy children population between 6 and 12 years old. A training test is required in these children., (Copyright © 2021 SPLF and Elsevier Masson SAS. All rights reserved.)

Background: The impact of the COVID-19 pandemic on functional exercise capacity seemed quickly clinically evident. The objective of this study was to assess the functional exercise capacity of patients with severe COVID-19 and to evaluate the effect of a telerehabilitation program in the specific context of the COVID-19 pandemic., Method: Patients hospitalized for severe or critical COVID-19 were recruited. The functional exercise capacity (1-min sit-to-stand test (STST)) was prospectively quantified at discharge. A telerehabilitation program was then proposed. A control group was composed with the patients refusing the program., Results: At discharge, none of the 48 recruited patients had a STST higher than the 50th percentile and 77% of them were below the 2.5th percentile. SpO2 was 92.6 ± 3.0% after STST and 15 patients had oxygen desaturation. After 3-months of follow-up, the number of repetitions during STST significantly increased either in telerehabilitation (n = 14) (p < 0.001) or in control groups (n = 13) (p = 0.002) but only one patient had a result higher than the 50th percentile (in Telerehabilitation group) and 37% of them were still under the 2.5th percentile for this result. The improvement was significantly and clinically greater after the telerehabilitation program (p = 0.005). No adverse events were reported by the patients during the program., Conclusions: Patients hospitalized for COVID-19 have a low functional exercise capacity at discharge and the recovery after three months is poor. The feasibility and the effect of a simple telerehabilitation program were verified, this program being able to substantially improve the functional recovery after three months., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background and Objective: We hypothesized that by reducing respiratory work and improving gas exchange, nasal high flow (NHF) would improve exercise tolerance in patients with chronic obstructive pulmonary disease (COPD) following respiratory exacerbation., Methods: This was a monocentric, randomized, controlled crossover study. Patients with severe to very severe COPD carried out two high-intensity constant work-rate exercise tests (CWRET) with and without NHF on two consecutive days. The primary outcome was the mean difference in endurance time between both conditions. The secondary aims included vastus lateralis oxygenation (StO 2 ), dyspnoea, leg discomfort, maximal inspiratory pressure (MIP), transcutaneous CO 2 pressure (PtcCO 2 ), respiratory rate (RR), heart rate (HR) and pulsed O 2 saturation (SpO 2 ), as well as the patients' opinions of the device., Results: A total of 19 patients were included (mean forced expiratory volume in 1 s = 28.7 ± 10.8%, age = 62.1 ± 9.1 years). No significant differences in endurance time during the CWRET were found between the two test conditions (-66.58 (95% CI: -155.9 to 22.7) s, P = 0.12). StO 2 , PtCO 2 and HR were reduced at the end of the exercise with NHF (-2.1% (95% CI: -4.3 to -0.0); -1.3 mm Hg (95% CI: -2.5 to -0.2); -2.7 bpm (95% CI: -5.0 to -0.5), respectively, P ≤ 0.05). No significant differences were found for any of the other secondary outcomes. Half of the patients evaluated the device as being moderately to very uncomfortable., Conclusion: NHF during exercise did not increase endurance time in patients with COPD following exacerbation., Clinical Trial Registration: NCT03058081 at clinicaltrials.gov., (© 2019 Asian Pacific Society of Respirology.)

Chronic obstructive pulmonary disease (COPD) is frequently associated with a reduced functional exercise capacity. This parameter is usually evaluated using 6-minute walking test (6MWT). New tools appear regularly. The aim of this study was to validate the 3-minute step test (3MStepT) and to compare 3MStepT and 6MWT in stable patients with COPD as a tool to quantify the functional exercise capacity. Patients with COPD admitted for a pulmonary rehabilitation program in a dedicated center were recruited and randomly performed both tests: 6MWT and 3MStepT. A training test was performed systematically before each test. Walking distance and number of repetitions (3MStepT) were measured. Cardiorespiratory parameters, dyspnea and lower limb fatigue (Borg) were recorded pre and post the tests. Fifty patients with COPD (FEV1: 45.2 ± 18.3) were included. 6MWT (423.6 ± 96.3 m) was strongly correlated with 3MStepT (62.1 ± 18.0; r  = 0.780; p  < 0.001). Heart rate and SpO2 were significantly different at the end of the 6MWT and 3MStepT (respectively, 106.2 ± 16.3 vs. 112.9 ± 13.4bpm, p  = 0.002; 87.6 ± 5.4 vs. 89.6 ± 5.3bpm, p  = 0.001). Lower limb fatigue was significantly higher after the 3MStepT (2.5 ± 2.6 vs. 3.4 ± 2.4, p  = 0.01). The 3MStepT is an alternative to the 6MWT to estimate functional exercise capacity in stable patients with COPD but cardiorespiratory adaptation and lower limb fatigue are not similar between these tests.

Congenital heart disease (CHD) is a common chronic disease. This study aimed to verify the relationship between spirometry and exercise capacity in children, considering the CHD severity. All cardiopulmonary exercise testing (CPET) and Spirometry from CHD children (5-18 years) were retrospectively reviewed during three years. CPET and Spirometry were analyzed and correlated based on the CHD severity[modified Ross classification (mR)]. Patients (n = 321) were analyzed and subdivided for CHD severity (n = 49, n = 149, n = 80, n = 43, from mR1 to mR4, respectively). The maximal workload (Wmax) in mR1 and mR2 was higher than in patients from mR3 and mR4. Peak oxygen uptake (peak VO2) was reduced in mR3 and mR4 compared to mR1 and mR2. Carbon dioxide output was only significantly lower in mR4. Although spirometric parameters were globally in the normal range, forced expiratory volume and forced vital capacity were different between subgroups (p < 0.001 and p = 0.002, respectively). Wmax and peakVO2 were weakly or moderately but significantly correlated with spirometry. Respiratory exchange ratio and final blood oxygen saturation were only significantly and weakly correlated to obstruction in small airways. The most severe CHD patients had lower exercise capacity and lung function parameters. A weak to moderate correlation between CPET and spirometry was found. However, the lung function reported in our study was normal, but with a negative correlation with the age. It reinforces the benefits of precocious and regularly spirometry and CPET assessment in CHD children.

Introduction: Bronchopulmonary dysplasia (BPD) is the most common complication of extreme preterm delivery, and is associated with reduced exercise tolerance and exercise capacity. The aim of this study was to assess the effects of a physical activity programme on exercise tolerance, exercise capacity, flexibility, and lung function in prematurely born children with BPD., Methods: This was a randomized controlled trial. Preterm children with BPD (4-6 years) were randomized to intervention (IG) and control (CG) groups. The CG did not participate in any physical activity during the study period. The IG performed a 4-week exercise programme based on aerobic interval and resistance training. Outcomes were based on the 6-minute walk test (6MWT), incremental shuttle walk test (ISWT), modified sit and reach test (MSRT) and spirometry results., Results: Twenty individuals were recruited. In the IG (n=10), statistical and clinical improvement was observed in the 6MWT (316.3±31.4m vs 376.2±39.5m; P=.002). Significant improvements were also seen in the IG in the ISWT (248.0±45.2m vs 465.3±58.2m; P=.013), MSRT (14.5±7.7cm vs 22.8±6.9cm; P=.003), and FEV 1 (102%±16% pred vs 104%±17% pred; P=.004). No significant differences between pre- and post-intervention were observed in the CG for all outcomes (n=10)., Conclusion: This 4-week programme resulted in statistical and clinical improvements in exercise tolerance, exercise capacity and flexibility in preterm children with BPD., (Copyright © 2018 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved.)

Introduction: Chronic obstructive pulmonary disease (COPD) is frequently associated with a reduced functional exercise performance. Even if this parameter is routinely evaluated using 6-minute walking test (6MWT), new field tests are regularly investigated as alternative tests. The aim of this study was to compare functional exercise performance evaluation by sit-to-stand test (STST) and 6MWT and to evaluate reliability and repeatability of the STST in COPD patients., Method: Forty-two COPD patients performed randomly two tests: 6MWT and STST. Each test was repeated two times. Distance (6MWD) and number of repetitions were measured. Cardiorespiratory parameters, dyspnea and lower limb fatigue (Borg) were recorded before and after the tests., Results: Sit-to-stand repetitions (19 ± 6) and 6MWD (441 ± 104 m) were correlated (r = .716; P < .001). Good repeatability was found for STST and 6MWT. Good reliability was observed for STST (ICC = 0.902). Variations of heart rate and pulsed oxygen saturation were significantly different between these two tests (23% ± 17% vs 13% ± 11%; P = .022 and -7.6% ± 4.6% vs -0.7% ± 2.7%; P < .001 for 6MWT and STST, respectively). Variations of dyspnea and lower limb fatigue were similar between both tests (P = .827 and P = .467)., Conclusion: The one minute sit-to-stand test is a valuable alternative to 6MWT to estimate functional exercise performance in COPD patients. The cardiorespiratory demand is different between both tests although the variation of dypsnea is similar. No learning effect was observed for STST., (© 2017 John Wiley & Sons Ltd.)

Introduction: Even if 6-min walking test (6MWT) is the criterion standard for functional exercise performance evaluation, new field tests are required as practical alternative. This study aims to establish the validity of the 6-min step test (6MST) and the 4-m gait speed (4MGS) in children., Method: It is a randomized cross-over trial. Sixty one healthy children from 6 to 12 years were recruited. 6MWT, 6MST and 4MGS were randomly performed on three consecutive days. Pulsed oxygen saturation (SpO2), heart rate (HR), dyspnea (VAS) and fatigue (PCERT) were used as outcomes., Results: The distance walked during 6MWT was correlated to the number of steps during 6MST (r = 0.320; p = 0.013) and not correlated to 4MGS (r = -0.074; p = 0.575). No correlation between number of steps during 6MST and 4MGS (r = -0.129; p = 0.332) was found. HR was lower than the theoretical maximal HR after the tests. The increase in HR was significantly higher for 6MST and significantly lower for 4MGS than for 6MWT and it was higher for 6MST than for 4MGS. Dyspnea and perceived exertion were lower after 6MWT than after 6MST and higher than after 4MGS. They were also higher during 6MST than during 4MGS., Conclusion: The three field tests are feasible in children. The 6MST and 4MGS are not valid surrogates to 6MWT in healthy children for functional exercise performance evaluation. Moreover, the cardio-respiratory response differs between the three tests., (Copyright © 2017 Elsevier B.V. All rights reserved.)

Background: Recently, gait speed reached an increasing importance in the management of respiratory patients. The aim of this retrospective study was to compare walking speed and physiological adaptations during the 6MWT in COPD and CF patients., Methods: 6MWT performed by COPD and CF patients were retrospectively reviewed. Global and sequential walking speeds were measured on six minutes and every sequence of two minutes respectively. Heart rate, oxygen saturation and dyspnea were analyzed., Results: 78 and 246 tests from CF and COPD patients were reviewed respectively. FEV1 (52.3 vs 56.2% pred) and FVC (72.5 vs 73.8% pred) were similar between both diseases. However, 6MWT in patients with CF were characterized by significantly higher heart rate, global walking speed and walking distance (+68%) while dyspnea evolutions and the proportions of patients presenting walking speed decline over the 6min were significantly lower., Conclusion: Walking speed and cardio-respiratory parameters evolution during 6MWT differ between COPD and CF patients., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Introduction: The aim of this study is to assess the effects of in-patient pulmonary rehabilitation in relation to the stages of COPD according to GOLD and the BODE index., Method: A prospective cohort study over 4 weeks. The 6-minute walk test, the relationship dyspnoea (EVA)/walking distance, dyspnoea (MRC scale), the Saint-George's respiratory questionnaire and the BODE index were estimated at the beginning and end of a pulmonary rehabilitation programme., Results: Fifty patients with COPD were included, distributed according to GOLD (II: 30%; III: 32%; IV: 38%) and BODE (quartile 1: 22%; quartile 2: 36%; quartile 3: 26%; quartile 4: 16%). All the patients benefited from the programme. For the GOLD classification, there was no significant difference between stages. For the BODE classification, a significant difference existed between quartiles concerning the evolution of dyspnoea (P=0,025), the relationship dyspnoea/walking distance (P<0,001) and BODE index (P<0,001), to the advantage of patients in quartiles 3 and 4., Conclusion: All patients benefit from rehabilitation in hospital; the most severe benefit the most. The BODE index seems to predict those who make the greatest improvement., (Copyright © 2011 SPLF. Published by Elsevier Masson SAS. All rights reserved.)