In adults with advanced lung disease, the 1-minute sit-to-stand test underestimates exertional desaturation compared with the 6-minute walk test: An observational study

Authors

Kathryn Watson
Peta Winship, The University of Notre Dame AustraliaFollow
Vinicius Cavalheri
Caitlin Vicary
Stephanie Stray
Natasha Bear, The University of Notre Dame AustraliaFollow
Kylie Hill

Publication Details

Watson, K., Winship, P., Cavalheri, V., Vicary, C., Stray, S., Bear, N., & Hill, K. (2023). In adults with advanced lung disease, the 1-minute sit-to-stand test underestimates exertional desaturation compared with the 6-minute walk test: An observational study. Journal of Physiotherapy, 69 (2), 108-113.

Abstract

Question: In adults with advanced lung disease, do the 6-minute walk test (6MWT) and 1-minute sit-to-stand test (1minSTS) elicit similar cardiorespiratory responses? Can the 6-minute walk distance (6MWD) be estimated from the 1minSTS result?

Design: Prospective observational study using data collected during routine clinical practice.

Participants: Eighty adults (43 males) with advanced lung disease, a mean age of 64 years (SD 10) and a mean forced expiratory volume in 1 second of 1.65 L (SD 0.77).

Outcome measures: Participants completed a 6MWT and a 1minSTS. During both tests, oxygen saturation (SpO₂), pulse rate, dyspnoea and leg fatigue (Borg 0 to 10) were recorded.

Results: Compared with the 6MWT, the 1minSTS resulted in higher nadir SpO₂ (MD 4%, 95% CI 3 to 5), lower end-test pulse rate (MD –4 beats/minute, 95% CI –6 to –1), similar dyspnoea (MD –0.3, 95% CI –0.6 to 0.1) and greater leg fatigue (MD 1.1, 95% CI 0.6 to 1.6). Among the participants who demonstrated severe desaturation (SpO₂ nadir , 85%) on the 6MWT (n = 18), five and ten participants were classified as moderate (nadir 85 to 89%) or mild desaturators (nadir 90%), respectively, on the 1minSTS. The relationship between the 6MWD and 1minSTS was: 6MWD (m) = 247 1 (7 3 number of transitions achieved during the 1minSTS) with poor predictive ability (r² = 0.44).

Conclusion: The 1minSTS elicited less desaturation than the 6MWT and classified a smaller proportion of people as ‘severe desaturators’ on exertion. It is therefore inappropriate to use the nadir SpO₂ recorded during a 1minSTS to make decisions about whether strategies are needed to prevent severe transient exertional desaturation during walking-based exercise. Further, the extent to which performance on the 1minSTS can estimate a person’s 6MWD is poor. For these reasons, the 1minSTS is unlikely to be helpful when prescribing walking-based exercise.

Keywords

exercise testing 6MWT, 1-min STS lung disease, physical therapy

Link to Publisher Version (URL)

10.1016/j.jphys.2023.02.001