Highlights
- •6MST is able to discriminate between the different levels of exercise capacity.
- •6MST strongly correlates to 6MWT in patients with sarcoidosis.
- •6MST is more physically demanding than 6MWT.
- •6MST is a valid alternative test for measuring functional exercise capacity.
Abstract
Background
Researchers and clinicians may benefit from alternative tests that do not require
large physical spaces or corridors for simply evaluating functional exercise capacity
in the clinical practice.
Objective
Aim of this study was to investigate whether six-minute stepper test (6MST) is a valid
tool for measuring functional exercise capacity in patients with sarcoidosis.
Methods
Thirty-six patients with sarcoidosis and 18 healthy controls were evaluated with 6MST
and six-minute walk test (6MWT). Patients performed 6MST twice. Cardiovascular and
symptom responses to tests including heart rate, blood pressure, SpO2, levels of dyspnea and fatigue were recorded.
Results
Receiver operating characteristic (ROC) curve analysis revealed an area under the
ROC curve of 0.74 for 6MST in identifying the patients and controls, indicating acceptable
discriminative ability. Patients performed significantly worse in 6MST compared to
controls (277±54 vs 349±87 steps; p<0.001). 6MST was able to explain 66% of variance in 6MWT (p<0.001), and there was a strong relationship between 6MWT and 6MST (r = 0.812). SpO2 responses to tests were similar, however, 6MST generated more severe heart rate,
dyspnea and fatigue responses. Intraclass correlation coefficient calculated for initial
and retest scores of 6MST was 0.990, indicating excellent test-retest reliability.
However, there was a systematical improvement (∼4%) in retest 6MST scores.
Conclusions
6MST is a valid and reliable alternative test for measuring functional exercise capacity
in sarcoidosis. 6MST may also help better testing the upper limits of cardiac system
and physical endurance as it is more physically demanding than 6MWT.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Heart & Lung: The Journal of Cardiopulmonary and Acute CareAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- BTS Clinical Statement on pulmonary sarcoidosis.Thorax. 2021; 76: 4-20
- Skeletal muscle weakness in patients with sarcoidosis and its relationship with exercise intolerance and reduced health status.Thorax. 2005; 60: 32-38
- Exercise capacity, muscle strength and fatigue in sarcoidosis.Eur Respir J. 2011; 38: 628-634
- Physical activity and respiratory muscle strength in patients with sarcoidosis: an observational study.Int J Gen Med. 2022; 15: 291-297
- Association between physical functions and quality of life in sarcoidosis.Sarcoidosis Vasc Dif. 2014; 31: 117-128
- The six-minute walk test: a useful metric for the cardiopulmonary patient.Intern Med J. 2009; 39: 495-501
- Six-minute walk test in managing and monitoring sarcoidosis patients.Curr Opin Pulm Med. 2007; 13: 439-444
- Assessment of functional capacity in clinical and research settings: a scientific statement from the American heart association committee on exercise, rehabilitation, and prevention of the council on clinical cardiology and the council on cardiovascular nursing.Circulation. 2007; 116: 329-343
- Cardiorespiratory responses to 6-minute walk test in interstitial lung disease: not always a submaximal test.BMC Pulm Med. 2014; 14: 136
- A step test to assess exercise-related oxygen desaturation in interstitial lung disease.Eur Respir J. 2007; 29: 330-336
- Six-minute stepper test to assess effort intolerance in interstitial lung diseases.Sarcoidosis Vasc Diffuse Lung Dis. 2012; 29: 107-112
- Joint statement of the American thoracic society (ATS), the European respiratory society (ERS) and the world association of sarcoidosis and other granulomatous disorders (WASOG) adopted by the ATS board of directors and by the ERS executive committee, february 1999.Am J Respir Crit Care Med. 1999; 160: 736-755
- ATS statement: guidelines for the six-minute walk test.Am J Respir Crit Care Med. 2002; 166: 111-117
- An original field evaluation test for chronic obstructive pulmonary disease population: the six-minute stepper test.Clin Rehabil. 2010; 24: 82-93
- A method of comparing the areas under receiver operating characteristic curves derived from the same cases.Radiology. 1983; 148: 839-843
- Six-minute stepper test: a valid clinical exercise tolerance test for COPD patients.Int J Chron Obstruct Pulmon Dis. 2016; 11: 657-663
- Sample size tables for correlation analysis with applications in partial correlation and multiple regression analysis.Multivariate Behav Res. 2003; 38: 309-323
- The 1-minute sit-to-stand test to detect desaturation during 6-minute walk test in interstitial lung disease.NPJ Prim Care Respir Med. 2022; 32: 5
- Measurement properties of step tests for exercise capacity in COPD: a systematic review.Clin Rehabil. 2021; 35: 578-588
- Sit-to-stand tests for COPD: a literature review.Respir Med. 2017; 128: 70-77
- Test-Retest reliability and validity of the six minute stepper test to evaluate functional exercise capacity in patients with ankylosing spondylitis.Mod Rheumatol. 2021;
- Validity and reliability of the 6-minute step test in healthy individuals: a cross-sectional study.Clin J Sport Med. 2016; 26: 69-75
- Validity of the six-minute step test of free cadence in patients with chronic obstructive pulmonary disease.Braz J Phys Ther. 2014; 18: 228-236
- Obesity and sarcoidosis: consequence or contributor?.Curr Opin Pulm Med. 2018; 24: 487-494
- Physical Inactivity in Pulmonary Sarcoidosis.Lung. 2019; 197: 285-293
- Reproducibility of the 6-minute walk test in obese adults.Int J Sports Med. 2009; 30: 725-727
- Can we use the 6-minute step test instead of the 6-minute walking test? An observational study.Physiotherapy. 2017; 103: 48-52
- Six-Minute Walk Test Vs. Three-Minute Step Test for Measuring Functional Endurance.J Strength Cond Res. 2015; 29: 3240-3244
- Reproducibility and sensitivity of the 6-minute stepper test in patients with COPD.COPD. 2015; 12: 533-538
- Reproducibility of 6-minute walking test in patients with COPD.Eur Respir J. 2011; 38: 261-267
Article info
Publication history
Published online: December 13, 2022
Accepted:
December 6,
2022
Received in revised form:
December 6,
2022
Received:
August 31,
2022
Footnotes
✰This study was approved by the Ethics Committee of Izmir Bakircay University (Approval number: 2021/467) and conducted in accordance with Helsinki Declaration.
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.